Variedades de la cirugía intrauterina en fetos con mielomeningocele, desde el contexto de la vanguardia ginecológica y pediátrica
Palabras clave:
Myelomeningocele, Spina bífida,, microneurocirugía; cirugía fetal; disrafismo espinal; resonancia magnética; ultrasonido; prenatal; sistema nervioso central; enfermedades fetales; diagnóstico prenatalResumen
Las disrafias espinales son una indicación importante de resonancia magnética fetal (RMF), considerando la evaluación de posibles candidatos para cirugía intrauterina. El mielomeningocele es la malformación congénita, dentro de los defectos del tubo neural, más
grave compatible con la vida.
En 2011 se publicó el estudio Management of Mielomeningocele Study (MOMS), estudio aleatorizado comparando los fetos operados prenatalmente con los operados postnatalmente. Los resultados mostraron la reducción de la necesidad de derivaciones ventrículo-peritoneales y una mejoría de la función motora con la intervención prenatal sin reportar una importante morbilidad materna.
La descripción y el nivel del daño espinal, el grado de hidrocefalia, la magnitud de la herniación del cerebelo, y la presencia de lesiones asociadas son variables importantes, útiles para la planificación preoperatoria y la comparación con estudios posnatales.
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