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

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.