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Abstract：
OBJECTIVE: The Management of Myelomeningocele Study (MOMS Trial) has inspired many fetal therapy centers (FTCs) to offer open fetal surgery for myelomeningocele (MMC). This is an initial effort to create a candidate model that can be applicable to many parts of Asia.
METHODS: A limited selection of specialists from 4 established FTCs in Thailand, Hong Kong, India, and Singapore met for a round table discussion. Experts from Children\'s Hospital of Philadelphia (CHOP) involved in the Trial moderated the session. The practice suggestions in this statement were from a targeted literature review and expert opinion.
RESULTS: A high prevalence of MMC in Asia supports an effort to adopt the procedure, but only in established FTCs with good maternal and neonatal ancillary supports. The falling incidence of MMCs may affect case volume and maintenance of skill. A regional approach was recommended. Fetal benefits have to be weighed against maternal risks, with a consideration of recent outcome data from the endoscopic approach. Responsible FTCs need standardized diagnosis and management, with their long-term outcome data available for an audit.
CONCLUSIONS: It is envisaged that the information presented by this multidisciplinary team would be useful for FTCs in Asia or elsewhere that plan to establish more advanced fetal care in the future.
METHODS: A limited selection of specialists from 4 established FTCs in Thailand, Hong Kong, India, and Singapore met for a round table discussion. Experts from Children\'s Hospital of Philadelphia (CHOP) involved in the Trial moderated the session. The practice suggestions in this statement were from a targeted literature review and expert opinion.
RESULTS: A high prevalence of MMC in Asia supports an effort to adopt the procedure, but only in established FTCs with good maternal and neonatal ancillary supports. The falling incidence of MMCs may affect case volume and maintenance of skill. A regional approach was recommended. Fetal benefits have to be weighed against maternal risks, with a consideration of recent outcome data from the endoscopic approach. Responsible FTCs need standardized diagnosis and management, with their long-term outcome data available for an audit.
CONCLUSIONS: It is envisaged that the information presented by this multidisciplinary team would be useful for FTCs in Asia or elsewhere that plan to establish more advanced fetal care in the future.
摘要：
目的：脊髓膜膨出治疗研究（MOMS试验）激发了许多胎儿治疗中心（FTCs）提供针对脊髓膜膨出（MMC）的开放式胎儿手术。这是创建适用于亚洲许多地区的候选模型的初步努力。
方法：从泰国4个已建立的FTC中选择有限的专家，香港,印度,新加坡举行了圆桌讨论会。参与试验的费城儿童医院（CHOP）的专家主持了会议。本声明中的实践建议来自有针对性的文献综述和专家意见。
结果：亚洲MMC的高患病率支持采用该程序的努力，但仅限于具有良好孕产妇和新生儿辅助支持的既定FTC。MMC的发生率下降可能会影响病例体积和技能的维持。有人建议采取区域办法。胎儿利益必须与产妇风险权衡，考虑到内窥镜方法的近期结局数据。负责任的FTC需要标准化的诊断和管理，他们的长期结果数据可用于审计。
结论：可以设想，这个多学科团队提供的信息将对亚洲或其他地区的FTC有用，这些FTC计划在未来建立更先进的胎儿护理。
方法：从泰国4个已建立的FTC中选择有限的专家，香港,印度,新加坡举行了圆桌讨论会。参与试验的费城儿童医院（CHOP）的专家主持了会议。本声明中的实践建议来自有针对性的文献综述和专家意见。
结果：亚洲MMC的高患病率支持采用该程序的努力，但仅限于具有良好孕产妇和新生儿辅助支持的既定FTC。MMC的发生率下降可能会影响病例体积和技能的维持。有人建议采取区域办法。胎儿利益必须与产妇风险权衡，考虑到内窥镜方法的近期结局数据。负责任的FTC需要标准化的诊断和管理，他们的长期结果数据可用于审计。
结论：可以设想，这个多学科团队提供的信息将对亚洲或其他地区的FTC有用，这些FTC计划在未来建立更先进的胎儿护理。
