Procedure-related complications of open vs endoscopic fetal surgery for treatment of spina bifida in an era of intrauterine myelomeningocele repair: systematic review and meta-analysis

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dc.contributor.authorAraujo Junior, E. [UNIFESP]
dc.contributor.authorEggink, A. J.
dc.contributor.authorVan den Dobbelsteen, J.
dc.contributor.authorMartins, W. P.
dc.contributor.authorOepkes, D.
dc.date.accessioned2019-07-22T15:46:57Z
dc.date.available2019-07-22T15:46:57Z
dc.date.issued2016
dc.description.abstractObjective To assess and compare the rate of procedure-related complications after intrauterine treatment of spina bifida by endoscopic surgery and by open fetal surgery. Methods Systematic literature searches in PubMed and SCOPUS databases were performed on 20 September 2015 to identify randomized controlled trials and observational studies on treatment of human spina bifida by endoscopic or open fetal surgery techniques. Only studies with >= 10 cases that were published in or after 2000 were included in the meta-analysis in order to reduce the risk of bias. Primary outcomes (complete dehiscence, focal dehiscence and/or markedly thin hysterotomy scaren
dc.description.abstractpreterm delivery<34 weeksen
dc.description.abstractmean gestational age at delivery) and secondary outcomes (oligohydramnios, prelabor rupture of membranes, placental abruption, chorioamnionitis and perinatal death) were assessed for both techniques. Precision of the estimated proportions was evaluated with 95% CIs. Inconsistency was assessed using the I-2 statistic. Results The search identified 1080 records that were examined based on title and abstract, of which 28 full-text articles were examined completely for eligibility. Nine records were excluded because cases were also described in other studies, leaving 19 records for analysis. When comparing endoscopic vs open fetal surgery, the rate of complete dehiscence, focal dehiscence and/or markedly thin hysterotomy scar was, respectively, 1% (95% CI, 0-4%) vs 26% (95% CI, 12-42%)en
dc.description.abstractpreterm delivery <34 weeks was 80% (95% CI, 41-100%) vs 45% (95% CI, 38-53%)en
dc.description.abstractoligohydramnios was 39% (95% CI, 9-75%) vs 14% (95% CI, 7-24%)en
dc.description.abstractprelabor rupture of membranes was 67% (95% CI, 12-100%) vs 38% (95% CI, 26-50%)en
dc.description.abstractand perinatal death was 14% (95% CI, 1-38%) vs 5% (95% CI, 3-8%). Conclusion Open fetal surgery for spina bifida seems to show lower rates of procedure-related complications than does endoscopic surgery, but the rate of hysterotomy scar complications is high after open surgery. Because of the low quality of evidence, the conclusions should be interpreted with caution. Copyright (C) 2015 ISUOG. Published by John Wiley & Sons Ltd.en
dc.description.affiliationLeiden Univ, Med Ctr, Dept Obstet & Fetal Therapy, Leiden, Netherlands
dc.description.affiliationUniv Fed Sao Paulo, Paulista Sch Med, Dept Obstet, Sao Paulo, SP, Brazil
dc.description.affiliationUniv Med Ctr, Dept Obstet & Gynecol, Erasmus MC, Rotterdam, Netherlands
dc.description.affiliationDelft Univ Technol, Dept Biomech Engn, Delft, Netherlands
dc.description.affiliationUniv Sao Paulo, Ribeirao Preto Sch Med, Dept Obstet & Gynecol, Ribeirao Preto, SP, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Paulista Sch Med, Dept Obstet, Sao Paulo, SP, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipConselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)
dc.description.sponsorshipDepartment of Obstetrics and Fetal Therapy, Leiden University Medical Center, The Netherlands
dc.format.extent151-U42
dc.identifierhttp://dx.doi.org/10.1002/uog.15830
dc.identifier.citationUltrasound In Obstetrics & Gynecology. Hoboken, v. 48, n. 2, p. 151-U42, 2016.
dc.identifier.doi10.1002/uog.15830
dc.identifier.issn0960-7692
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/51201
dc.identifier.wosWOS:000383699600004
dc.language.isoeng
dc.publisherWiley
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectfetoscopyen
dc.subjectopen fetal surgeryen
dc.subjectperinatal complicationsen
dc.subjectspina bifidaen
dc.subjectsystematic reviewen
dc.titleProcedure-related complications of open vs endoscopic fetal surgery for treatment of spina bifida in an era of intrauterine myelomeningocele repair: systematic review and meta-analysisen
dc.typeinfo:eu-repo/semantics/article
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