Obstet Gynecol. 2017 Sep;130(3):e164-e167. doi: 10.1097/AOG.0000000000002303.
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疾病，在美国每 3000 例活产儿中约有 1 例患病。残疾的严重程度通常与脊髓脊膜膨出缺陷的水平有关，病变的较高上水平通常对应更大的缺陷。开放性胎儿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。尽管已经证明胎儿和儿科受益的潜力，但可能会在急性、术后、整个妊娠期间以及随后的妊娠期间出现显著的母体并发症和合并症。对于符合胎儿脊髓脊膜膨出宫内修复标准的妊娠女性，应向其提供关于所有管理选择的非指导咨询，包括开放性胎儿手术的可能性。脊髓脊膜膨出修复的胎儿手术仅应在人员和资源配备适当的设施中提供给经过仔细选择的患者。
