Obstet Gynecol. 2013 Jan;121(1):218-9. doi: 10.1097/01.aog.0000425666.02754.46.
Myelomeningocele, the most severe form of spina bifida, occurs in approximately 1 in 1,500 births in the United States. Fetuses in whom myelomeningocele is diagnosed typically are delivered at term and are treated in the early neonatal period. A recent randomized controlled trial found that fetal surgery for myelomeningocele improved a number of important outcomes, but also was associated with maternal and fetal risks. Maternal-fetal surgery is a major procedure for the woman and her fetus, and it has significant implications and complications that occur acutely, postoperatively, for the duration of the pregnancy, and in subsequent pregnancies. Therefore, it should only be offered at facilities with the expertise, multidisciplinary teams, services, and facilities to provide the intensive care required for these patients.
脊膜脊髓膨出是最严重的神经管缺陷，在美国的发病率约为每 1500 例活产儿中有 1 例。诊断为脊膜脊髓膨出的胎儿通常会足月分娩，并在新生儿早期接受治疗。最近的一项随机对照试验发现，胎儿脊膜脊髓膨出手术可以改善许多重要的结局，但也与母婴风险相关。对于女性及其胎儿来说，母胎手术是一项重大的手术，它会带来显著的影响和并发症，这些影响和并发症可能在术后即刻、妊娠期间和后续妊娠中急性出现。因此，只有在具有专业知识、多学科团队、服务和设施的机构中才能提供此类患者所需的重症监护。
