{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:23:52Z","timestamp":1788870232946,"version":"build-2803163510"},"reference-count":6,"publisher":"S. Karger AG","issue":"5","license":[{"start":{"date-parts":[[2003,1,1]],"date-time":"2003-01-01T00:00:00Z","timestamp":1041379200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2003,1,1]],"date-time":"2003-01-01T00:00:00Z","timestamp":1041379200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Fetal Diagn Ther"],"published-print":{"date-parts":[[2003]]},"abstract":"<i>Objective:<\/i> To review the incidence of posthysterotomy chorioamniotic membrane separation and delivery outcome following open fetal surgery [myelomeningocele (MMC); cystic adenomatoid malformation (CCAM); congenital diaphragmatic hernia (CDH); sacrococcygeal teratoma (SCT)]. <i>Study Design:<\/i> Retrospective review of a maternal population undergoing open fetal surgery at a single tertiary level program (1998\u20132001) following the initiation of close postoperative ultrasound follow-up for membrane separation. Onset of membrane separation was coded as not present (NP), immediate (<2 weeks) or delayed (>2 weeks) from day of surgery. <i>Results:<\/i> Fifty-three charts were reviewed: MMC 43, CCAM 7, CDH 1, and SCT 2. In the MMC group there were 26 NP, 8 immediate, and 9 delayed. Preterm labor occurred in 4 patients with only 2 having had membrane separation. Risk of membrane separation is increased for surgery done at less than 23 weeks gestation (p < 0.005). Delay from MMC surgery to delivery was 11.0, 9.8, 12.0 weeks for NP, immediate, and delay, respectively. In the MMC group, there were 3 neonatal deaths (NND) at 9, 9, and 21 days post surgery (PROM\/PTL; chorioamnionitis, PROM\/PTL, respectively). No membrane separation was present in the CCAM, CDH, and SCT cases. <i>Conclusions: <\/i>(1) Membrane separation was significantly more likely to occur if surgery was performed prior to 23 weeks. (2) Membrane separation post hysterotomy (17\/50 = 34%) may be associated with an increased risk of PROM but not delivery before 30 weeks gestation. (3) Delivery prior to 33 weeks gestation for MMC groups was 12\/43 (28%) with 3 NND (7%). (4) Elective delivery at 36\u201337 weeks gestation was possible for 43% of the fetal surgery population.<\/jats:p>","DOI":"10.1159\/000071972","type":"journal-article","created":{"date-parts":[[2003,8,18]],"date-time":"2003-08-18T08:23:26Z","timestamp":1061195006000},"page":"314-320","source":"Crossref","is-referenced-by-count":56,"title":["Chorioamniotic Membrane Separation following Open Fetal Surgery: Pregnancy Outcome"],"prefix":"10.1159","volume":"18","author":[{"given":"R. Douglas","family":"Wilson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark P.","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy M.","family":"Crombleholme","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan W.","family":"Flake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly L.","family":"Hedrick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"King","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori J.","family":"Howell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. Scott","family":"Adzick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2003,8,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.19.1873"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.19.1819"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.19.1826"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(95)90640-1"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1159\/000048010"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.113127"}],"container-title":["Fetal Diagnosis and Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/71972","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/71972","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T03:34:42Z","timestamp":1745465682000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000071972"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003]]},"references-count":6,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2003,10,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000071972","archive":["Portico"],"relation":{},"ISSN":["1015-3837","1421-9964"],"issn-type":[{"value":"1015-3837","type":"print"},{"value":"1421-9964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003]]}}}