Variedades de la cirugía intrauterina en fetos con mielomeningocele, desde el contexto de la vanguardia ginecológica y pediátrica
Keywords:
Myelomeningocele; spina bifida; Microneurosurgery; fetal surgery; spinal dysraphism; magnetic resonance imaging; ultrasound; prenatal; central nervous system; fetal diseases; prenatal diagnosisAbstract
Spinal dysraphisms are an important indication for fetal magnetic resonance imaging (fetal MRI), particularly in the evaluation of potential candidates for intrauterine surgery.
Myelomeningocele is the most severe congenital malformation among neural tube defects that is compatible with life.
In 2011, the Management of Myelomeningocele Study (MOMS) was published, a randomized trial comparing fetuses treated with prenatal surgery versus those treated postnatally. The results demonstrated a reduction in the need for ventriculoperitoneal shunting and an improvement in motor function with prenatal intervention, without reporting significant maternal morbidity.
The description and level of spinal damage, the degree of hydrocephalus, the extent of cerebellar herniation, and the presence of associated lesions are important variables that are useful for preoperative planning and for comparison with postnatal studies.
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