Scott Adzik

81 statements · 3 topics · summaries given as host listed separately

Fetal Surgery · guest expert

Featured statements

▶ Ep 8 · 1:49:07
Fetal MRI is mandatory for preoperative evaluation because ultrasound alone can incorrectly identify hindbrain herniation; in 9 cases with absent hindbrain herniation on MRI, ultrasound showed positive or equivocal findings.
clinical · Fetal Surgery
▶ Ep 8 · 1:50:06
Compared to open fetal MMC repair, fetoscopic repair has higher rates of fetal death, premature rupture of membranes, chorioamnionitis, oligohydramnios, premature delivery, and persistent hindbrain herniation.
clinical · Fetal Surgery
▶ Ep 2 · 1:49:47
Fetoscopic MMC repair using 3 or more ports leads to membrane fixation and tearing with uterine growth, resulting in premature birth 3-6 weeks after surgery and delivery before 30 weeks as a rule.
clinical · Myelomeningocele
▶ Ep 2 · 1:26:09
In fetal sheep models, mid-gestational spinal cord exposure leads to progressive neurologic injury that mimics human MMC, with paralysis and loss of sensation below the lesion level.
clinical · Myelomeningocele
▶ Ep 2 · 1:23:41
The two-hit hypothesis for MMC proposes that secondary damage occurs in utero from amniotic fluid, meconium, or hydrodynamic forces after the initial failure of neurulation.
clinical · Spina Bifida
▶ Ep 2 · 1:44:57
Mean gestational age at delivery was 34 weeks in the prenatal surgery group versus 37 weeks in the postnatal group, with 13% of prenatal cases delivered before 30 weeks.
clinical · Spina Bifida

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Scott's statements about Fetal Surgery 43 statements

