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- Title
Modified Hysterotomy Closure Technique for Open Fetal Surgery.
- Authors
Zaretsky, Michael V.; Liechty, Kenneth W.; Galan, Henry L.; Behrendt, Nicholas J.; Reeves, Shane; Marwan, ahmed I.; Wilkinson, Corbett; Handler, Michael; Lagueux, Megan; Crombleholme, Timothy M.
- Abstract
<bold>Objective: </bold>We reviewed our experience with open fetal surgical myelomeningocele repair to assess the efficacy of a new modification of the hysterotomy closure technique regarding hysterotomy complication rates at the time of cesarean delivery.<bold>Methods: </bold>A modification of the standard hysterotomy closure was performed on all patients undergoing prenatal myelomeningocele repair. The closure consisted of an interrupted full-thickness #0 polydioxanone (PDS) retention suture as well as a running #0 PDS suture to re-approximate the myometrial edges, and the modification was a third imbricating layer resulting in serosal-to-serosal apposition. A standard omental patch was placed per our routine. Both operative reports and verbal descriptions of hysterotomy from delivering obstetricians were reviewed.<bold>Results: </bold>A total of 49 patients underwent prenatal repair of myelomeningocele, 43 having adequate follow-up for evaluation. Of those, 95.4% had completely intact hysterotomy closures, with only 1 partial dehiscence (2.3%) and 1 thinned scar (2.3%). There were no instances of uterine rupture.<bold>Discussion: </bold>In patients undergoing this modified hysterotomy closure technique, a much lower than expected complication rate was observed. This simple modified closure technique may improve hysterotomy healing and reduce obstetric morbidity.
- Subjects
FETAL surgery; MYELOMENINGOCELE; UTERINE surgery; SURGICAL wound dehiscence; ORGAN rupture; FETOSCOPY; LONGITUDINAL method; OBSTETRICS surgery; PRENATAL care; SPINA bifida; RETROSPECTIVE studies
- Publication
Fetal Diagnosis & Therapy, 2018, Vol 44, Issue 2, p105
- ISSN
1015-3837
- Publication type
journal article
- DOI
10.1159/000479683