Current diagnosis, management and treatment of fetal myelomeningocele
DOI:
https://doi.org/10.29166/rfcmq.v47i2.3554Keywords:
meningomyelocele, spinal dysraphism, prenatal diagnosisAbstract
Introduction: Fetal myelomeningocele is spinal cord extrusion that occurs due to the caudal neuropore incomplete closure, which exposes the neural plate to mechanical and chemical trauma to the uterus wall and amniotic fluid respectively, with serious sequelae. Prenatal detection innovated the diagnosis and with this intra-uterine repair has improved treatment strategies, generating care options in those patients who comply the selection criteria for prenatal surgery.
Objective: Submit a bibliographic review on the diagnosis, management and treatment of fetal myelomeningocele and to offer the scientific community a consultation tool to improve knowledge of the subject and timely treatment alternatives for fetuses with this malformation.
Methodology: This is a systematic review study without meta-analysis, based on the PRISMA recommendations. The information search was structured under the PICO system. The searches were carried out in Pubmed, Tripdatabase and Pubmed Central; selecting articles published during the last ten years in English or Spanish, on diagnosis, management and treatment of fetal myelomeningocele.
Results: 120 articles met the search criteria, of which 42 were eligible, with relevant information for determining the current diagnosis, management and treatment of fetal myelomeningocele through innovative procedures.
Discussion: Neural tube defects appear as a consequence of an alteration of the neurulation process between days 21-28 after conception. MMCf is considered the most common non-fatal congenital defect of the CNS. It is characterized by protrusion of the meninges and spinal cord with permanent neurological damage. For this reason, the diagnosis and timely management of this pathology have allowed intra utero fetal surgery to be considered the optimal method, improving rhombencephalon hernia, reducing the need for a ventricular shunt and maintaining the
lower motor skills, as well as neuronal, bladder and gastrointestinal function, improving the quality of life of the patient affected by this pathology.
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Copyright (c) 2023 LIZETH CALI TOBAR, Lautaro Chávez-Iza, Alberto López-Mayorga
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