Open the Fetal Surgery collection →

Fetal Surgical Intervention for Myelomeningocele: Fetal Surgery 2012

▶ Ep 8 · 46:05
quote New procedures are developed in the centers where the people are, the people that is, who feel a personal motivation to develop them. ↗
▶ Ep 8 · 1:22:06
epidemiological Spina bifida affects approximately 1500 babies born per year in the US, about 30 per week or 5-6 per day. ↗
▶ Ep 8 · 1:22:06
epidemiological Spina bifida affects approximately 1500 babies born per year in the US, about 30 per week or 5-6 per day. ↗
▶ Ep 8 · 1:23:20
clinical With standard postnatal care, approximately 14% of MMC patients die by age 5, mostly due to symptomatic brain stem compression from hindbrain herniation. ↗
▶ Ep 8 · 1:23:20
clinical With standard postnatal care, approximately 14% of MMC patients die by age 5, mostly due to symptomatic brain stem compression from hindbrain herniation. ↗
▶ Ep 8 · 1:23:33
clinical About 85% of MMC patients require ventricular shunts with standard postnatal care, with approximately half developing shunt complications within one year. ↗
▶ Ep 8 · 1:23:33
clinical About 85% of MMC patients require ventricular shunts with standard postnatal care, with approximately half developing shunt complications within one year. ↗
▶ Ep 8 · 1:23:41
clinical The two-hit hypothesis for MMC proposes that secondary damage occurs in utero from amniotic fluid, meconium, or hydrodynamic forces after the initial failure of neurulation. ↗
▶ Ep 8 · 1:23:41
clinical The two-hit hypothesis for MMC proposes that secondary damage occurs in utero from amniotic fluid, meconium, or hydrodynamic forces after the initial failure of neurulation. ↗
▶ Ep 8 · 1:26:09
clinical In fetal sheep models, mid-gestational spinal cord exposure leads to progressive neurologic injury that mimics human MMC, with paralysis and loss of sensation below the lesion level. ↗
▶ Ep 8 · 1:26:09
clinical In fetal sheep models, mid-gestational spinal cord exposure leads to progressive neurologic injury that mimics human MMC, with paralysis and loss of sensation below the lesion level. ↗
▶ Ep 8 · 1:26:43
clinical In utero coverage of experimentally created MMC in fetal sheep rescues neurologic function at birth, with lambs able to stand, walk, and maintain continence. ↗
▶ Ep 8 · 1:30:15
clinical Hindbrain herniation reverses after prenatal MMC repair because closing the defect prevents CSF leak, reestablishing the pressure column in the spinal canal. ↗
▶ Ep 8 · 1:30:15
clinical Hindbrain herniation reverses after prenatal MMC repair because closing the defect prevents CSF leak, reestablishing the pressure column in the spinal canal. ↗
▶ Ep 8 · 1:33:10
clinical In CHOP's pre-MOMS experience with 50 fetal MMC repairs, the shunt rate by one year was 40%, compared to 85% with postnatal repair. ↗
▶ Ep 8 · 1:33:10
clinical In CHOP's pre-MOMS experience with 50 fetal MMC repairs, the shunt rate by one year was 40%, compared to 85% with postnatal repair. ↗
▶ Ep 8 · 1:33:41
clinical Two-thirds of prenatally repaired MMC patients showed motor function two or more levels better than the anatomic lesion level. ↗
▶ Ep 8 · 1:33:41
clinical Two-thirds of prenatally repaired MMC patients showed motor function two or more levels better than the anatomic lesion level. ↗
▶ Ep 8 · 1:42:18
clinical The MOMS trial was stopped early on December 7, 2010 by the Data Safety Monitoring Board due to demonstrated efficacy of prenatal surgery. ↗
▶ Ep 8 · 1:42:18
clinical The MOMS trial was stopped early on December 7, 2010 by the Data Safety Monitoring Board due to demonstrated efficacy of prenatal surgery. ↗
▶ Ep 8 · 1:42:55
clinical In the MOMS trial, shunts were placed in 40% of the prenatal surgery group compared to 82% of the postnatal surgery group. ↗
▶ Ep 8 · 1:42:55
clinical In the MOMS trial, shunts were placed in 40% of the prenatal surgery group compared to 82% of the postnatal surgery group. ↗
▶ Ep 8 · 1:43:31
clinical At 30 months, 42% of babies in the prenatal surgery group could walk independently versus only 21% in the postnatal surgery group. ↗
▶ Ep 8 · 1:43:31
clinical At 30 months, 42% of babies in the prenatal surgery group could walk independently versus only 21% in the postnatal surgery group. ↗
▶ Ep 8 · 1:44:32
clinical At the time of delivery in the MOMS trial, the hysterotomy site was intact in about two-thirds of cases, very thin in one-quarter, with dehiscence in 9% and complete dehiscence in one case. ↗
▶ Ep 8 · 1:44:32
clinical At the time of delivery in the MOMS trial, the hysterotomy site was intact in about two-thirds of cases, very thin in one-quarter, with dehiscence in 9% and complete dehiscence in one case. ↗
▶ Ep 8 · 1:44:57
clinical Mean gestational age at delivery was 34 weeks in the prenatal surgery group versus 37 weeks in the postnatal group, with 13% of prenatal cases delivered before 30 weeks. ↗
▶ Ep 8 · 1:44:57
clinical Mean gestational age at delivery was 34 weeks in the prenatal surgery group versus 37 weeks in the postnatal group, with 13% of prenatal cases delivered before 30 weeks. ↗
▶ Ep 8 · 1:45:42
quote Prenatal repair of myelomeningocele is not a cure. ↗
▶ Ep 8 · 1:45:42
quote Prenatal repair of myelomeningocele is not a cure. ↗
▶ Ep 8 · 1:46:17
clinical Longer operating room times and postoperative oligohydramnios correlate with increased risk for preterm birth in fetal MMC repair. ↗
▶ Ep 8 · 1:46:17
clinical Longer operating room times and postoperative oligohydramnios correlate with increased risk for preterm birth in fetal MMC repair. ↗
▶ Ep 8 · 1:47:07
epidemiological A Washington University financial model using MOMS trial data showed that over $3 million would be saved for 100 babies treated prenatally versus postnatally. ↗
▶ Ep 8 · 1:47:57
clinical Since the end of the MOMS trial, CHOP has had 359 referrals, with 202 evaluated on-site, but only 60 (30%) underwent fetal surgery. ↗
▶ Ep 8 · 1:47:57
clinical Since the end of the MOMS trial, CHOP has had 359 referrals, with 202 evaluated on-site, but only 60 (30%) underwent fetal surgery. ↗
▶ Ep 8 · 1:49:07
clinical Fetal MRI is mandatory for preoperative evaluation because ultrasound alone can incorrectly identify hindbrain herniation; in 9 cases with absent hindbrain herniation on MRI, ultrasound showed positive or equivocal findings. ↗
▶ Ep 8 · 1:49:07
clinical Fetal MRI is mandatory for preoperative evaluation because ultrasound alone can incorrectly identify hindbrain herniation; in 9 cases with absent hindbrain herniation on MRI, ultrasound showed positive or equivocal findings. ↗
▶ Ep 8 · 1:49:47
clinical Fetoscopic MMC repair using 3 or more ports leads to membrane fixation and tearing with uterine growth, resulting in premature birth 3-6 weeks after surgery and delivery before 30 weeks as a rule. ↗
▶ Ep 8 · 1:49:47
clinical Fetoscopic MMC repair using 3 or more ports leads to membrane fixation and tearing with uterine growth, resulting in premature birth 3-6 weeks after surgery and delivery before 30 weeks as a rule. ↗
▶ Ep 8 · 1:50:06
clinical Compared to open fetal MMC repair, fetoscopic repair has higher rates of fetal death, premature rupture of membranes, chorioamnionitis, oligohydramnios, premature delivery, and persistent hindbrain herniation. ↗
▶ Ep 8 · 1:50:06
clinical Compared to open fetal MMC repair, fetoscopic repair has higher rates of fetal death, premature rupture of membranes, chorioamnionitis, oligohydramnios, premature delivery, and persistent hindbrain herniation. ↗
▶ Ep 8 · 2:34:14
clinical The discrepancy between meeting shunt criteria and receiving shunts occurred because an independent neurosurgical review committee determined criteria, but individual neurosurgeons made placement decisions, and most discrepancies involved criterion 3 (head size/ventricle changes) without accompanying symptoms. ↗
▶ Ep 8 · 2:36:43
clinical Using revised shunt criteria based on modified criterion 3, there is a close match between shunt criteria and actual shunt placement in both prenatal (46%) and postnatal (86%) groups. ↗
Scott's statements about Myelomeningocele 19 statements

