Management of Myelomeningocele

DOI Web Site 6 Citations 52 References
  • Date Hiroaki
    Department of Neurosurgery, Chiba Children's Hospital
  • Ito Chiaki
    Department of Neurosurgery, Chiba Children's Hospital
  • Numata Osamu
    Department of Neurosurgery, Chiba Children's Hospital

Bibliographic Information

Other Title
  • 脊髄髄膜瘤にかかわる諸問題

Search this article

Description

The medical and social problems facing patients with myelomeningocele are reviewed. Standard care is usually started after an elective cesarean delivery even if the fetus was diagnosed with myelomeningocele prenatally. Management of patients with complex congenital anomalies such as lower myelodysplasia, hydrocephalus, Chiari malformation etc., requires a multidisciplinary team, composed of not only doctors but WOC (wound, ostomy, continence) nurses and medical social workers. Quite recently, parents of a fetus with myelomeningocele have acquired a new treatment option, surgical repair in utero. Intrauterine repair of myelomeningocele was first successfully performed in 1997 and it appears to reduce the incidence of hindbrain herniation and shunt-dependent hydrocephalus. A 5-year multicenter clinical trial to evaluate the efficacy and safety of fetal surgical repair of myelomeningocele in utero is now ongoing in the USA (Management of myelomeningocele study: MOMS). Though the etiology of myelomeningocele is thought to be multifactorial, it is apparent that supplementation and fortification of folic acid to all women before pregnancy can reduce the occurrence rate of this kind of birth defect (neural tube defect). The reported prevalence of myelomeningocele in Japan is 0.55/1,000 births and has not declined in these ten years. It is strongly recommended to educate all women before conception that myelomeningocele can be preventable with periconceptual supplementation of 0.4mg folic acid per day.

Journal

Citations (6)*help

See more

References(52)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top