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Impact of the cystic neural tube defects on fetal motor function in prenatal myelomeningocele repairs: A retrospective cohort study
Author(s) -
Corroenne Romain,
Sanz Cortes Magdalena,
Johnson Rebecca M.,
Whitehead William E.,
Donepudi Roopali,
MehollinRay Amy R.,
Huisman Thierry A. G. M.,
Espinoza Jimmy,
Nassr Ahmed A.,
Belfort Michael A.,
Shamshirsaz Alireza A.
Publication year - 2021
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.5992
Subject(s) - medicine , lesion , retrospective cohort study , gestational age , prenatal diagnosis , gestation , cohort , ultrasound , pregnancy , surgery , neural tube , fetus , obstetrics , radiology , embryo , genetics , biology , microbiology and biotechnology
Abstract Objective To determine the impact of the lesion type (cystic [myelomeningocele] or flat [myeloschisis]) on the fetal motor function (MF) in cases candidates for prenatal open neural tube defect (ONTD) repair. Methods Retrospective cohort study of patients with ONTD who underwent prenatal repair at a single institution between 2011 and 2019. The lesion type and the measurements of the length and width of the lesions to calculate the surface of the ellipsoid lesion were performed using MR scans. Prenatal MF of the lower extremities was evaluated by ultrasound following a metameric distribution at the time of referral. Intact MF was defined as the observation of plantar flexion of the ankle. Logistic regression was performed to determine the predictive value of the type of lesion for having an intact MF at the time of referral. Results 103 patients were included at 22.9 (19–25.4) weeks; 65% had cystic and 35% had flat lesions. At the time of referral, there was a higher proportion of cases with an intact MF in the presence of flat lesions (34/36; 94.4%) as compared to cystic lesion (48/67; 71.6%, p < 0.01). When adjusting for gestational age and anatomical level of the lesion, flat ONTD were 3.1 times more likely to be associated by intact motor function (CI%95 [2.1–4.6], p < 0.01) at the time of referral. Conclusion Cystic ONTD are more likely to be associated with impaired MF at mid‐gestation in candidates for prenatal ONTD repair.