Prenatal Evolution of Chiari Ii Malformation After Intrauterine Fetal Mmc Repair. Patients Selection, Maternal, Fetal and Neonatal Results

Olejek A; Zamlynski M; Olszak-Wasik K; Horzelska E; Herman-Sucharska I; Beksinska-Figatowska M; Zamlynski J

Volume : V, Issue : II, February - 2015

Prenatal Evolution of Chiari Ii Malformation After Intrauterine Fetal Mmc Repair. Patients Selection, Maternal, Fetal and Neonatal Results

Olejek A, Zamlynski M, Olszak 45 Wasik K, Horzelska E, Herman 45 Sucharska I, Beksinska 45 Figatowska M, Zamlynski J

Abstract :

The aim of our study was to analyze the Chiari II malformation and maternal complications, intrauterine fetal development and newborn outcomes after intrauterine myelomeningocele repairs (IUMR). 71 cases of IUMR performed on singleton pregnancies, aged 20,0–25,6 weeks of gestation. After IUMR hindain hernia (HH), hydrocephalus (HC), lower extremity movement (LM) as well as Fetus well being were evaluated by USG/MRI. Postnatal maternal morbidity, neonatological complications, need of ventriculo–peritonal shunt (VPS) placement up to 12 month were evaluated. After IUMR we noted: HH in 96,9% cases, Stationary HC in 50.7% fetuses. LM remained constant. Chorioamniotic separation in 21% of pregnancies, iPPROM 52.1%. Most pregnancies were delivered prematurely. The completely healed hysterotomy site was observed in 83%. Most neonates 37/70 scored 8–10 Apgar points at birth. Intracranial hemorrhage (IH) I°–II° up to 50%. Neonatal mortality 3 cases (4,2%). Proper IUMR qualification for fetuses with Chiari II results in decrease of neurological complications of MMC. We intend to monitor further development of our fetal patients.