Blumenfeld Yair J, Belfort Michael A
Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California.
Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Houston, Texas, USA.
Curr Opin Obstet Gynecol. 2018 Apr;30(2):123-129. doi: 10.1097/GCO.0000000000000443.
To examine updates in fetal spina bifida surgical repair, as well as promising results emerging from translational medicine.
Although the Management of Myelomeningocele Study sponsored by the National Institutes of Health helped establish the neonatal benefits of prenatal spina bifida repair via uterine hysterotomy, also known as 'open' fetal surgery, fetoscopic approaches may yield better maternal and obstetric outcomes.
Spina bifida is a severe congenital malformation associated with significant neonatal and childhood morbidity and mortality. Although 'open' fetal spina bifida repair has become the standard prenatal surgical approach due to proven neonatal benefit, this approach is associated with significant maternal and obstetric risks. Recent developments from multidisciplinary clinical and translational research have highlighted the potential for novel fetoscopic surgical approaches to decrease maternal morbidity and reduce obstetric risks. Moreover, novel stem cell therapies coupled with in-utero medical approaches targeting the pathophysiological pathways associated with spina bifida are likely to make additional significant impact.
探讨胎儿脊柱裂手术修复的最新进展，以及转化医学中出现的有前景的成果。
尽管美国国立卫生研究院资助的脊髓脊膜膨出管理研究通过子宫剖宫产术（也称为“开放式”胎儿手术）帮助确立了产前脊柱裂修复对新生儿的益处，但胎儿镜手术方法可能会带来更好的母体和产科结局。
脊柱裂是一种严重的先天性畸形，与显著的新生儿和儿童发病率及死亡率相关。尽管由于已证实对新生儿有益，“开放式”胎儿脊柱裂修复已成为标准的产前手术方法，但这种方法与显著的母体和产科风险相关。多学科临床和转化研究的最新进展凸显了新型胎儿镜手术方法降低母体发病率和减少产科风险的潜力。此外，新型干细胞疗法与针对脊柱裂相关病理生理途径的宫内医学方法相结合，可能会产生更大的显著影响。
