{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:23:56Z","timestamp":1788870236630,"version":"build-2803163510"},"reference-count":45,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"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":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the occurrence of fetal bradycardia in open versus fetoscopic fetal spina bifida surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a single\u2010institution retrospective cohort study of patients undergoing open (<jats:italic>n<\/jats:italic>\u00a0=\u00a025) or fetoscopic (<jats:italic>n<\/jats:italic>\u00a0=\u00a026) spina bifida repair between 2017 and 2022. From October 2017 to June 2020, spina bifida repairs were performed via an open classical hysterotomy, and from November 2020 to June 2022 fetoscopic repairs were performed following transition to this technique. Fetal heart rate (FHR) in beats per minute (bpm) was recorded via echocardiography every 15\u00a0min during the procedure. Cohort characteristics, fetal bradycardia and maternal physiologic parameters were compared between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fetuses undergoing an open repair more frequently developed bradycardia defined as &lt;110 bpm (32% vs. 3.8%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.008), and a trend was observed for FHR decreases more than 25 bpm from baseline (20% vs. 3.8%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.073). Profound bradycardia less than 80 bpm was rare, occurring in only three operations (two in open, one in fetoscopic repair) with two fetuses (one in each group) requiring emergency cesarean delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>When compared to open fetal surgery, fetal bradycardia occurred less frequently in fetoscopic surgery despite a significantly greater anesthetic exposure and the use of the intraamniotic carbon dioxide insufflation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.6626","type":"journal-article","created":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T03:05:51Z","timestamp":1718420751000},"page":"1088-1097","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Fetal bradycardia in open versus fetoscopic prenatal repair of spina bifida"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6576-1631","authenticated-orcid":false,"given":"Steven T.","family":"Papastefan","sequence":"first","affiliation":[{"name":"Department of Surgery The Chicago Institute for Fetal Health Ann and Robert H. 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Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0414-9606","authenticated-orcid":false,"given":"Daniel R.","family":"Liesman","sequence":"additional","affiliation":[{"name":"Department of Surgery The Chicago Institute for Fetal Health Ann and Robert H. Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0240-4649","authenticated-orcid":false,"given":"Morgan M.","family":"Langereis","sequence":"additional","affiliation":[{"name":"Department of Surgery The Chicago Institute for Fetal Health Ann and Robert H. 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Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Department of Obstetrics and Gynecology Rush University Medical Center  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0064-2399","authenticated-orcid":false,"given":"Michelle A.","family":"Kominiarek","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Division of Maternal Fetal Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2820-3574","authenticated-orcid":false,"given":"Robin M.","family":"Bowman","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery Ann and Robert H. 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