{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T11:55:41Z","timestamp":1775390141577,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T00:00:00Z","timestamp":1685664000000},"content-version":"vor","delay-in-days":1,"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":[[2023,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Absent or reversed end\u2010diastolic flow (AREDF) in the umbilical artery (UA) on Doppler is a known phenomenon during fetal interventions, such as fetal open spina bifida (OSB) repair. We aimed to evaluate the clinical importance of these Doppler findings by investigating the impact of UA\u2010AREDF on postoperative, neonatal and 2\u2010year neurodevelopmental outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective study of pregnancies undergoing fetal OSB repair at the Zurich Center for Fetal Diagnosis and Therapy between 2010 and 2019. The group with UA\u2010AREDF during or immediately after the intervention was compared to the group with normal UA Doppler. Primary endpoint was the FIGO scores of cardiotocography (CTG) 1, 2 and 6\u2009h postoperatively and on day\u20091 after surgery. Secondary endpoints were the neonatal parameters and 2\u2010year neurodevelopmental outcome assessed using the Bayley Scales of Infant and Toddler Development, Third Edition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data of 130 patients were analyzed. None of the fetuses had UA\u2010AREDF before OSB repair. Normal UA Doppler was observed in 107 (82%) patients and UA\u2010AREDF was observed in 23 (18%) during or immediately after OSB surgery. UA\u2010AREDF was more often observed after version of the fetus (<jats:italic>P<\/jats:italic>\u2009=\u20090.045). Seventeen (13%) cases had absent end\u2010diastolic flow (UA\u2010AEDF) and six (5%) cases had reversed end\u2010diastolic flow (UA\u2010REDF). UA\u2010AREDF disappeared in all 23 cases within the first day after OSB surgery. One\u2010third of all CTGs were restricted in oscillation after surgery, but no significant difference in CTG 1, 2 and 6\u2009h postoperatively or on the first postoperative day was found between the UA\u2010AREDF and normal\u2010Doppler groups (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). Gestational age at delivery, UA pH, 5\u2010min Apgar score and birth weight were comparable between the two groups, and there was no difference in the 2\u2010year neurodevelopmental outcome (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). The neonatal and 2\u2010year neurodevelopmental outcomes also did not differ significantly between the UA\u2010REDF and UA\u2010AEDF groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Postoperative CTG abnormalities occur and recover at a similar rate in fetuses with transitory UA\u2010AREDF and those with normal Doppler during fetal OSB repair. UA\u2010AREDF during fetal OSB repair did not negatively influence postnatal or 2\u2010year neurodevelopmental outcomes. \u00a9 2022 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.26118","type":"journal-article","created":{"date-parts":[[2022,11,11]],"date-time":"2022-11-11T04:18:43Z","timestamp":1668140323000},"page":"734-739","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact on postoperative, neonatal and 2\u2010year neurodevelopmental outcomes of <scp>UA\u2010AREDF<\/scp> during and after fetal spina bifida repair"],"prefix":"10.1002","volume":"61","author":[{"given":"L.","family":"Ruegg","sequence":"first","affiliation":[{"name":"Department of Obstetrics University Hospital of Zurich  Zurich Switzerland"},{"name":"University of Zurich  Zurich 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Switzerland"},{"name":"Zurich Center for Fetal Diagnosis and Therapy University of Zurich  Zurich Switzerland"},{"name":"Spina Bifida Center University Children's Hospital Zurich  Zurich Switzerland"},{"name":"Department of Pediatric Surgery University Children's Hospital Zurich  Zurich Switzerland"},{"name":"Children's Research Center University Children's Hospital Zurich  Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Mazzone","sequence":"additional","affiliation":[{"name":"University of Zurich  Zurich Switzerland"},{"name":"Zurich Center for Fetal Diagnosis and Therapy University of Zurich  Zurich Switzerland"},{"name":"Spina Bifida Center University Children's Hospital Zurich  Zurich Switzerland"},{"name":"Department of Pediatric Surgery University Children's Hospital Zurich  Zurich Switzerland"},{"name":"Children's Research Center University Children's Hospital Zurich  Zurich 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