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Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
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Transuterine Fetal Tracheal Occlusion Model in Mice
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Open Spina Bifida: Why Not Fetal Surgery?

Luca Mazzone1,2,3, Ueli Moehrlen4,5,6, Barbara Casanova4,5,6

  • 1Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland, luca.mazzone@kispi.uzh.ch.

Fetal Diagnosis and Therapy
|September 12, 2018
PubMed
Summary
This summary is machine-generated.

Most patients counseled for prenatal open spina bifida repair (SBR) do not undergo fetal surgery. Key reasons include exclusion criteria and pregnancy termination, highlighting the need for better patient information.

Keywords:
Exclusion criteriaFetal surgeryMyelomeningoceleNeural tube defectPrenatal counselingPrenatal open spina bifida repairSpina bifidaTermination of pregnancy

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Area of Science:

  • Medical research
  • Fetal surgery
  • Maternal-fetal medicine

Background:

  • Prenatal open spina bifida repair (SBR) is a complex fetal intervention.
  • A significant number of patients counseled for SBR do not proceed with the surgery.

Purpose of the Study:

  • To investigate the reasons why patients counseled for prenatal open spina bifida repair do not undergo the procedure.
  • To analyze the outcomes and decision-making processes of these patients.

Main Methods:

  • Retrospective analysis of data from 160 patients seeking counseling for prenatal SBR.
  • Data collected between December 2010 and March 2017 at the Zurich Center for Fetal Diagnosis and Therapy.

Main Results:

  • 65% of patients (104 out of 160) did not undergo prenatal SBR.
  • Major reasons for not proceeding included meeting exclusion criteria (52%), pregnancy termination (35%), and choosing non-surgical management (4%).
  • Primary exclusion criteria were delayed presentation, absence of hindbrain herniation, and concomitant spinal anomalies.

Conclusions:

  • A high percentage of patients do not qualify for prenatal SBR, emphasizing the need for standardized evaluations at specialized centers.
  • Improved, objective, and understandable information is crucial for informing women about fetal intervention options for open spina bifida.