{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T10:33:40Z","timestamp":1790332420982,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,1,13]],"date-time":"2016-01-13T00:00:00Z","timestamp":1452643200000},"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":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To report our preliminary experience in the use of prenatal ultrasound examination to assess lower\u2010limb movements in fetuses with myelomeningocele. We aimed to determine the accuracy of this method to establish the segmental level of neurological lesion, as this is the best known predictor of the future ability to walk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a preliminary, observational study including fetuses with myelomeningocele operated on prenatally. The patterns of movements present and absent in the affected fetuses' lower limbs were evaluated systematically by ultrasound examination. According to the known nerve function associated with each muscle group, the segmental level of neurological lesion was established before birth. The agreement for the segmental levels assigned, between the prenatal ultrasound technique and the classical neurological clinical examination after birth (gold standard), was tested using the weighed kappa (w\u03ba) index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010one fetuses with myelomeningocele were evaluated at the Hospital Universitari Vall d'Hebron. After counseling, the parents opted for prenatal surgery (26 cases), termination of pregnancy (43 cases) or postnatal repair (two cases). Five patients did not fulfil the inclusion criteria for prenatal surgery and three were excluded after birth. In the 18 fetuses that underwent surgery and were analyzed, the agreement between prenatal and postnatal segmental levels assigned was 91.7% for the right limb (w\u03ba = 0.80) and 88.9% for the left limb (w\u03ba = 0.73).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The agreement found between prenatal and postnatal assignment of level of lesion in this preliminary study suggests that neurological sonographic evaluation is feasible before birth. This may provide accurate individualized information about the motor function and future ambulation prognosis of fetuses with myelomeningocele. Copyright \u00a9 2015 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.15732","type":"journal-article","created":{"date-parts":[[2015,8,26]],"date-time":"2015-08-26T09:55:05Z","timestamp":1440582905000},"page":"162-167","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["Prenatal ultrasound evaluation of segmental level of neurological lesion in fetuses with myelomeningocele: development of a new technique"],"prefix":"10.1002","volume":"47","author":[{"given":"E.","family":"Carreras","sequence":"first","affiliation":[{"name":"Maternal\u2010Fetal Medicine, Hospital Universitari Vall d'Hebron Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Maroto","sequence":"additional","affiliation":[{"name":"Maternal\u2010Fetal Medicine, Hospital Universitari Vall d'Hebron Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Illescas","sequence":"additional","affiliation":[{"name":"Maternal\u2010Fetal Medicine, Hospital Universitari Vall d'Hebron Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Mel\u00e9ndez","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Ar\u00e9valo","sequence":"additional","affiliation":[{"name":"Maternal\u2010Fetal Medicine, Hospital Universitari Vall d'Hebron Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. L.","family":"Peir\u00f3","sequence":"additional","affiliation":[{"name":"Paediatric Surgery Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. G.","family":"Garc\u00eda\u2010Fontecha","sequence":"additional","affiliation":[{"name":"Paediatric Orthopaedic Surgery Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Belfort","sequence":"additional","affiliation":[{"name":"Maternal\u2010Fetal Medicine Texas Children's Hospital  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Cuxart","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,1,13]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ddrr.93"},{"key":"e_1_2_5_3_1","first-page":"213","article-title":"Fetal spina bifida in a mouse model: loss of neural function in utero","volume":"106","author":"Stiefel D","year":"2007","journal-title":"J Neurosurg"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2012.10.003"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2009.05.002"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2011.04049.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.114.2.427"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2011.04148.x"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1014379"},{"key":"e_1_2_5_10_1","first-page":"106","article-title":"The segmental innervation of the lower limb muscles in man","volume":"35","author":"Sharrard WJ","year":"1964","journal-title":"Ann R Coll Surg Engl"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.46.248.539"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2010.12.046"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-013-2984-6"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2009.06.022"},{"key":"e_1_2_5_15_1","first-page":"426","volume-title":"Fundamentals of Biostatistics","author":"Rosner B.","year":"1995"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)91022-6"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6423"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0378-3782(97)00090-X"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.185.1.1523291"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000364806"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1203\/PDR.0b013e31815ed03e"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.2740"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-013-2178-5"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1159\/000363738"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.15732","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.15732","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T17:41:58Z","timestamp":1738345318000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.15732"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1,13]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,2]]}},"alternative-id":["10.1002\/uog.15732"],"URL":"https:\/\/doi.org\/10.1002\/uog.15732","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,1,13]]},"assertion":[{"value":"2015-04-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-08-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-01-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}