Decreased Maternal Morbidity and Improved Perinatal Results of Magnesium-Free Tocolysis and Classical Hysterotomy in Fetal Open Surgery for Myelomeningocele Repair: A Single-Center Study
Fetal and maternal risks associated with open fetal surgery (OFS) in the management of meningomyelocele (MMC) are considerable and necessitate improvement. A modified technique of hysterotomy (without a uterine stapler) and magnesium-free tocolysis (with Sevoflurane as the only uterine muscle relaxa...
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MDPI AG
2023-01-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/11/2/392 |
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| author | Mateusz Zamłyński Anita Olejek Ewa Horzelska Tomasz Horzelski Jacek Zamłyński Rafał Bablok Iwona Maruniak-Chudek Katarzyna Olszak-Wąsik Agnieszka Pastuszka |
| author_facet | Mateusz Zamłyński Anita Olejek Ewa Horzelska Tomasz Horzelski Jacek Zamłyński Rafał Bablok Iwona Maruniak-Chudek Katarzyna Olszak-Wąsik Agnieszka Pastuszka |
| author_sort | Mateusz Zamłyński |
| collection | DOAJ |
| description | Fetal and maternal risks associated with open fetal surgery (OFS) in the management of meningomyelocele (MMC) are considerable and necessitate improvement. A modified technique of hysterotomy (without a uterine stapler) and magnesium-free tocolysis (with Sevoflurane as the only uterine muscle relaxant) was implemented in our new magnesium-free tocolysis and classical hysterotomy (MgFTCH) protocol. The aim of the study was to assess the introduction of the MgFTCH protocol in reducing maternal and fetal complications. The prospective study cohort (SC) included 64 OFS performed with MgFTCH at the Fetal Surgery Centre Bytom (FSCB) (2015–2020). Fetal and maternal outcomes were compared with the retrospective cohort (RC; <i>n</i> = 46), and data from the Zurich Center for Fetal Diagnosis and Therapy (ZCFDT; <i>n</i> = 40) and the Children’s Hospital of Philadelphia (CHOP; <i>n</i> = 100), all using traditional tocolysis. The analysis included five major perinatal complications (Clavien-Dindo classification, C-Dc) which developed before the end of 34 weeks of gestation (GA, gestational age). None of the newborns was delivered before 30 GA. Only two women presented with grade 3 complications and none with 4th or 5th grade (C-Dc). The incidence of perinatal death (3.3%) was comparable with the RC (4.3%) and CHOP data (6.1%). MgFTCH lowers the risk of major maternal and fetal complications. |
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| language | English |
| last_indexed | 2024-03-11T09:07:27Z |
| publishDate | 2023-01-01 |
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| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-e61b25ba126a4521847ff956c26da4f72023-11-16T19:17:33ZengMDPI AGBiomedicines2227-90592023-01-0111239210.3390/biomedicines11020392Decreased Maternal Morbidity and Improved Perinatal Results of Magnesium-Free Tocolysis and Classical Hysterotomy in Fetal Open Surgery for Myelomeningocele Repair: A Single-Center StudyMateusz Zamłyński0Anita Olejek1Ewa Horzelska2Tomasz Horzelski3Jacek Zamłyński4Rafał Bablok5Iwona Maruniak-Chudek6Katarzyna Olszak-Wąsik7Agnieszka Pastuszka8Department of Gynecology, Obstetrics and Oncological Gynecology, Bytom, Medical University of Silesia, 41-902 Katowice, PolandDepartment of Gynecology, Obstetrics and Oncological Gynecology, Bytom, Medical University of Silesia, 41-902 Katowice, PolandDepartment of Gynecology, Obstetrics and Oncological Gynecology, Bytom, Medical University of Silesia, 41-902 Katowice, PolandDepartment of Gynecology, Obstetrics and Oncological Gynecology, Bytom, Medical University of Silesia, 41-902 Katowice, PolandDepartment of Gynecology, Obstetrics and Oncological Gynecology, Bytom, Medical University of Silesia, 41-902 Katowice, PolandDepartment of