Shurtleff D B, Luthy D A, Nyberg D A, Mack L A
Department of Pediatrics, University of Washington School of Medicine, Seattle, USA.
Eur J Pediatr Surg. 1994 Dec;4 Suppl 1:25-8. doi: 10.1055/s-2008-1066149.
14 years experience with 354 infants born with myelomeningocele are reviewed in view of prelabor and pre-rupture of amniotic membranes vs vaginal delivery or delivery by cesarian section after labor and rupture of amniotic membrane. The apparent lack of effect of severity of impairment determined by prenatal diagnosis on parental decision to carry their baby to term, the negative effect on motor function of kyphos or congenital kyphoscoliosis, the equivocal effect of breech presentation with or without rupture of amniotic membranes and the beneficial effect of prelabor and prerupture of membranes delivery of selected infants is discussed. The need for further multiple center, collaborative study to identify the contribution of a number of factors influencing the outcome of fetuses diagnosed as having myelomeningocele is emphasized.
鉴于胎膜早破及临产前与经阴道分娩或胎膜破裂及产后剖宫产相比，对354例患有脊髓脊膜膨出的婴儿进行了14年的回顾性研究。讨论了产前诊断确定的损伤严重程度对父母决定将婴儿足月分娩的明显影响、脊柱后凸或先天性脊柱侧弯对运动功能的负面影响、胎膜破裂与否的臀位产的不确定影响以及胎膜早破及临产前分娩对部分婴儿的有益影响。强调需要进一步开展多中心协作研究，以确定影响诊断为脊髓脊膜膨出胎儿结局的多种因素的作用。
