{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T07:25:34Z","timestamp":1775028334128,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,11,3]],"date-time":"2014-11-03T00:00:00Z","timestamp":1414972800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess maternal morbidity and outcome in women undergoing minimal\u2010access fetoscopic surgery for spina bifida aperta.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective study of 51 women undergoing minimal\u2010access fetoscopic surgery to improve postnatal neurological outcome of spina bifida aperta, at a mean gestational age of 24 weeks, at our center between July 2010 and June 2013. We analyzed various perioperative complications of surgery, namely: maternal and fetal death, need for maternal blood transfusion, placental abruption, pulmonary edema, spontaneous labor, oligohydramnios, chorioamnionitis, chorioamniotic membrane separation, duration of hospitalization, amniotic fluid leakage, gestational age at delivery and status of hysterotomy site.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In none of the 51 women was there maternal demise, spontaneous labor, placental abruption or a need for maternal blood transfusion in the perioperative period. Chorioamniotic membrane separation occurred in one patient, mild pulmonary edema occurred in one and oligohydramnios occurred in seven. All fetuses survived surgery, but there was one very early preterm delivery 1\u2009week after the procedure and this neonate died immediately, from early postoperative chorioamnionitis. Amniotic fluid leakage occurred in 43 patients, at a mean gestational age of 29.7 (range, 22.6\u201337.3) weeks; two of these patients developed chorioamnionitis. Duration of maternal hospitalization after surgery was 7.2 (range, 4\u201312) days. Mean gestational age at delivery was 33 (range, 24.6\u201338.1) weeks. All abdominal and uterine trocar insertion sites healed well.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Minimal\u2010access fetoscopic surgery for spina bifida aperta is apparently safe for most maternal patients. Despite the common occurrence of amniotic leakage, the majority of women deliver beyond 32 weeks of gestation. Copyright \u00a9 2014 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.13389","type":"journal-article","created":{"date-parts":[[2014,4,21]],"date-time":"2014-04-21T11:14:42Z","timestamp":1398078882000},"page":"525-531","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":99,"title":["Percutaneous minimal\u2010access fetoscopic surgery for spina bifida aperta. Part <scp>II<\/scp>: maternal management and outcome"],"prefix":"10.1002","volume":"44","author":[{"given":"J.","family":"Degenhardt","sequence":"first","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology University of Giessen\u2010Marburg  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Sch\u00fcrg","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Giessen\u2010Marburg  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Winarno","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology University of Giessen\u2010Marburg  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Oehmke","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology University of Giessen\u2010Marburg  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Khaleeva","sequence":"additional","affiliation":[{"name":"German Center for Fetal Surgery &amp; Minimally Invasive Therapy (DZFT) University of Giessen\u2010Marburg  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Kawecki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology University of Giessen\u2010Marburg  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Enzensberger","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology University of Giessen\u2010Marburg  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.\u2010R.","family":"Tinneberg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology University of Giessen\u2010Marburg  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Faas","sequence":"additional","affiliation":[{"name":"Department of Neonatology University of Giessen\u2010Marburg  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Ehrhardt","sequence":"additional","affiliation":[{"name":"Department of Neonatology University of Giessen\u2010Marburg  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Axt\u2010Fliedner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology University of Giessen\u2010Marburg  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Kohl","sequence":"additional","affiliation":[{"name":"German Center for Fetal Surgery &amp; Minimally Invasive Therapy (DZFT) University of Giessen\u2010Marburg  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,11,3]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.grf.0000184799.17975.e9"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000067560"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1014379"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe1101228"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(97)80050-6"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000020981"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004640000129"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004649900462"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-002-9184-0"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000089301"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aep016"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-008-0153-0"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199804001-00142"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(96)90024-X"},{"key":"e_1_2_5_16_1","first-page":"69","volume-title":"Anesthesia for Fetal Intervention and Surgery","author":"Myers LB","year":"2005"},{"key":"e_1_2_5_17_1","unstructured":"Neue Z\u00fcrcher Zeitung.Spina Bifida: The best for Karl Felix.http:\/\/www.nzz.ch\/wissen\/wissenschaft\/das\u2010beste\u2010fuer\u2010karl\u2010felix\u20101.18121596[Accessed 11 March 2014]."},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3468(95)90009-8"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2000.108871"},{"key":"e_1_2_5_20_1","first-page":"644A","article-title":"Impact of fetoscopic versus open fetal surgery on fetoplacental blood flow and outcome in human fetuses. 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