Gynecology, Obstetrics and Oncological Gynecology, Bytom, Medical University of Silesia, 41-902 Katowice, PolandDepartment of Neonatology and Neonatal Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, PolandDepartment of Gynecology, Obstetrics and Oncological Gynecology, Bytom, Medical University of Silesia, 41-902 Katowice, PolandDepartment of Gynecology, Obstetrics and Oncological Gynecology, Bytom, Medical University of Silesia, 41-902 Katowice, PolandFetal and maternal risks associated with open fetal surgery (OFS) in the management of meningomyelocele (MMC) are considerable and necessitate improvement. A modified technique of hysterotomy (without a uterine stapler) and magnesium-free tocolysis (with Sevoflurane as the only uterine muscle relaxant) was implemented in our new magnesium-free tocolysis and classical hysterotomy (MgFTCH) protocol. The aim of the study was to assess the introduction of the MgFTCH protocol in reducing maternal and fetal complications. The prospective study cohort (SC) included 64 OFS performed with MgFTCH at the Fetal Surgery Centre Bytom (FSCB) (2015–2020). Fetal and maternal outcomes were compared with the retrospective cohort (RC; <i>n</i> = 46), and data from the Zurich Center for Fetal Diagnosis and Therapy (ZCFDT; <i>n</i> = 40) and the Children’s Hospital of Philadelphia (CHOP; <i>n</i> = 100), all using traditional tocolysis. The analysis included five major perinatal complications (Clavien-Dindo classification, C-Dc) which developed before the end of 34 weeks of gestation (GA, gestational age). None of the newborns was delivered before 30 GA. Only two women presented with grade 3 complications and none with 4th or 5th grade (C-Dc). The incidence of perinatal death (3.3%) was comparable with the RC (4.3%) and CHOP data (6.1%). MgFTCH lowers the risk of major maternal and fetal complications.https://www.mdpi.com/2227-9059/11/2/392open fetal surgeryfetal surgeryspina bifidamaternal complicationsmyelomeningocele |
| spellingShingle | Mateusz Zamłyński Anita Olejek Ewa Horzelska Tomasz Horzelski Jacek Zamłyński Rafał Bablok Iwona Maruniak-Chudek Katarzyna Olszak-Wąsik Agnieszka Pastuszka Decreased Maternal Morbidity and Improved Perinatal Results of Magnesium-Free Tocolysis and Classical Hysterotomy in Fetal Open Surgery for Myelomeningocele Repair: A Single-Center Study Biomedicines open fetal surgery fetal surgery spina bifida maternal complications myelomeningocele |
| title | Decreased Maternal Morbidity and Improved Perinatal Results of Magnesium-Free Tocolysis and Classical Hysterotomy in Fetal Open Surgery for Myelomeningocele Repair: A Single-Center Study |
| title_full | Decreased Maternal Morbidity and Improved Perinatal Results of Magnesium-Free Tocolysis and Classical Hysterotomy in Fetal Open Surgery for Myelomeningocele Repair: A Single-Center Study |
| title_fullStr | Decreased Maternal Morbidity and Improved Perinatal Results of Magnesium-Free Tocolysis and Classical Hysterotomy in Fetal Open Surgery for Myelomeningocele Repair: A Single-Center Study |
| title_full_unstemmed | Decreased Maternal Morbidity and Improved Perinatal Results of Magnesium-Free Tocolysis and Classical Hysterotomy in Fetal Open Surgery for Myelomeningocele Repair: A Single-Center Study |
| title_short | Decreased Maternal Morbidity and Improved Perinatal Results of Magnesium-Free Tocolysis and Classical Hysterotomy in Fetal Open Surgery for Myelomeningocele Repair: A Single-Center Study |
| title_sort | decreased maternal morbidity and improved perinatal results of magnesium free tocolysis and classical hysterotomy in fetal open surgery for myelomeningocele repair a single center study |
| topic | open fetal surgery fetal surgery spina bifida maternal complications myelomeningocele |
| url | https://www.mdpi.com/2227-9059/11/2/392 |
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