Fetal open spinal dysraphism repair through a mini-hysterotomy: Influence of gestational age at surgery on children's ability to walk.

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 ability of children to walk.

METHODS:

Children who underwent in utero repair of OSD and had formal neurological assessment after 2.5 years of age were compared regarding their ability to walk in relation to pre-surgical predictors.

RESULTS:

Sixty-nine children fulfilled the inclusion criteria. Among them, 63.7% (44/69) were able to walk with or without orthesis. Fetal OSD correction performed earlier in gestation (from 19.7 to 26.9 weeks) was associated with a higher probability of walking with or without orthesis (p = 0.033). The median GA at delivery was 35.3 weeks. Multivariate binary logistic regression showed that the upper anatomical level of the OSD (<L4 or > L5) (p < 0.004; OR: 10.31 [95% CI: 2.07-51.28]) and GA at the time of fetal surgery (p = 0.026; OR = 0.68 [95% CI: 0.48-0.95]) were independent predictors of the postnatal ability to walk with or without orthesis.

CONCLUSION:

Fetuses with OSD who were operated on earlier in pregnancy (range: 19.7-26.9 weeks), were more likely to walk with or without orthesis.

• Authors: Cleisson Fábio Andrioli Peralta, Rafael Davi Botelho, Vanessa Imada, Fabricio Lamis, Danielle Ribeiro Vieira Antunes, Fernando Nani, Andreza Gonzaga Bartilotti Balsalobre
• Journal: Prenatal diagnosis (Prenat Diagn) Vol. 41 Issue 13 Pg. 1634-1642 (Dec 2021) ISSN: 1097-0223 [Electronic] England
• PMID: 34583428 (Publication Type: Journal Article)
• Copyright: © 2021 John Wiley & Sons Ltd.

Topics

• Adult
• Child
• Female
• Fetal Therapies (methods, standards, statistics & numerical data)
• Gestational Age
• Humans
• Hysterectomy (methods, standards, statistics & numerical data)
• Pregnancy
• Retrospective Studies
• Spinal Dysraphism (complications, surgery)
• Walking (statistics & numerical data)