{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T03:19:19Z","timestamp":1785467959698,"version":"3.56.0"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T00:00:00Z","timestamp":1710806400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate whether prenatal repair of spina bifida aperta through mini\u2010hysterotomy results in less prematurity, as compared to standard hysterotomy, when adjusting for known prematurity risks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a bi\u2010centric, propensity score matched, controlled study, that is, adjusting for factors earlier reported to result in premature delivery or membrane rupture, in consecutive women having prenatal repair either through stapled hysterotomy or sutured mini\u2010hysterotomy (\u22643.5\u00a0cm). Matches were pairwise compared and cox\u2010regression analysis was performed to define the hazard ratio of delivery &lt;37\u00a0weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 346 meeting the MOMS\u2010criteria, 78 comparable pairs were available for matched\u2010controlled analysis. Mini\u2010hysterotomy patients were younger and had a higher BMI. Mini\u2010hysterotomy was associated with a 1.67\u2010lower risk of delivery &lt;37\u00a0weeks (hazard ratio: 0.60; 95% CI: 0.42\u20130.85; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.004) and 1.72 for delivery &lt;34\u00a0+\u00a06\u00a0weeks (hazard ratio: 0.58; 95% CI: 0.34\u20130.97; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.037). The rate of intact uterine scar at birth (mini\u2010hysterotomy: 98.7% vs. hysterotomy: 90.4%; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.070), the rate of reversal of hindbrain herniation within 1\u00a0week after surgery (88.9% vs. 97.4%; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.180) and the rate of cerebrospinal fluid leakage (0% vs. 2.7%; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.50) were comparable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Prenatal spina bidifa repair through mini\u2010hysterotomy was associated with a later gestational age at delivery and a comparable intact uterus rate without apparent compromise in neuroprotection.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.6547","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T14:30:02Z","timestamp":1710858602000},"page":"644-652","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Length of hysterotomy for fetal spina bifida repair is associated with prematurity risk"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5622-4183","authenticated-orcid":false,"given":"Kanokwaroon","family":"Watananirun","sequence":"first","affiliation":[{"name":"My FetUZ Fetal Research Center Department of Development and Regeneration Cluster Women and Child Biomedical Sciences KU Leuven  Leuven Belgium"},{"name":"Maternal and Fetal Medicine Unit Department of Obstetrics and Gynecology Faculty of Medicine Siriraj Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna M. 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F.","family":"Vargas","sequence":"additional","affiliation":[{"name":"The Heart Hospital of Sao Paulo  Sao Paulo Brazil"},{"name":"PROADI\u2010Ministry of Health  Sao Paulo Brazil"},{"name":"Gestar Fetal Surgery Center  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simen","family":"Vergote","sequence":"additional","affiliation":[{"name":"My FetUZ Fetal Research Center Department of Development and Regeneration Cluster Women and Child Biomedical Sciences KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9884-5778","authenticated-orcid":false,"given":"Liesbeth","family":"Lewi","sequence":"additional","affiliation":[{"name":"My FetUZ Fetal Research Center Department of Development and Regeneration Cluster Women and Child Biomedical Sciences KU Leuven  Leuven Belgium"},{"name":"Clinical Department of Obstetrics and Gynaecology University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo O. L.","family":"Filippo","sequence":"additional","affiliation":[{"name":"The Heart Hospital of Sao Paulo  Sao Paulo Brazil"},{"name":"PROADI\u2010Ministry of Health  Sao Paulo Brazil"},{"name":"Gestar Fetal Surgery Center  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"McCulloch","sequence":"additional","affiliation":[{"name":"IDEAL Collaboration Nuffield Department of Surgical Sciences University of Oxford  Oxford UK"},{"name":"IDEAL Collaboration Nuffield Department of Surgery Oxford University Hospitals John Radcliffe Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7837-4684","authenticated-orcid":false,"given":"Roland","family":"Devlieger","sequence":"additional","affiliation":[{"name":"My FetUZ Fetal Research Center Department of Development and Regeneration Cluster Women and Child Biomedical Sciences KU Leuven  Leuven Belgium"},{"name":"Clinical Department of Obstetrics and Gynaecology University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7279-5311","authenticated-orcid":false,"given":"Cleisson F. 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