{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T16:52:18Z","timestamp":1762102338254,"version":"3.37.3"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,3,5]],"date-time":"2019-03-05T00:00:00Z","timestamp":1551744000000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100015158","name":"Fondren Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100015158","id-type":"DOI","asserted-by":"crossref"}]},{"name":"O'Quinn Foundation"},{"DOI":"10.13039\/100001877","name":"Sterling Turner Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100001877","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Tramuto Foundation"}],"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>Objective<\/jats:title><jats:p>The effect of fetoscopic myelomeningocele (MMC) repair on fetal growth is unknown. Fetal surgery itself and\/or exposure to a carbon dioxide (CO<jats:sub>2<\/jats:sub>) environment during spina bifida repair may affect placental function and impair fetal growth. Our aim was to assess and compare growth in fetuses, neonates and infants who underwent prenatal fetoscopic or open MMC repair.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fetal biometrics were obtained serially using ultrasound after fetoscopic (<jats:italic>n<\/jats:italic>\u00a0=\u200932) or open hysterotomy (<jats:italic>n<\/jats:italic>\u00a0=\u200934) MMC repair <jats:italic>in utero<\/jats:italic> at a single institution between November 2011 and July 2017. Measurements obtained during growth scans on initial evaluation prior to surgery, and those taken at 6\u2009weeks post\u2010surgery, were transformed into percentiles and compared between groups. Additional neonatal and infant anthropometric measurements, including weight, length\/height and head circumference, were also transformed into percentiles and compared between the groups. The proportions of cases in each group with estimated fetal weight (EFW) or postnatal weight &lt;\u200910<jats:sup>th<\/jats:sup> and &lt;\u20093<jats:sup>rd<\/jats:sup> percentiles were calculated and compared. A linear mixed model was used to analyze the serial fetal growth measurements of each parameter, and random intercepts and slopes were used to compare study variables between the study groups. The duration of surgery (skin\u2010to\u2010skin time at fetoscopic and open MMC repair) and duration of CO<jats:sub>2<\/jats:sub> exposure (fetoscopic repair) were evaluated for any effect on the fetal, neonatal or infant biometric percentiles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fetuses which underwent fetoscopic repair had a larger abdominal circumference percentile at referral (57\u2009\u00b1\u200921 <jats:italic>vs<\/jats:italic> 46\u2009\u00b1\u200923; <jats:italic>P<\/jats:italic>\u00a0=\u20090.04). There were no other differences between the two groups in fetal biometric percentiles at the time of referral, 6\u2009weeks post\u2010surgery or at birth. There were no differences between groups in EFW percentile or in proportions of cases with birth weight &lt;\u200910<jats:sup>th<\/jats:sup> and &lt;\u20093<jats:sup>rd<\/jats:sup> percentiles. Linear mixed\u2010model analysis did not show any significant differences in any fetal growth parameter between the groups over time. There were no significant correlations between duration of surgery or duration of CO<jats:sub>2<\/jats:sub> exposure and any of the biometric percentiles evaluated. Postnatal growth showed no significant differences between the groups in weight, height or head circumference percentiles, at 6\u201318, 18\u201330 or &gt;\u200930\u2009months of age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Babies exposed to fetoscopic or open MMC repair <jats:italic>in\u2010utero<\/jats:italic> did not show significant differences in fetal or postnatal growth parameters. These results support the safety of the use of CO<jats:sub>2<\/jats:sub> gas for fetoscopic surgery. Copyright \u00a9 2019 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.20220","type":"journal-article","created":{"date-parts":[[2019,1,24]],"date-time":"2019-01-24T15:45:00Z","timestamp":1548344700000},"page":"314-323","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Does fetoscopic or open repair for spina bifida affect fetal and postnatal growth?"],"prefix":"10.1002","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0265-9859","authenticated-orcid":false,"given":"M.","family":"Sanz Cortes","sequence":"first","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology, Division of Maternal\u2010Fetal Medicine Baylor College of Medicine &amp; Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.","family":"Davila","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology, Division of Maternal\u2010Fetal Medicine Baylor College of Medicine &amp; Texas Children's Hospital  Houston TX USA"},{"name":"Departmento de Obstetricia y Ginecologia, Hospital Universitario \u2018Dr. Jose E. Gonzalez\u2019 Universidad Autonoma de Nuevo Leon  Monterrey Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Torres","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology, Division of Maternal\u2010Fetal Medicine Baylor College of Medicine &amp; Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Yepez","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology, Division of Maternal\u2010Fetal Medicine Baylor College of Medicine &amp; Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology, Division of Maternal\u2010Fetal Medicine Baylor College of Medicine &amp; Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. V.","family":"Guimaraes","sequence":"additional","affiliation":[{"name":"Department of Radiology Stanford University &amp; Lucile Packard Children's Hospital  Stanford CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Sangi\u2010Haghpeykar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology, Division of Maternal\u2010Fetal Medicine Baylor College of Medicine &amp; Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. E.","family":"Whitehead","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Baylor College of Medicine &amp; Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Castillo","sequence":"additional","affiliation":[{"name":"Department of Developmental Pediatrics Baylor College of Medicine &amp; Texas Children's Hospital  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1924-7965","authenticated-orcid":false,"given":"A. 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