{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:05:36Z","timestamp":1790827536902,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2006,11,6]],"date-time":"2006-11-06T00:00:00Z","timestamp":1162771200000},"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":[[2006,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify criteria useful for differentiating closed from open spina bifida antenatally.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>A retrospective study of cases of spina bifida diagnosed in a referral center between 1997 and 2004.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 66 cases of fetal spina bifida diagnosed at a median gestational age of 21 (range, 16\u201334) weeks, detailed follow\u2010up was available for 57. Of these, open defects were found in 53 (93.0%) and closed defects in four (7.0%). Closed spina bifida was associated in two cases with a posterior cystic mass with thick walls and a complex appearance, while in two cases the spinal lesion could not be clearly differentiated from an open defect, particularly at mid\u2010gestation. Open spina bifida was always associated with typical alterations of cranial anatomy, including the so\u2010called \u2018banana\u2019 and \u2018lemon\u2019 signs, while in closed spina bifida the cranium was unremarkable. When the data were available, levels of amniotic fluid alpha\u2010fetoprotein were always abnormally elevated with open spina bifida and within normal limits with closed forms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this study 7% of cases of spina bifida diagnosed in utero were closed. The differentiation between open and closed forms is best shown by the sonographic demonstration of abnormal or normal cranial anatomy. Copyright \u00a9 2006 ISUOG. 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