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P12.06: Prenatal myelomeningocele repair: predictors of the severity and evolution of chorioamniotic membrane separation
Author(s) -
Corroenne R.,
Yepez M.C.,
Pallapati J.,
Pan E.,
Shamshirsaz A.,
Espinoza J.,
Johnson R.M.,
Wesley L.,
Belfort M.A.,
Cortes M. Sanz
Publication year - 2019
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.20992
Subject(s) - medicine , amnion , gestational age , fetoscopy , retrospective cohort study , surgery , prenatal diagnosis , gestation , fetus , cohort , ultrasound , fetal surgery , pregnancy , obstetrics , in utero , radiology , genetics , biology
Objectives: To describe Doppler changes in umbilical artery (UA), middle cerebral artery (MCA) and ductus venosus (DV) during fetal myelomeningocele repair through a mini-hysterotomy. Methods: A prospective cohort of fetuses with spina bifida referred to our fetal surgery centre during a one-year period (March 2018April 2019) for open fetal surgery. Fetal myelomeningocele repair was performed through a 1.5 to 2.5cm hysterotomy and Doppler in UA, MCA and DV were taken intraoperatively to describe the changes during fetal surgery. Results: Doppler data were available in all the 17 fetuses with fetal surgery for myelomeningocele repair performed during the study period. MCA vasodilation (pulsatility index bellow 5th centile) and abnormal CPR (< 5th centile) was observed in 8 (47%) and 4 cases (23.5%), respectively. A transient increased in UA pulsatility index (> 95th centile) and DV was observed in one case at the end of surgical repair but none showed absent or reversed diastolic blood flow during fetal intervention. All Doppler changes resolved during fetal surgery. Conclusions: Fetal Doppler examination is feasible during open fetal surgery for myelomeningocele. Transient MCA vasodilation was observed during fetal surgery but no changes in the UA and DV were observed.