Guzmán HME, Acevedo GS, Gallardo GJM, Velázquez TB, Bermúdez THM, Camargo ML

Language: Spanish
References: 22
Page: 215-229
PDF size: 264.45 Kb.

ABSTRACT

Introduction: Recent technological advances in fetal surgery have led to the possibility of intervention among some non-lethal diseases such as some forms of fetal hydrocephalus. Prevention in neurodevelopmental sequelae is the main goal of the fetal surgical option.
Objectives: 1. To describe indications and surgical procedures for treatment of fetal hydrocephalus. 2. To describe the fetal mortality pattern related to fetal surgery for fetal hifrocephalus. 3. To describe neonatal morbidity following fetal surgery and follow-up methods.
Materials and methods: Papers identification process was carried out through database search (medline, OVID), from 1980 to 2006, manual search and written communication with some authors.
Results: Five studies with forty-five patients were included. Ventriculo-amniotic shunt was performed in 42 patients, while cephalocentesis was performed in three cases. The etiology of fetal hydrocephalus was diverse. Mortality rate following fetal surgery was 25% (11). Follow-up of the survivals recipients was carried out in 75% of the cases, for 8.2 months ± 5.8. Satandarization process for hydrocephalus volume assessment, catheter characteristics, fetal surgery technique, follow-up of the survivals recipients was not detected.
Conclusions: The natural history of fetal hudrocephalus (and ventriculomegaly) has not been well described, or at least in a precise manner. However, it seems that early diagnosed isolated fetal hydrocephalus could be candidates to fetal surgery. It is necessary further multicenter studies with better clinical desing models.

REFERENCES

1. Birnholz JC, Frigoletto FD. Antenatal treatment of hydrocephalus. N Engl J Med 1981; 304(17): 1021-3.

2. Clewell WH, Jonson ML, Meier PR, (incluir hasta 6 autores) Placement of ventriculoamniotic shunt for hydrocephalus in fetus. N Engl J Med 1981; 305: 955.

3. Frigoleto FD, Birnhplz JC, Greene MF. Antenatal treatment of hydrocephalus by ventriculoamniotic shunting. N Engl J Med 1982; 248: 2496-7.

4. Depp R, Sabbagha RE, Brown JT, et al. (incluir hasta 6 autores). Surgery for hydrocephalus successful in utero ventriculoamniotic shunt for Dandy- Walker Syndrome. Obstet Gynecol 1983; 61: 710-4.

5. Manning FA, Harrison MR, Rodeck C. Catheter shunt for fetal hydrocephalus. Report of the international fetal surgery registry. N Engl J Med 1987; 315: 336-40.

6. Benacerraf BRBJ. The diagnosis of fetal hydrocephalus prior to 22 weeks. J Clin Ultrasound 1987; 15: 531-6.

7. Oi SHY, Hidaka M, Sato O, Matsumoto S. Intrauterine high-resolution magnetic resonance imaging in fetal hydrocephalus and prenatal estimation of postnatal outcomes with “perspective classification”. J Neurosurg 1998; 88: 685-94.

8. Sutton LN, Sun P, Adzick NS. Fetal neurosurgery (topic review). Neurosurgery online 2001; 48(1): 124-44.

9. McAllister JP. Neonatal hydrocephalus. Mechanisms and consequences. Neurosurg Clin North Am 1998; 9: 73-93.

10. Braun KP, Vandertop WP, Gooskens RH, Tulleken KA, Nicolay K. NMR spectroscopic evaluation of cerebral metabolism in hydrocephalus: a review. Neurol Res 2000; 22: 51-64.

11. Osaka KHH, Matsumoto S, Yasuda M. Development of the cerebrospinal fluid pathway in the normal and abnormal human embryos. Child Brain 1980; 6: 26-38.

12. Simon EM, Coakley FV. Fast MR imaging of fetal CNS anomalies in utero. Am J Neuroradiol 2000; 21: 1688-98.

13. Glick PL, Harrison MR, Halks-Miller M, Adzick NS, Nakayama DK, Anderson JH. Correction of congenital hydrocephalus in utero II. Efficacy of in utero shunting. J Pediatr Surg 1984; 19: 870-81.

14. Hudgins RJ, Edwards MS, Goldstein R, Callen PW, Harrison MR, Filly RA, Golbus MS. Natural history of fetal ventriculomegaly. Pediatrics1988; 82: 692-7.

15. Vintzileos AM, Campbell WA, Weinbaum PJ, Nochimson DJ. Perinatal management and outcome of fetal ventriculomegaly. Obstet Gynecol 1987; 69: 5-11.

16. Reñiré DS, Pierre-Kahn A, Hirsch JF. Prenatal hydrocephalus: outcome and prognosis. Childs Nerv Syst 1988; 4: 213-22.

17. Oi SZ, Yamada H, Kimura M, Ehara K, Matsumoto S, Katayama K. Factors affecting prognosis of intrauterine hydrocephalus diagnosed in the third trimester – computerized data analysis on controversies in fetal surgery. Neurol Med Chir 1990; 30: 456-61.

18. Drugan A, Krause B, Canady A, Zador IE, Sacks AJ, Evans MI. The natural history of prenatally diagnosed cerebral ventriculomegaly. JAMA 1989; 261: 1785-8.

19. Harrison MR (2002) El paciente prenatal. McGraw-Hill Interamericana. 3a. Ed.

20. Vintzileos AM, Campbell WA, Weinbaum DJ. Perinatal management and out come of fetal ventriculomegaly. Obstet Gynecol 1987; 69(1): 5-11.

21. Hulley SB. Diseño de la investigación clínica. Ed. DOYMA; 2001.

22. Cornelia S, Von Koch, N, Chiralin Gupta. In: Utero Sugery for Hydrocephalus. Department of Neurological Surgery. University of California San Francisco; 2004.