Abstract
The optimal route of delivery of fetuses with myelomeningocele is controversial. The aim of this study is to determine whether route of delivery predisposes to perinatal complications and influences short-term outcomes in patients with myelomeningocele. The authors performed a retrospective review of the medical records of 26 patients with myelomeningocele admitted to the Neonatal Intensive Care Unit in this hospital from 2001 to 2015. They compared perinatal complications and short-term outcomes of elective cesarean section (n = 21) and vaginal delivery (n = 5) groups. There were no ruptured nor infectious myelomeningoceles cases in either group. No statistically significant difference in ambulation status at two years of age was observed between the two groups. The present data suggest that perinatal complications and short-term outcomes were not associated with route of delivery. Vaginal delivery might be the optimal route of delivery for fetal myelomeningocele if there is no obstetric contraindication.
Highlights
The worldwide incidence of neural tube defects (NTDs) ranges from 1.0 to 10.0 per 1,000 births, with myelomeningocele being the commonest NTD [1]
Patients with lipomeningomyelocele often have almost normal lower leg function, most newborns with open NTDs exhibit severe neurologic impairment of the lower extremities at birth. These findings suggest that neurologic injury may occur antenatally or at the time of delivery, and that direct injury to the spinal cord may cause damage to and loss of function of the spinal cord [5, 6]
Number Ambulatory status Ambulate independently Ambulate with assisting device Not ambulatory cause elective cesarean section was performed before the onset of labor
Summary
The worldwide incidence of neural tube defects (NTDs) ranges from 1.0 to 10.0 per 1,000 births, with myelomeningocele being the commonest NTD [1]. Patients with lipomeningomyelocele (in which neural tissue is covered and protected by skin) often have almost normal lower leg function, most newborns with open NTDs exhibit severe neurologic impairment of the lower extremities at birth These findings suggest that neurologic injury may occur antenatally or at the time of delivery, and that direct injury to the spinal cord may cause damage to and loss of function of the spinal cord [5, 6]. It is the present authors policy to deliver fetuses with antenatally diagnosed myelomeningocele by cesarean section in order to prevent infection and damage to the myelomeningocele at delivery This ensures a smooth transition of care from the obstetrician to the neonatologist and pediatric neurosurgeon after delivery. These studies demonstrated no benefit in terms of motor function from delivery by cesarean section, or avoidance of labor in these fetuses [8, 9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