Open the Myelomeningocele collection →

Fetal Surgical Intervention for Myelomeningocele: Fetal Surgery 2012

▶ Ep 2 · 1:22:06
epidemiological Spina bifida affects approximately 1500 babies born per year in the US, about 30 per week or 5-6 per day. ↗
▶ Ep 2 · 1:23:20
clinical With standard postnatal care, approximately 14% of MMC patients die by age 5, mostly due to symptomatic brain stem compression from hindbrain herniation. ↗
▶ Ep 2 · 1:23:33
clinical About 85% of MMC patients require ventricular shunts with standard postnatal care, with approximately half developing shunt complications within one year. ↗
▶ Ep 2 · 1:23:41
clinical The two-hit hypothesis for MMC proposes that secondary damage occurs in utero from amniotic fluid, meconium, or hydrodynamic forces after the initial failure of neurulation. ↗
▶ Ep 2 · 1:26:09
clinical In fetal sheep models, mid-gestational spinal cord exposure leads to progressive neurologic injury that mimics human MMC, with paralysis and loss of sensation below the lesion level. ↗
▶ Ep 2 · 1:30:15
clinical Hindbrain herniation reverses after prenatal MMC repair because closing the defect prevents CSF leak, reestablishing the pressure column in the spinal canal. ↗
▶ Ep 2 · 1:33:10
clinical In CHOP's pre-MOMS experience with 50 fetal MMC repairs, the shunt rate by one year was 40%, compared to 85% with postnatal repair. ↗
▶ Ep 2 · 1:33:41
clinical Two-thirds of prenatally repaired MMC patients showed motor function two or more levels better than the anatomic lesion level. ↗
▶ Ep 2 · 1:42:18
clinical The MOMS trial was stopped early on December 7, 2010 by the Data Safety Monitoring Board due to demonstrated efficacy of prenatal surgery. ↗
▶ Ep 2 · 1:42:55
clinical In the MOMS trial, shunts were placed in 40% of the prenatal surgery group compared to 82% of the postnatal surgery group. ↗
▶ Ep 2 · 1:43:31
clinical At 30 months, 42% of babies in the prenatal surgery group could walk independently versus only 21% in the postnatal surgery group. ↗
▶ Ep 2 · 1:44:32
clinical At the time of delivery in the MOMS trial, the hysterotomy site was intact in about two-thirds of cases, very thin in one-quarter, with dehiscence in 9% and complete dehiscence in one case. ↗
▶ Ep 2 · 1:44:57
clinical Mean gestational age at delivery was 34 weeks in the prenatal surgery group versus 37 weeks in the postnatal group, with 13% of prenatal cases delivered before 30 weeks. ↗
▶ Ep 2 · 1:45:42
quote Prenatal repair of myelomeningocele is not a cure. ↗
▶ Ep 2 · 1:46:17
clinical Longer operating room times and postoperative oligohydramnios correlate with increased risk for preterm birth in fetal MMC repair. ↗
▶ Ep 2 · 1:47:57
clinical Since the end of the MOMS trial, CHOP has had 359 referrals, with 202 evaluated on-site, but only 60 (30%) underwent fetal surgery. ↗
▶ Ep 2 · 1:49:07
clinical Fetal MRI is mandatory for preoperative evaluation because ultrasound alone can incorrectly identify hindbrain herniation; in 9 cases with absent hindbrain herniation on MRI, ultrasound showed positive or equivocal findings. ↗
▶ Ep 2 · 1:49:47
clinical Fetoscopic MMC repair using 3 or more ports leads to membrane fixation and tearing with uterine growth, resulting in premature birth 3-6 weeks after surgery and delivery before 30 weeks as a rule. ↗
▶ Ep 2 · 1:50:06
clinical Compared to open fetal MMC repair, fetoscopic repair has higher rates of fetal death, premature rupture of membranes, chorioamnionitis, oligohydramnios, premature delivery, and persistent hindbrain herniation. ↗
Scott's statements about Spina Bifida 19 statements

