1. Fetal open spinal dysraphism repair through a mini-hysterotomy: Influence of gestational age at surgery on children's ability to walk.
- Author
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Peralta CFA, Botelho RD, Imada V, Lamis F, Antunes DRV, Nani F, and Balsalobre AGB
- Subjects
- Adult, Child, Female, Fetal Therapies methods, Fetal Therapies standards, Fetal Therapies statistics & numerical data, Humans, Hysterectomy methods, Hysterectomy statistics & numerical data, Pregnancy, Retrospective Studies, Spinal Dysraphism complications, Gestational Age, Hysterectomy standards, Spinal Dysraphism surgery, Walking statistics & numerical data
- 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 (
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., (© 2021 John Wiley & Sons Ltd.) - Published
- 2021
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