All publications of “Denise Araujo Lapa Pedreira”

5 results

Novel multidisciplinary approach to monitor and treat fetuses with gastroschisis using the Svetliza Reducibility Index and the EXIT-like procedure

Gustavo Henrique de Oliveira, Javier Svetliza, Denise Cristina Mós Vaz-Oliani, Humberto Liedtke Junior, Antonio Helio Oliani, Denise Araujo Lapa Pedreira

DOI: 10.1590/S1679-45082017AO3979

ABSTRACT Objective: To describe our initial experience with a novel approach to follow-up and treat gastroschisis in “zero minute” using the EXITlike procedure. Methods: Eleven fetuses with prenatal diagnosis of gastroschisis were evaluated. The Svetliza Reductibility Index was used to prospectively evaluate five cases, and six cases were used as historical controls. The Svetliza Reductibility Index consisted in dividing the real abdominal wall defect diameter by the larger intestinal loop to be fitted in such space. The EXIT-like procedure consists […]

Advances in fetal surgery

Denise Araujo Lapa Pedreira

DOI: 10.1590/S1679-45082016MD3449

ABSTRACTThis paper discusses the main advances in fetal surgical therapy aiming to inform health care professionals about the state-of-the-art techniques and future challenges in this field. We discuss the necessary steps of technical evolution from the initial open fetal surgery approach until the development of minimally invasive techniques of fetal endoscopic surgery (fetoscopy).

Fetoscopy for meningomyelocele repair: past, present and future

Nicole Silva Bevilacqua, Denise Araujo Lapa Pedreira

DOI: 10.1590/S1679-45082015RW3032

ABSTRACTMeningomyelocele is a malformation with high prevalence, and one of its main comorbidities is Arnold-Chiari malformation type II. The intrauterine repair of this defect has been studied to reduce the progressive spinal cord damage during gestation. The purpose of the present review was to describe the evolution of fetal surgery for meningomyelocele repair. Searches on PubMed database were conducted including articles published in the last 10 years. Twenty-seven articles were selected, 16 experimental studies and 11 studies in humans. A […]

Comparison between two surgical techniques for prenatal correction of meningomyelocele in sheep

Silvia Rejane Fontoura Herrera, Ricardo José de Almeida Leme, Paulo Roberto Valente, Élia Garcia Caldini, Paulo Hilário Nascimento Saldiva, Denise Araujo Lapa Pedreira

DOI: 10.1590/S1679-45082012000400011

Objective:To compare the classical neurosurgical technique with a new simplified technique for prenatal repair of a myelomeningocelelike defect in sheep.METHODS:A myelomeningocele-like defect (laminectomy and dural excision) was created in the lumbar region on day 90 of gestation in 9 pregnant sheep. Correction technique was randomized. In Group 1 the defect was corrected using the classic neurosurgical technique of three-layer suture (dura mater, muscle and skin closure) performed by a neurosurgeon. In Group 2, a fetal medicine specialist used a biosynthetic […]

Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep

Denise Araujo Lapa Pedreira, Gregório Lorenzo Acácio, Rogério Chaccur Abou-Jamra, Rita de Cássia Sanches Oliveira, Elia Garcia Caldini, Paulo Hilário Nascimento Saldiva

DOI: 10.1590/s1679-45082010ao1440

ABSTRACTObjective:To change the gasless fetoscopy technique in order to reduce the diameter of entry orifices in the myometrium.Methods:Seven pregnant ewes were submitted to fetoscopy for repairing a large skin defect measuring 4.0 × 3.0 cm, created in the fetal lumbar region at the gestational age of 100 days. The defect was repaired through continuous suture of the skin with approximation of borders. Gasless fetoscopy was used for performing the suture with three orifices to allow entry of the trocar into […]