Complications of Therapies for Fetal Myelomeningocele

Surgical

• Spontaneous labor: The risk of preterm spontaneous labor (24% to 38%) is among the most frequent and well-known sequelae following intrauterine repair (1,2).
• Premature rupture of membranes: Currently, the reported incidence of premature rupture of membranes is between 20% and 32% (3,6), lower than that reported in the MOMS trial (46%) (1).
• Chorioamnion separation: The incidence of chorioamnion separation following fetal myelomeningocele repair is between 0% and 23% (3,6).
• Uterine dehiscence: As measured at the time of delivery, the rate of focal (7% to 9%) and overt (<2%) uterine dehiscence is low (1,2).
• Shunting: The need for permanent CSF diversion following fetal myelomeningocele repair is ~40%, approximately half the rate following postnatal repair (82%) (1).
• Fetal wound dehiscence: With optimal surgical technique and surgeon experience, the rate of lumbar incisional dehiscence following open repair is low (<4%) (5).
• Prenatal death: A small but not insignificant risk (~3%) of prenatal death exists following fetal myelomeningocele repair and must be discussed with the patient and family beforehand (1,6).