{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T08:55:10Z","timestamp":1770540910435,"version":"3.49.0"},"reference-count":49,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,2,11]],"date-time":"2019-02-11T00:00:00Z","timestamp":1549843200000},"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;amp; Gyne"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To report on the prenatal ultrasonographic diagnosis of spina bifida (SB) and its natural history, treatment and long\u2010term outcome in a large tertiary referral center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All cases of SB diagnosed between February 1980 and December 2015 in the Obstetric Prenatal Diagnosis Day Unit of the Obstetrics and Gynecology Department at the Catholic University of the Sacred Heart, Rome, were reviewed. All infants with an open defect were delivered by elective Cesarean section and underwent early repair of the spinal defect. A ventriculoperitoneal (VP) shunt and\/or third ventriculostomy was performed when needed. Complete postnatal follow\u2010up was carried out by our multidisciplinary team in the majority of cases. The cohort was analyzed in two groups: Group 1 included patients referred between February 1980 and December 1999; Group 2 included patients referred between January 2000 and December 2015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was a total of 222 cases of SB with a prenatal diagnosis rate of 94.6% (<jats:italic>n<\/jats:italic>\u2009=\u2009210), with the majority of defects being meningomyeloceles (<jats:italic>n<\/jats:italic>\u2009=\u2009142 (64.0%)), affecting the lumbosacral level (<jats:italic>n<\/jats:italic>\u2009=\u2009110 (49.5%)) and being \u2265\u20092\u2009cm in size (<jats:italic>n<\/jats:italic>\u2009=\u2009163\/195 (83.6%)). There were 174 (78.4%) live births, with more terminations in Group 2 (26.1%) than in Group 1 (10.8%;<jats:italic>P<\/jats:italic>\u2009=\u20090.003). Postnatal surgical repair was conducted in 157 cases (99.4% of eligible cases), with death of an infant who was operated on occurring more often in Group 1 (14.1%) than in Group 2 (4.2%;<jats:italic>P<\/jats:italic>\u2009=\u20090.03). VP shunt placement was required in 60.3% of infants operated on after January 2000. Long\u2010term follow\u2010up was available for 136 children (111 with open defects and 25 with closed defects). Infants born since 2000 with an open defect had normal ambulation or a mild defect in 50% of cases and normal or mild deficit of sphincter function in 37.8% of cases. An intelligence quotient of \u2265\u200970 was observed in the majority of children (81.4%; 35\/43 cases). Worse motor function was associated with progressive prenatal ventriculomegaly, level of lesion and VP shunt placement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We describe the prenatal diagnosis, natural history and long\u2010term outcome of a large contemporary cohort of SB fetuses and infants. In an era of pioneering fetal surgical techniques for<jats:italic>in\u2010utero<\/jats:italic>SB repair, it is important to acknowledge that advances in conventional neonatology and pediatric neurosurgery have allowed increased life expectancy and improved quality of life in patients with SB. Copyright \u00a9 2018 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.20136","type":"journal-article","created":{"date-parts":[[2018,10,6]],"date-time":"2018-10-06T02:53:37Z","timestamp":1538794417000},"page":"302-308","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Prenatal diagnosis, natural history, postnatal treatment and outcome of 222 cases of spina bifida: experience of a tertiary center"],"prefix":"10.1002","volume":"53","author":[{"given":"L.","family":"Masini","sequence":"first","affiliation":[{"name":"Department of Women and Child Health, Obstetrics and Neonatology Area, Centro Studi per la Tutela della Salute della Madre e del Concepito Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2358-2993","authenticated-orcid":false,"given":"C.","family":"De Luca","sequence":"additional","affiliation":[{"name":"Department of Women and Child Health, Obstetrics and Neonatology Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Noia","sequence":"additional","affiliation":[{"name":"Department of Women and Child Health, Obstetrics and Neonatology Area, Centro Studi per la Tutela della Salute della Madre e del Concepito Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Caruso","sequence":"additional","affiliation":[{"name":"Department of Women and Child Health, Obstetrics and Neonatology Area, Centro Studi per la Tutela della Salute della Madre e del Concepito Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Lanzone","sequence":"additional","affiliation":[{"name":"Department of Women and Child Health, Obstetrics and Neonatology Area, Centro Studi per la Tutela della Salute della Madre e del Concepito Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Rendeli","sequence":"additional","affiliation":[{"name":"Spina Bifida Center, Department of Women and Child Health, Paediatrics Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Ausili","sequence":"additional","affiliation":[{"name":"Spina Bifida Center, Department of Women and Child Health, Paediatrics Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Massimi","sequence":"additional","affiliation":[{"name":"Paediatric Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Tamburrini","sequence":"additional","affiliation":[{"name":"Paediatric Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Apicella","sequence":"additional","affiliation":[{"name":"Department