Outcomes Data: Open Fetal Surgery for Spina Bifida (Myelomeningocele) Repair
First in Texas
Physicians affiliated with The Fetal Center at Children’s Memorial Hermann Hospital were the first in Texas to perform open fetal surgery for the repair of myelomeningocele, the most severe form of spina bifida, in May 2011. This procedure followed the published results from the seven-year multicenter clinical trial, the Management of Myelomeningocele Study (MOMS), in March 2011. Overall, The Fetal Center’s outcomes data is better than or mirrors those reported in the MOMS trial.
Below is an overview of The Fetal Center’s clinical outcomes data for the fetal surgical repair of spina bifida. The data is compared to the MOMS trial results, which included 183 surgically eligible randomized patients – 80 patients underwent postnatal surgical repair and 78 underwent fetal surgery for spina bifida repair.
We strive to be transparent and provide up-to-date information on our patient outcomes. Our hope is that the data below serves as a helpful resource when making informed decisions regarding care.
For more information or to speak with a clinician at The Fetal Center, call (832) 325-7288 or email email@example.com.
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Since 2011, The Fetal Center has evaluated more than 190 women for fetal spina bifida repair; 77 patients met criteria for fetal surgery and 54 patients elected to undergo open fetal surgical repair. The data below is an overview of The Fetal Center’s clinical outcomes data from May 2011 – August 2017.
Fetal Surgery for Spina Bifida Repair – Summary
| ||The Fetal Center Cohort (n=54)||MOMS Trial: Fetal Surgery (n=78)||MOMS Trial: Postnatal Surgery (n=80)|
|Gestational Age at Surgery||25.02±.6||23.6±1.4||n/a|
|Gestational Age at Delivery||34.1±3.5||34.1±3.1||37.3±1.1|
|Perinatal/Neonatal Demise||3 (6%)||2 (3%)||2 (3%)|
|VP Shunt at One Year||20/47 (43%)||31 (40%)||66 (82%)|
|(The Fetal Center) Date range: May 2011 – August 2017; N = 54 patients. As of August 2017, four patients are pending delivery.|
Gestational Age at Delivery
Mothers who undergo open fetal surgery for spina bifida repair are carefully followed by the multidisciplinary team at The Fetal Center through the remainder of their pregnancy, with a scheduled C-section delivery at 37 weeks for patients at The Fetal Center. Overall, 28 percent of our patients delivered past 37 weeks gestation as compared to 21 percent in the MOMS trial. At The Fetal Center, the mean gestational age at delivery is 34.1 weeks, the median is 34.9 weeks, and the range is 11.9 weeks.
Gestational Age at Delivery
The affiliated team makes significant efforts to eliminate or minimize any potential maternal complications related to fetal surgery. For most of the conditions considered below, The Fetal Center had a lower complication rate as compared to the MOMS trial.
Ventriculoperitoneal (VP) Shunt Rate
The MOMS trial showed increasing benefits to the baby, including a reduction in the need for shunts. Overall, The Fetal Center’s cohort data closely mirrored the VP shunt rate of the MOMS trial.
| ||The Fetal Center Cohort||MOMS Trial|
|VP Shunt at One Year||20/47 (43%)||31/78 (40%)|
|(The Fetal Center) Date range: May 2011 – August 2017. N = 47 patients, excluding neonatal demises. As of August 2017, four patients are pending delivery.|
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