Open the Spina Bifida collection →

Fetal Surgical Intervention for Myelomeningocele: Fetal Surgery 2012

▶ Ep 2 · 1:22:06
epidemiological Spina bifida affects approximately 1500 babies born per year in the US, about 30 per week or 5-6 per day. ↗
▶ Ep 2 · 1:23:20
clinical With standard postnatal care, approximately 14% of MMC patients die by age 5, mostly due to symptomatic brain stem compression from hindbrain herniation. ↗
▶ Ep 2 · 1:23:33
clinical About 85% of MMC patients require ventricular shunts with standard postnatal care, with approximately half developing shunt complications within one year. ↗
▶ Ep 2 · 1:23:41
clinical The two-hit hypothesis for MMC proposes that secondary damage occurs in utero from amniotic fluid, meconium, or hydrodynamic forces after the initial failure of neurulation. ↗
▶ Ep 2 · 1:26:09
clinical In fetal sheep models, mid-gestational spinal cord exposure leads to progressive neurologic injury that mimics human MMC, with paralysis and loss of sensation below the lesion level. ↗
▶ Ep 2 · 1:30:15
clinical Hindbrain herniation reverses after prenatal MMC repair because closing the defect prevents CSF leak, reestablishing the pressure column in the spinal canal. ↗
▶ Ep 2 · 1:33:10
clinical In CHOP's pre-MOMS experience with 50 fetal MMC repairs, the shunt rate by one year was 40%, compared to 85% with postnatal repair. ↗
▶ Ep 2 · 1:33:41
clinical Two-thirds of prenatally repaired MMC patients showed motor function two or more levels better than the anatomic lesion level. ↗
▶ Ep 2 · 1:42:18
clinical The MOMS trial was stopped early on December 7, 2010 by the Data Safety Monitoring Board due to demonstrated efficacy of prenatal surgery. ↗
▶ Ep 2 · 1:42:55
clinical In the MOMS trial, shunts were placed in 40% of the prenatal surgery group compared to 82% of the postnatal surgery group. ↗
▶ Ep 2 · 1:43:31
clinical At 30 months, 42% of babies in the prenatal surgery group could walk independently versus only 21% in the postnatal surgery group. ↗
▶ Ep 2 · 1:44:32
clinical At the time of delivery in the MOMS trial, the hysterotomy site was intact in about two-thirds of cases, very thin in one-quarter, with dehiscence in 9% and complete dehiscence in one case. ↗
▶ Ep 2 · 1:44:57
clinical Mean gestational age at delivery was 34 weeks in the prenatal surgery group versus 37 weeks in the postnatal group, with 13% of prenatal cases delivered before 30 weeks. ↗
▶ Ep 2 · 1:45:42
quote Prenatal repair of myelomeningocele is not a cure. ↗
▶ Ep 2 · 1:46:17
clinical Longer operating room times and postoperative oligohydramnios correlate with increased risk for preterm birth in fetal MMC repair. ↗
▶ Ep 2 · 1:47:57
clinical Since the end of the MOMS trial, CHOP has had 359 referrals, with 202 evaluated on-site, but only 60 (30%) underwent fetal surgery. ↗
▶ Ep 2 · 1:49:07
clinical Fetal MRI is mandatory for preoperative evaluation because ultrasound alone can incorrectly identify hindbrain herniation; in 9 cases with absent hindbrain herniation on MRI, ultrasound showed positive or equivocal findings. ↗
▶ Ep 2 · 1:49:47
clinical Fetoscopic MMC repair using 3 or more ports leads to membrane fixation and tearing with uterine growth, resulting in premature birth 3-6 weeks after surgery and delivery before 30 weeks as a rule. ↗
▶ Ep 2 · 1:50:06
clinical Compared to open fetal MMC repair, fetoscopic repair has higher rates of fetal death, premature rupture of membranes, chorioamnionitis, oligohydramnios, premature delivery, and persistent hindbrain herniation. ↗

Summaries Scott gave as host · 15 summaries

Recaps of other experts' statements, not Scott's own clinical position.

