{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T10:35:14Z","timestamp":1777631714050,"version":"3.51.4"},"reference-count":31,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Fetal Diagn Ther"],"published-print":{"date-parts":[[2024]]},"abstract":"<b><i>Introduction:<\/i><\/b> The Management of Myelomeningocele Study (MOMS) eligibility criteria preclude in utero surgery for fetal spina bifida (fSB) when the maternal body mass index (BMI) is \u226535 kg\/m<sup>2<\/sup>. Some centers still respect this criterion, while others, like ours, do not. This study aimed to assess whether maternal and fetal safety is compromised with higher maternal BMIs. <b><i>Methods:<\/i><\/b> Data of 192 patients with open fSB repair at our center were retrospectively analyzed. According to their BMI, patients were divided into three groups: group 1 (BMI &lt;30 kg\/m<sup>2<\/sup>), group 2 (BMI 30\u201335 kg\/m<sup>2<\/sup>), and group 3 (BMI &gt;35 kg\/m<sup>2<\/sup>). Subgroup analysis was performed to assess differences in maternal and fetal outcomes. Additionally, complications were divided into grades 1 to 5 according to their severity and outcome consequences and compared among groups. <b><i>Results:<\/i><\/b> Out of 192 patients, 146 (76.0%) had a BMI &lt;30 kg\/m<sup>2<\/sup>, 28 (14.6%) had a BMI 30\u201335 kg\/m<sup>2<\/sup>, and 18 (9.4%) had a BMI &gt;35 kg\/m<sup>2<\/sup>. Significant differences occurring more often in either group 2 or 3 compared to group 1 were maternal wound seroma (50% or 56% vs. 32%, <i>p<\/i> = 0.04), amniotic fluid leakage (14% or 6% vs. 2%, <i>p<\/i> = 0.01) as well as vaginal bleeding (11% or 35% vs. 9%, <i>p<\/i> = 0.01). On the contrary, duration of tocolysis with atosiban was shorter in patients with BMI &gt;30 kg\/m<sup>2<\/sup> (4 or 5 vs. 6 days, <i>p<\/i> = 0.01). When comparing severity of maternal or fetal complications, grade 1 intervention-related complications occurred significantly more often in group 3 compared to group 1 or 2 (78% vs. 45% or 57%, <i>p<\/i> = 0.02). Gestational age at delivery was around 36 weeks in all groups without significant differences. <b><i>Conclusion:<\/i><\/b> This investigation did not identify clinically relevant maternal and\/or fetal outcome problems related to BMIs &gt;35 kg\/m<sup>2<\/sup>. Additional studies are however needed to confirm our results. <\/jats:p>","DOI":"10.1159\/000536071","type":"journal-article","created":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T22:00:31Z","timestamp":1704751231000},"page":"175-183","source":"Crossref","is-referenced-by-count":11,"title":["Fetal Spina Bifida Repair in Obese Mothers: Is Maternal and Fetal Safety 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