[Preliminary results from the French study on prenatal repair for fetal myelomeningoceles (the PRIUM study)]

S Friszer; F Dhombres; F Di Rocco; A Rigouzzo; C Garel; L Guilbaud; V Forin; M-L Moutard; M Zerah; J-M Jouannic

doi:10.1016/j.jgyn.2015.09.002

[Preliminary results from the French study on prenatal repair for fetal myelomeningoceles (the PRIUM study)]

J Gynecol Obstet Biol Reprod (Paris). 2016 Sep;45(7):738-44. doi: 10.1016/j.jgyn.2015.09.002. Epub 2015 Nov 10.

[Article in French]

Authors

S Friszer¹, F Dhombres¹, F Di Rocco², A Rigouzzo³, C Garel⁴, L Guilbaud¹, V Forin⁵, M-L Moutard⁶, M Zerah², J-M Jouannic⁷

Affiliations

¹ Service de médecine fœtale, centre pluridisciplinaire de l'Est Parisien, hôpital Armand-Trousseau, AP-HP, Paris 6, 26, avenue Arnold-Netter, 75012 Paris, France.
² Service de neurochirurgie pédiatrique, hôpital Necker-Enfants-Malades, AP-HP, Paris 5, 49, rue de Sèvres, 75015 Paris, France.
³ Département d'anesthésie, hôpital Armand-Trousseau, AP-HP, Paris 6, 26, avenue Arnold-Netter, 75012 Paris, France.
⁴ Service de radiopédiatrie, hôpital Armand-Trousseau, AP-HP, Paris 6, 26, avenue Arnold-Netter, 75012 Paris, France.
⁵ Unité pédiatrique de médecine physique et de réadaptation, hôpital Armand-Trousseau, AP-HP, Paris 6, 26, avenue Arnold-Netter, 75012 Paris, France.
⁶ Service de neuropédiatrie, hôpital Armand-Trousseau, AP-HP, Paris 6, 26, avenue Arnold-Netter, 75012 Paris, France.
⁷ Service de médecine fœtale, centre pluridisciplinaire de l'Est Parisien, hôpital Armand-Trousseau, AP-HP, Paris 6, 26, avenue Arnold-Netter, 75012 Paris, France. Electronic address: [email protected].

PMID: 26566108
DOI: 10.1016/j.jgyn.2015.09.002

Abstract

Objectives: To present the preliminary results of the PRIUM study, a French pilot study of prenatal repair for myelomeningoceles (MMC).

Material and methods: The fetal surgery for MMC is offered in cases of patients that did not opt for termination of pregnancy.

Results: Thirty-six patients were referred in an 18-month period. Eight patients were not eligible for prenatal repair. Another type of dysraphism was made in 6 cases (one spina-lipoma, 5 cases of limited dorsal myeloschisis). Twenty-two patients were eligible to fetal surgery. A prenatal repair was performed in three cases (14%). Four patients opted for a conventional postnatal treatment. Fifteen patients opted for termination of the pregnancy.

Conclusion: The establishment of a prenatal repair of MMC protocol in France was justified. The experience of the first 18months of this study however suggests that only a limited number of couples will choose this procedure after specialized counseling in a reference center.

Keywords: Chirurgie fœtale; Diagnostic prénatal; Fetal surgery; Myelomeningocele; Myéloméningocèle; Prenatal diagnosis.

MeSH terms

Adult
Female
Fetal Diseases / surgery*
Fetal Therapies / methods*
Fetal Therapies / standards
France
Humans
Meningomyelocele / surgery*
Pilot Projects
Pregnancy
Young Adult