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On Oct. 4, CHOP's Center for Fetal Diagnosis and Treatment hosted a reunion at the Cleveland Botanical Gardens for families across the Midwest who traveled to CHOP for fetal surgery or specialized care immediately after birth.
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The CFDT Center at CHOP recently reviewed outcomes for fetal MMC repair since the MOMS results were reported, from referral and evaluation through surgery, delivery and neonatal discharge.
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Before the start of the Management of Myelomeningocele Study (MOMS) in 2003, an initial group of 58 patients at CHOP underwent in utero repair of their myelomeningocele between 21 and 25 weeks' gestation. Urologic results after fMMC repair are discussed here.
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Myelomeningocele (MMC) poses a diagnostic and therapeutic challenge. A thorough and detailed examination of the entire fetus, with visualization of every spinal segment, is necessary.
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Fetal closure of an MMC is technically more challenging than the standard postnatal closure. The access is smaller, the structures are smaller and more delicate, the placode must be handled with more care, avoiding blood loss is critical, and the surgery must be performed quickly to limit the exposure of the fetus to the extrauterine environment.
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The Children's Hospital of Philadelphia has initiated a standard practice of continuous intraoperative echocardiographic monitoring for all fetuses undergoing myelomeningocele repair.
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While the MOMS trial has demonstrated conclusively that open fetal surgery for repair of myelomeningocele improves outcomes, open fetal surgery for MMC is not a cure.
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Caitlin Chasar is achieving her dreams with fierce determination and the help of the Spina Bifida Program at The Children's Hospital of Philadelphia.
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Specialists at CHOP's Center for Fetal Diagnosis and Treatment report on 100 recent cases of fetal surgery for spina bifida, achieving results similar to the landmark clinical trial that established a new standard of care for prenatal repair of spina bifida.
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A special reunion brought together 1,500 people from 22 states; nearly all of the children in attendance were prenatally diagnosed with a birth defect.