ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2017
Maternal-fetal surgery for myelomeningocele: some thoughts on ethical, legal, and psychological issues in a Western European situation.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 14 citations in OpenAlex.
- Neurologic Outcome Comparison between Fetal Open-, Endoscopic- and Neonatal-Intervention Techniques in Spina Bifida Aperta.Diagnostics (Basel, Switzerland) · 2023Article
- A New Ethical Framework for Assessing the Unique Challenges of Fetal Therapy Trials.The American journal of bioethics : AJOB · 2022Article
- Neurosurgical procedures for children with myelomeningocele after fetal or postnatal surgery: a comparative effectiveness study.Developmental medicine and child neurology · 2021Article
- Fetal surgery for open spina bifida.The obstetrician & gynaecologist : the journal for continuing professional development from the Royal College of Obstetricians & Gynaecologists · 2019Review
- Review on myelomeningocele management and its current status in Saudi Arabia.Neurosciences (Riyadh, Saudi Arabia) · 2019Review
- A study to assess global availability of fetal surgery for myelomeningocele.Prenatal diagnosis · 2018Article
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Authors and funding
3 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe results of the Management of Myelomeningocele Study (MOMS) randomized controlled trial have demonstrated that maternal-fetal surgery (MFS) for myelomeningocele (MMC) compared to postnatal MMC repair has clear neurological benefits for the child at 12 and 30 months of age. Level I evidence nevertheless does not provide answers to many questions in this delicate field. Since the beginning of 2012, our fetal center has been offering MFS for spina bifida aperta (SBA) to patients from different European and non-European countries, in a societal context where termination of pregnancy is the option chosen by most patients when being informed of this diagnosis.
methodsWe aim to explore in this text some of the ethical, legal, and psychological issues that we have encountered.
resultsFor many of these questions, we do not have definite answers. A pregnant patient when diagnosed with a MMC fetus is a vulnerable subject. She needs to be referred to a highly specialized center with sufficient expertise in diagnosis and in all therapeutic options. Objective but compassionate counseling is of paramount importance. It is required that a multidisciplinary professional team obtains full voluntary consent from the mother after providing an appropriate information including diagnosis, short-, medium-, and long-term prognosis as well as benefits and harms of the fetal surgery.
conclusionThe latter should be offered with full respect for maternal choice and individual assessment and perception of potential risks taking into consideration legislation in the fetal center and the parents' country legislation.
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