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Cryopreserved Human Umbilical Cord for In Utero Myeloschisis Repair
Ramesha Papanna1, Stephen Fletcher, Kenneth J Moise
1Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal-Fetal Medicine, the Department of Pediatrics, Division of Pediatric Neurosurgery, and the Department of Pediatric Surgery, UTHealth McGovern Medical School and the Fetal Center, Houston, Texas; and TissueTech, Inc. with Ocular Surface Center, Miami, Florida.
Background:
There is an urgent need is for a regenerative patch for in utero repair of spina bifida in situations in which primary closure is difficult.
Cases:
We present two cases of large myeloschisis defects that underwent in utero spina bifida repair at midgestation with closure of the skin defect by using a cryopreserved human umbilical cord patch. The pregnancies were uncomplicated, and the births occurred at 37 weeks by planned cesarean delivery. The repair sites were intact with no evidence of cerebrospinal fluid leakage, with skin regenerated after delivery over a period of 3-4 weeks. The short-term outcomes after delivery showed reversal of hindbrain herniation, minimal spinal cord tethering, and normal function of the lower extremities.
Conclusion:
Cryopreserved human umbilical cord may be a suitable patch system for the spina bifida closure.
