Fetal open spinal dysraphism repair through a mini-hysterotomy: Influence of gestational age at surgery on the perinatal outcomes and postnatal shunt rates.
Prenat Diagn
; 40(6): 689-697, 2020 05.
Article
en En
| MEDLINE
| ID: mdl-32112579
ABSTRACT
OBJECTIVE:
To analyze the impact of gestational age (GA) at the time of fetal open spinal dysraphism (OSD) repair through a mini-hysterotomy on the perinatal outcomes and the infants' ventriculoperitoneal shunt rates.METHODS:
Retrospective study of cases of fetal OSD correction performed from 2014 and 2019.RESULTS:
One hundred and ninety women underwent fetal surgery for OSD through a mini-hysterotomy, and 176 (176/19092.6%) have since delivered. Fetal OSD correction performed earlier in the gestational period, ranging from 19.7 to 26.9 weeks, was associated with lower rates of postnatal ventriculoperitoneal shunting (P .049). Earlier fetal surgeries were associated with shorter surgical times (P .01), smaller hysterotomy lengths (P < .001), higher frequencies of hindbrain herniation reversal (P .003), and longer latencies from surgery to delivery (P < .001). Median GA at delivery was 35.3 weeks. Multivariate binary logistic regression showed that both fetal lateral ventricle-to-hemisphere ratio (%; P < .001; OR 1.14 [95% CI 1.09-1.21]) and GA at the time of fetal surgery (P .016; OR 1.37 [95% CI 1.07-1.77]) were independent predictors of postnatal ventriculoperitoneal shunting.CONCLUSION:
Fetuses with OSD who were operated on earlier in the gestational interval, which ranged from 19.7 to 26.9 weeks, were less prone to receiving postnatal ventriculoperitoneal shunts.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Espina Bífida Quística
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Edad Gestacional
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Derivación Ventriculoperitoneal
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Procedimientos Neuroquirúrgicos
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Terapias Fetales
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Female
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Humans
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Male
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Middle aged
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Newborn
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Pregnancy
Idioma:
En
Revista:
Prenat Diagn
Año:
2020
Tipo del documento:
Article
País de afiliación:
Brasil