Fetal Myelomeningocele Repair (Maternal-Fetal Surgery)

Treatment for Neural tube defects

Typical Dosage: N/A (surgical procedure)

Effectiveness
80%
Safety Score
50%
Clinical Trials
4
Participants
1K

Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
50
DangerousModerateSafe
Treatment Details
Dosage Range
N/A (surgical procedure)
Time to Effect
Immediate surgical correction, long-term neurodevelopmental benefits
Treatment Duration
Single surgical intervention (typically 19-26 weeks gestation)
Evidence Quality
HIGH
Number Needed to Treat (NNT)
2.6(Treat 2.6 patients to see 1 additional successful outcome)
Number Needed to Harm (NNH)
21(Treat 21 patients to see 1 additional serious adverse event)
Confidence Score
90%confidence in effectiveness data
Health Economics
Annual Cost of Care
Drug Cost:$0
Monitoring:$10,000
Side Effect Mgmt:$30,000
Total Annual:$140,000
Cost-Effectiveness Analysis
Cost-Effectiveness Rating
POOR
ICER
$305,055/QALY
QALYs Gained
0.96
Outcome-Based Costs
Cost per Responder
$233,333.33
Cost per Remission
$233,333.33
Comparison vs Postnatal Myelomeningocele Repair
Cost Difference
+$100,000/year
More expensive
QALY Difference
+1.00 QALYs
Better outcomes
Dominance
No dominance
Fetal Myelomeningocele Repair (Maternal-Fetal Surgery) Outcomes

for Neural tube defects

Efficacy Outcomes
Overall Effectiveness
+80%
Response Rate
+60%
Remission Rate
+60%
Common Side Effects
Preterm birth (before 37 weeks)
+46%
Chorioamnionitis
+5%
Uterine dehiscence
+2%
Increased need for shunt revision (postnatal, if initial shunt placed)
+10%

Sources:

cambridge.org
nih.gov
nih.gov

WARNING: LIMITED TRIALS AVAILABLE

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Active Clinical Trials
1 active trial recruiting for Fetal Myelomeningocele Repair (Maternal-Fetal Surgery) in Neural tube defects

In Utero Fetoscopic Repair Program for Sacral Myelomeningoceles and Mye-LDM

NCT04770805ACTIVE NOT RECRUITINGNA
View Study
10 participants
INTERVENTIONAL
Paris, France
Started: Apr 16, 2021
Completed Clinical Trials
2 completed trials for Fetal Myelomeningocele Repair (Maternal-Fetal Surgery) in Neural tube defects

Management of Myelomeningocele Study (MOMS)

NCT00060606COMPLETEDNA
View Study
183 participants
INTERVENTIONAL
San Francisco, United States +2 more
Started: Feb 1, 2003

Extended Criteria For Fetal Myelomeningocele Repair

NCT02664207COMPLETEDNA
View Study
12 participants
INTERVENTIONAL
Houston, United States +1 more
Started: Jan 26, 2016