Obstet Gynecol. 2017 Sep;130(3):672-673. doi: 10.1097/AOG.0000000000002294.
Myelomeningocele, a severe form of spina bifida, occurs in approximately 1 in 3,000 live births in the United States. The extent of disability is generally related to the level of the myelomeningocele defect, with a higher upper level of lesion generally corresponding to greater deficits. Open maternal-fetal surgery for myelomeningocele repair is a major procedure for the woman and her affected fetus. Although there is demonstrated potential for fetal and pediatric benefit, there are significant maternal implications and complications that may occur acutely, postoperatively, for the duration of the pregnancy, and in subsequent pregnancies. Women with pregnancies complicated by fetal myelomeningocele who meet established criteria for in utero repair should be counseled in a nondirective fashion regarding all management options, including the possibility of open maternal-fetal surgery. Maternal-fetal surgery for myelomeningocele repair should be offered only to carefully selected patients at facilities with an appropriate level of personnel and resources.
脊髓脊膜膨出是一种严重的神经管缺陷，在美国约每 3000 例活产儿中就有 1 例。残疾的严重程度通常与脊髓脊膜膨出缺陷的水平有关，病变的上半部分越高，通常对应的缺陷就越大。开放性胎儿-母体手术治疗脊髓脊膜膨出是对女性及其受影响胎儿的一项重大手术。尽管已经证明对胎儿和儿科有益，但可能会出现急性、术后、妊娠期间和随后妊娠中的严重母体并发症。对于符合子宫内修复标准的胎儿脊髓脊膜膨出妊娠的女性，应该以非指示性的方式向其提供所有管理选项的咨询，包括开放性胎儿-母体手术的可能性。只有在人员和资源配备适当的设施中，才能向经过精心挑选的患者提供用于治疗脊髓脊膜膨出的胎儿-母体手术。