Summaries Scott gave as host · Fetal Surgery 5 summaries

Open the Fetal Surgery collection →

Fetal Surgical Intervention for Myelomeningocele: Fetal Surgery 2012

▶ Ep 8 · 46:05
host summary Scott Adzik summarizing a resource: New procedures are developed in the centers where the people are, the people that is, who feel a personal motivation to develop them. ↗
▶ Ep 8 · 1:26:43
host summary Scott Adzik summarizing a resource: In utero coverage of experimentally created MMC in fetal sheep rescues neurologic function at birth, with lambs able to stand, walk, and maintain continence. ↗
▶ Ep 8 · 1:47:07
host summary Scott Adzik summarizing a resource: A Washington University financial model using MOMS trial data showed that over $3 million would be saved for 100 babies treated prenatally versus postnatally. ↗
▶ Ep 8 · 2:34:14
host summary Scott Adzik summarizing a resource: The discrepancy between meeting shunt criteria and receiving shunts occurred because an independent neurosurgical review committee determined criteria, but individual neurosurgeons made placement decisions, and most discrepancies involved criterion 3 (head size/ventricle changes) without accompanying symptoms. ↗
▶ Ep 8 · 2:36:43
host summary Scott Adzik summarizing a resource: Using revised shunt criteria based on modified criterion 3, there is a close match between shunt criteria and actual shunt placement in both prenatal (46%) and postnatal (86%) groups. ↗
Summaries Scott gave as host · Myelomeningocele 5 summaries

Open the Myelomeningocele collection →

Fetal Surgical Intervention for Myelomeningocele: Fetal Surgery 2012

▶ Ep 2 · 46:05
host summary Scott Adzik summarizing a resource: New procedures are developed in the centers where the people are, the people that is, who feel a personal motivation to develop them. ↗
▶ Ep 2 · 1:26:43
host summary Scott Adzik summarizing a resource: In utero coverage of experimentally created MMC in fetal sheep rescues neurologic function at birth, with lambs able to stand, walk, and maintain continence. ↗
▶ Ep 2 · 1:47:07
host summary Scott Adzik summarizing a resource: A Washington University financial model using MOMS trial data showed that over $3 million would be saved for 100 babies treated prenatally versus postnatally. ↗
▶ Ep 2 · 2:34:14
host summary Scott Adzik summarizing a resource: The discrepancy between meeting shunt criteria and receiving shunts occurred because an independent neurosurgical review committee determined criteria, but individual neurosurgeons made placement decisions, and most discrepancies involved criterion 3 (head size/ventricle changes) without accompanying symptoms. ↗
▶ Ep 2 · 2:36:43
host summary Scott Adzik summarizing a resource: Using revised shunt criteria based on modified criterion 3, there is a close match between shunt criteria and actual shunt placement in both prenatal (46%) and postnatal (86%) groups. ↗
Summaries Scott gave as host · Spina Bifida 5 summaries

Open the Spina Bifida collection →

Fetal Surgical Intervention for Myelomeningocele: Fetal Surgery 2012

▶ Ep 2 · 46:05
host summary Scott Adzik summarizing a resource: New procedures are developed in the centers where the people are, the people that is, who feel a personal motivation to develop them. ↗
▶ Ep 2 · 1:26:43
host summary Scott Adzik summarizing a resource: In utero coverage of experimentally created MMC in fetal sheep rescues neurologic function at birth, with lambs able to stand, walk, and maintain continence. ↗
▶ Ep 2 · 1:47:07
host summary Scott Adzik summarizing a resource: A Washington University financial model using MOMS trial data showed that over $3 million would be saved for 100 babies treated prenatally versus postnatally. ↗
▶ Ep 2 · 2:34:14
host summary Scott Adzik summarizing a resource: The discrepancy between meeting shunt criteria and receiving shunts occurred because an independent neurosurgical review committee determined criteria, but individual neurosurgeons made placement decisions, and most discrepancies involved criterion 3 (head size/ventricle changes) without accompanying symptoms. ↗
▶ Ep 2 · 2:36:43
host summary Scott Adzik summarizing a resource: Using revised shunt criteria based on modified criterion 3, there is a close match between shunt criteria and actual shunt placement in both prenatal (46%) and postnatal (86%) groups. ↗