{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T18:35:57Z","timestamp":1785522957741,"version":"3.56.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,1,8]],"date-time":"2014-01-08T00:00:00Z","timestamp":1389139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,1,8]],"date-time":"2014-01-08T00:00:00Z","timestamp":1389139200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      <jats:italic>To investigate whether the need for ventriculoperitoneal shunting in neonates with open spina bifida can be predicted prenatally<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      <jats:italic>\n                        This was a retrospective cohort study of all fetuses with open spina bifida identified at a single referral center between 1998 and 2012. Ultrasound records were reviewed and outcomes were ascertained from maternal, neonatal and pediatric records. The performance of screening was determined by receiver\u2013operating characteristics (\n                        <jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content>\n                        ) curve analysis\n                      <\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:italic>We identified 124 cases of isolated open spina bifida, of which 48 were liveborn. Detailed postnatal follow\u2010up was available for 39 cases, with an average follow\u2010up time of 3.6\u2009years. A shunt was inserted in 22 (56.4%) cases. The width of the posterior horn of the lateral ventricle (Vp) and the ratio between its width and that of the cerebral hemisphere (Vp\/H) at diagnosis were significantly greater in cases that required a shunt compared with those that did not subsequently require a shunt (Vp: median 12.4\u2009mm<\/jats:italic>\n                      vs\n                      <jats:italic>7.7\u2009mm<\/jats:italic>\n                      , P\u2009&lt;\u2009\n                      <jats:italic>0.001, and Vp\/H: median 0.54<\/jats:italic>\n                      vs\n                      <jats:italic>0.33<\/jats:italic>\n                      , P\u2009&lt;\u2009\n                      <jats:italic>0.001, respectively). Similarly, at the last scan before delivery, Vp and Vp\/H were significantly higher in those requiring a shunt (Vp: median 23.1\u2009mm<\/jats:italic>\n                      vs\n                      <jats:italic>8.2\u2009mm<\/jats:italic>\n                      , P\u2009&lt;\u2009\n                      <jats:italic>0.001; and Vp\/H: 0.54<\/jats:italic>\n                      vs\n                      <jats:italic>0.21<\/jats:italic>\n                      , P\u2009&lt;\u2009\n                      <jats:italic>0.001, respectively). Using Vp and Vp\/H at the initial assessment, the rates of detection of fetuses requiring a shunt postnatally were 68.2% and 86.4% for a false\u2010positive rate of 13%, with positive likelihood ratios of 6 and 7, respectively. All fetuses with a Vp of \u2265\u200912\u2009mm or a Vp\/H of \u2265\u20090.6 at the time of diagnosis required postnatal shunt insertion (positive predictive value\u2009=\u2009100%)<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      <jats:italic>In cases with open spina bifida the need for a postnatal shunt can be predicted prenatally. This novel observation should be useful in the prediction of outcome and therefore for accurate prenatal counseling and triaging cases for fetal surgery. Copyright \u00a9 2013 ISUOG. Published by John Wiley &amp; Sons Ltd<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.13202","type":"journal-article","created":{"date-parts":[[2013,9,5]],"date-time":"2013-09-05T07:33:02Z","timestamp":1378366382000},"page":"159-164","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Prenatal prediction of need for ventriculoperitoneal shunt in open spina bifida"],"prefix":"10.1002","volume":"43","author":[{"given":"A.","family":"Khalil","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology St George's University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Caric","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology St George's University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Papageorghiou","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology St George's University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Bhide","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology St George's University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Akolekar","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology St George's University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Thilaganathan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Academic Department of Obstetrics and Gynaecology St George's University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,1,8]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)91610-7"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11175"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.05.014"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000335677"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12420"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7329"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10128"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2009.05.002"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2199"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199103073241004"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)17445-X"},{"key":"e_1_2_5_13_1","first-page":"104","article-title":"Symptomatic Chiari malformations in childhood","author":"Oaks W","year":"1992","journal-title":"In Spinal dysraphism"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/neurosurgery\/30.CN_suppl_1.407"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00261592"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.4103\/2152-7806.101801"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3909"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)91022-6"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0378-3782(97)00090-X"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-011-1484-z"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-004-0969-4"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016349.2010.512062"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/jms.7.4.169"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1014379"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.109.3.409"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2003.10.702"}],"container-title":["Ultrasound in Obstetrics &amp; 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