{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T02:27:07Z","timestamp":1740104827631,"version":"3.37.3"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,2,21]],"date-time":"2018-02-21T00:00:00Z","timestamp":1519171200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To establish a method to quantify the position of the cerebellum by ultrasonography in normal fetuses, fetuses with myelomeningocele (MMC), and fetuses that underwent in utero MMC repair.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Reference points identifiable on ultrasound were established. The basilar portion of the occipital bone and upper portion of the odontoid process were considered as the external and internal limits, respectively, of the level zero of a line that was designated the occipitum\u2010dens line (ODL). Eighty\u2010three normal fetuses were assessed 1 occasion (cross\u2010sectional study) in addition to 25 fetuses with MMC and 25 fetuses that underwent in utero MMC repair. The groups were compared using analysis of variance or the Kruskal\u2010Wallis test. The intraclass correlation coefficient (ICC) was used to determine intra\u2010 and interobserver reproducibility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The analysis of ODL indicated that all normal fetuses had the cerebellar tonsil above level zero at a mean distance of 2.8\u00a0\u00b1\u00a01.1\u00a0mm (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.125). The fetuses with MMC had the cerebellar tonsil below level zero, except in 2 cases of myelocystocele. All the fetuses that underwent in utero MMC repair exhibited regression of the cerebellar herniation (0.5\u00a0mm per week,<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.005). Herniation increased gradually (1.0\u00a0mm per week,<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.005) in fetuses that did not undergo MMC repair. ICC indicated good intra\u2010 and interobserver reproducibility (0.996 and 0.983, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The reference points for ODL may be used to assess cerebellar height. ODL allowed the demonstration of the regression of cerebellar herniation in fetuses that underwent in utero MMC repair.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.5229","type":"journal-article","created":{"date-parts":[[2018,2,10]],"date-time":"2018-02-10T19:02:38Z","timestamp":1518289358000},"page":"280-285","source":"Crossref","is-referenced-by-count":3,"title":["Cerebellar herniation demonstrated by the occipitum\u2010dens line: Ultrasonography assessment of normal fetuses, fetuses with myelomeningocele, and fetuses that underwent antenatal myelomeningocele surgery"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5426-9433","authenticated-orcid":false,"given":"Enoch Quinder\u00e9 de S\u00e1","family":"Barreto","sequence":"first","affiliation":[{"name":"Department of Obstetrics Paulista School of Medicine\u2014Federal University of S\u00e3o Paulo (EPM\u2010UNIFESP) S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00e9rgio","family":"Cavalheiro","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Paulista School of Medicine\u2014Federal University of S\u00e3o Paulo (EPM\u2010UNIFESP) S\u00e3o Paulo SP Brazil"},{"name":"Hospital and Maternity Santa Joana S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herbene Jos\u00e9 Figuinha","family":"Milani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Paulista School of Medicine\u2014Federal University of S\u00e3o Paulo (EPM\u2010UNIFESP) S\u00e3o Paulo SP Brazil"},{"name":"Hospital and Maternity Santa Joana S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maur\u00edcio Mendes","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Paulista School of Medicine\u2014Federal University of S\u00e3o Paulo (EPM\u2010UNIFESP) S\u00e3o Paulo SP Brazil"},{"name":"Hospital and Maternity Santa Joana S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6145-2532","authenticated-orcid":false,"given":"Edward","family":"Araujo J\u00fanior","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Paulista School of Medicine\u2014Federal University of S\u00e3o Paulo (EPM\u2010UNIFESP) S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciano Marcondes Machado","family":"Nardozza","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Paulista School of Medicine\u2014Federal University of S\u00e3o Paulo (EPM\u2010UNIFESP) S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio Fernandes","family":"Moron","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Paulista School of Medicine\u2014Federal University of S\u00e3o Paulo (EPM\u2010UNIFESP) S\u00e3o Paulo SP Brazil"},{"name":"Hospital and Maternity Santa Joana S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,2,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1014379"},{"key":"e_1_2_6_3_1","first-page":"568","article-title":"The median survival time in open spina bifida","volume":"39","author":"Hunt GM","year":"1997","journal-title":"Dev Med Child Neurol"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1098-2779(2000)6:1<6::AID-MRDD2>3.0.CO;2-B"},{"key":"e_1_2_6_5_1","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780192618849.001.0001","volume-title":"Epidemiology and Control of Neural Tube Defects","author":"Elwood JM","year":"1992"},{"key":"e_1_2_6_6_1","unstructured":"International Center on Birth Defects. 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