Letter to ‘Suprapubic pressure facilitates the procedure of office hysteroscopy: A randomized controlled trial’: Technical considerations

2018 ◽  
Vol 45 (3) ◽  
pp. 751-751
Author(s):  
Tarek Shokeir
2014 ◽  
Vol 37 (3) ◽  
pp. 166-171 ◽  
Author(s):  
Gregory G. Heuer ◽  
N. Scott Adzick ◽  
Leslie N. Sutton

Myelomeningocele (MMC) is one of the most common serious congenital malformations. Typically this condition has been treated with closure of the MMC defect shortly after birth. In general, surgery for MMC aims to provide a multilayered closure to provide protection to the neural elements, prevent leakage of spinal fluid and reduce infection risks. A randomized controlled trial, the Management of Myelomeningocele Study (MOMS), has shown that closure during the fetal period can be performed relatively safely and can result in significant benefit to the child. Whereas the surgical technique of prenatal closure of an MMC defect is similar to a postnatal closure, there are some important technical differences. The goal of this paper is to describe the technique of fetal closure of MMC defects, highlight the unique steps that are needed for this surgery and delineate some potential pitfalls.


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