of Women and Child Health, Obstetrics and Neonatology Area, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"De Santis","sequence":"additional","affiliation":[{"name":"Department of Women and Child Health, Obstetrics and Neonatology Area, Centro Studi per la Tutela della Salute della Madre e del Concepito Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,2,11]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/tera.1420340206"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2005.03.009"},{"key":"e_1_2_5_4_1","unstructured":"Istituto Superiore di Sanit\u00e0[National register of rare diseases: congenital malformation and folic acid] Registro Nazionale Malattie Rare: malformazioni congenite e acido folico [webpage on the Internet]PieriniA BianchiF SalernoP TaruscioD editors. Rome Italy: Istituto Superiore di Sanit\u00e02006. Available from:http:\/\/www.iss.it\/binary\/acid4\/cont\/2006_6_34.pdf. [Accessed October 4 2016]."},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1995.tb11287.x"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2170"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.584"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-199910000-00014"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000364806"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)91610-7"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4524"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1980.tb04453.x"},{"key":"e_1_2_5_13_1","first-page":"54","article-title":"Early diagnosis of spina bifida: the value of cranial ultrasound markers","volume":"76","author":"Thiagarajah S","year":"1990","journal-title":"Obstet Gynecol"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23086"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2013.10.006"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016349.2010.512062"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-016-3165-4"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2006.04.042"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-016-3105-3"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-39546-3_22"},{"key":"e_1_2_5_21_1","unstructured":"Societ\u00e0 italiana di Ecografia Ostetrica e ginecologica.Linee Guida. Edizione 2015. Editeam Gruppo Editoriale: Cento (FE) Italy 2015;23\u201331."},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8831"},{"key":"e_1_2_5_23_1","volume-title":"WAIS. Scala d'Intelligenza Wechsler per Adulti","author":"Wechsler D","year":"1974"},{"key":"e_1_2_5_24_1","volume-title":"Scala d'intelligenza Wechsler per bambini","author":"Wechsler D.","year":"1987"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-999603"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.1999.780605.x"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4533"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8061"},{"key":"e_1_2_5_29_1","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1111\/j.1469-8749.1996.tb12098.x","article-title":"School\u2010aged children with spina bifida in Western Australia\u00a0\u2013\u00a0parental perspectives on functional outcome","volume":"38","author":"Kalucy M","year":"1996","journal-title":"Dev Med Child Neurol"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2014.09.039"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2013.02.015"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1014379"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-2114"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.3171\/2015.7.PEDS15336"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.07.052"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181eeb251"},{"key":"e_1_2_5_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.09.016"},{"key":"e_1_2_5_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.03.029"},{"key":"e_1_2_5_39_1","volume-title":"Report of a WHO technical consultation on birth spacing","author":"World Health organization","year":"2006"},{"key":"e_1_2_5_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002303"},{"key":"e_1_2_5_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.09.065"},{"key":"e_1_2_5_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15987"},{"key":"e_1_2_5_43_1","doi-asserted-by":"publisher","DOI":"10.1159\/000479505"},{"key":"e_1_2_5_44_1","doi-asserted-by":"publisher","DOI":"10.1159\/000318201"},{"key":"e_1_2_5_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scr.2017.05.003"},{"key":"e_1_2_5_46_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0036-1592316"},{"key":"e_1_2_5_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001512"},{"key":"e_1_2_5_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-012-1047-2"},{"key":"e_1_2_5_49_1","doi-asserted-by":"publisher","DOI":"10.2174\/157018010791163442"},{"key":"e_1_2_5_50_1","first-page":"31","volume-title":"Neural Tube Defects: Prevalence, Pathogenesis and Prevention","author":"De Luca C","year":"2013"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.20136","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.20136","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T02:50:56Z","timestamp":1720666256000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.20136"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,11]]},"references-count":49,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1002\/uog.20136"],"URL":"https:\/\/doi.org\/10.1002\/uog.20136","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,11]]},"assertion":[{"value":"2017-10-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}