{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T08:49:15Z","timestamp":1783068555280,"version":"3.54.6"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,1,2]],"date-time":"2021-01-02T00:00:00Z","timestamp":1609545600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"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":[[2021,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This observational study reports on the postnatal mortality and 30\u2010month outcome of children who underwent fully percutaneous fetoscopic repair of myelomeningocele (MMC) at a single center in Giessen, Germany.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between October 2010 and August 2014, a total of 72 patients underwent fully percutaneous fetoscopic MMC closure at 21\u2009+\u20090 to 29\u2009+\u20091 (mean, 23\u2009+\u20095) weeks' gestation. Of these, 52 (72%) participated in this study; however, 30\u2010month mortality data are available for all 72 children. Children were examined at four timepoints: shortly after birth and at 3\u2009months, 12\u2009months and 30\u2009months of corrected age. The patients underwent age\u2010specific standardized neurological examinations and assessment of leg movements and ambulation at all timepoints. Cognitive and motor development were assessed using the Bayley Scales of Infant Development, second edition (BSID\u2010II), at 30\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All 72 children survived the intrauterine procedure, however, four (5.6%) infants died postnatally (including two of the 52 comprising the study cohort). Of the 52 patients included in the study, 11.5% were delivered before the 30\n                      <jats:sup>th<\/jats:sup>\n                      week of gestation (mean, 33\u2009+\u20091\u2009weeks) and, of the survivors, 48.1% had ventriculoperitoneal shunt placement. Of the 50 infants that were alive at 30\u2009months, independent ambulation, without orthosis, was feasible for 46%. At 30\u2009months of follow\u2010up, 46% of children presented with a functional level that was at least two segments better than the anatomical level of the lesion. At 30\u2009months, 70% of the children presented with BSID\u2010II psychomotor development index score of \u2265\u200970 and 80% with BSID\u2010II mental development index score of \u2265\u200970.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Intrauterine repair of MMC by percutaneous fetoscopy shows largely similar outcomes to those reported for open repair, with respect to mortality, prematurity, shunt\u2010placement rates, motor and mental development and free ambulation. \u00a9 2020 The Authors.\n                      <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic>\n                      published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.22116","type":"journal-article","created":{"date-parts":[[2020,6,8]],"date-time":"2020-06-08T10:09:52Z","timestamp":1591610992000},"page":"113-118","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Fully percutaneous fetoscopic repair of myelomeningocele: 30\u2010month follow\u2010up data"],"prefix":"10.1002","volume":"57","author":[{"given":"D.","family":"Diehl","sequence":"first","affiliation":[{"name":"Department of Pediatric Neurology University Hospital Giessen\u2010Marburg  Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Belke","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology University Hospital Giessen\u2010Marburg  Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Kohl","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Justus\u2010Liebig\u2010University Giessen  Giessen Germany"},{"name":"German Center for Fetal Surgery &amp; Minimally Invasive Therapy (DZFT) University of Mannheim (UMM)  Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Axt\u2010Fliedner","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Justus\u2010Liebig\u2010University Giessen  Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Degenhardt","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Justus\u2010Liebig\u2010University Giessen  Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Khaleeva","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Justus\u2010Liebig\u2010University Giessen  Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Oehmke","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Justus\u2010Liebig\u2010University Giessen  Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Faas","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Neonatology Justus\u2010Liebig\u2010University Giessen  Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Ehrhardt","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Neonatology Justus\u2010Liebig\u2010University Giessen  Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Kolodziej","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Justus\u2010Liebig\u2010University Giessen  Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Uhl","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Justus\u2010Liebig\u2010University Giessen  Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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