Resultado cognitivo en pre-escolares con cirugía fetal por mielomeningocele

Publicado el 03.06.2010

En un estudio del grupo CHOP de Pensilvania, se examina el resultado cognitiivo de un subrgrupo de niños preescolares que fueron sometidos a cirugía fetal por mielomeningocele. El análisis del subrgupo de niños con seguimiento (n=30, la mitad) mostró que su comportamiento cognitivo era similar al promedio.

Preschool neurodevelopmental outcome of
children following fetal myelomeningocele closure

Enrico Danzer,
MD, Marsha Gerdes,
PhD, Michael
W. Bebbington, MD, Deborah
M. Zarnow, MD, N.
Scott Adzick, MD, Mark
P. Johnson, MD

Received
23 September 2009; received
in revised form 25 January 2010; accepted 2 February 2010. published online
29 March 2010.

Objective

We sought to investigate the preschool
neurodevelopmental outcomes of children following fetal myelomeningocele
(fMMC) surgery.

Study Design

Prior to the Management of Myelomeningocele
Study trial, 54 children underwent fMMC closure at our institution.
Thirty (56%) returned at 5 years of age for standardized neurocognitive
examination. Scores were grouped as high-average, average, mildly
delayed, and severely delayed by SD intervals.

Results

Mean verbal intelligence quotient (VIQ),
performance intelligence quotient (PIQ), and full intelligence quotient
(FIQ) scores were within normal population range. High-average or
average scores for VIQ, PIQ, FIQ, and processing speed were found in
93%, 90%, 90%, and 60%, respectively. Mean FIQ and processing speed of
nonshunted children were significantly higher than for those who
required shunt placement (P = .02 and P = .01,
respectively). Mean VIQ and PIQ tended to be higher in nonshunted fMMC
children (P = .05).

Conclusion

The majority of fMMC children in this
highly selective population had average preschool neurodevelopmental
scores. fMMC children who did not require shunt placement were more
likely to have better scores.

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