Early management and decision making for the treatment of myelomeningocele

R. H. Gross, A. Cox, R. Tatyrek, M. Pollay, W. A. Barnes

Research output: Contribution to journalArticlepeer-review

69 Scopus citations

Abstract

A program for early selection and treatment of the infant with myelomeningocele was developed at the University of Oklahoma Health Sciences Center in 1977. Over a 5-year period 69 babies were evaluated, 36 babies were recommended for early vigorous treatment. Of the 33 babies for whom only supportive care was recommended, five were initially treated at the parents' request, two underwent delayed vigorous treatment, one was subsequently treated by 'crisis management', one moved and did not return for follow-up, and 24 received only supportive care. All 24 babies died between 1 to 189 days of age (mean 37 days). The involvement of several physicians and paramedical support personnel is considered essential for this approach of early selection and treatment. Continued support and regular follow-up is necessary for any baby who receives only supportive care. Parents retain legal custody. Although ethical concerns make any approach difficult, the method presented is considered to be the best alternative available at this time.

Original languageEnglish (US)
Pages (from-to)450-458
Number of pages9
JournalPediatrics
Volume72
Issue number4
StatePublished - 1983
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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