{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T03:44:12Z","timestamp":1779335052490,"version":"3.51.4"},"reference-count":46,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The objective of this study was to determine the effects of in utero bipedicle flaps on maternal-fetal morbidity\/mortality, the need for CSF diversion, and long-term functional outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Eighty-six patients who underwent fetal myelomeningocele repair from 2011 to 2021 at a single institution were reviewed. Primary outcomes included intrauterine fetal demise, postnatal death, postnatal myelomeningocele repair dehiscence, and CSF diversion by final follow-up.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The cohorts were no different with regard to race, ethnicity, maternal age at fetal surgery, body mass index, gravidity, parity, gestational age at fetal surgery, estimated fetal weight at fetal surgery, or fetal lesion level. Of the 86 patients, 64 underwent primary linear repair and 22 underwent bipedicle flap repair. There were no significant differences in rates of intrauterine fetal demise, postnatal mortality, midline repair site dehiscence, or the need for CSF diversion by final follow-up. Operative times were longer (32.5 vs 18.7 minutes, p &lt; 0.001) and gestational age at delivery was lower (232 vs 241 days, p = 0.01) in the bipedicle flap cohort, but long-term functional outcomes were not different.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Analysis of the total cohort affirms the long-term benefits of fetal myelomeningocele repair. In utero bipedicle flaps are safe and can be used for high-tension lesions without increasing perioperative risks to the mother or fetus. In utero flaps preserve the long-term benefits seen with primary linear repair and may expand inclusion criteria for fetal repair, providing life-changing care for more patients.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2022.10.peds22357","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T13:34:29Z","timestamp":1669383269000},"page":"143-150","source":"Crossref","is-referenced-by-count":9,"title":["Intrauterine closure of myelomeningocele defects with primary linear repair versus bipedicle fasciocutaneous flaps: a post-MOMS cohort study with long-term follow-up"],"prefix":"10.3171","volume":"31","author":[{"given":"Matthew E.","family":"Pontell","sequence":"first","affiliation":[{"name":"Departments of Plastic Surgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron M.","family":"Yengo-Kahn","sequence":"additional","affiliation":[{"name":"Neurologic Surgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Taylor","sequence":"additional","affiliation":[{"name":"The Fetal Center at Vanderbilt, Vanderbilt University Medical Center, Nashville;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morgan","family":"Kane","sequence":"additional","affiliation":[{"name":"Pediatric Rehabilitation Services, Monroe Carell Jr. Children\u2019s Hospital at Vanderbilt, Nashville;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J Michael","family":"Newton","sequence":"additional","affiliation":[{"name":"The Fetal Center at Vanderbilt, Vanderbilt University Medical Center, Nashville;"},{"name":"Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly A.","family":"Bennett","sequence":"additional","affiliation":[{"name":"The Fetal Center at Vanderbilt, Vanderbilt University Medical Center, Nashville;"},{"name":"Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John C.","family":"Wellons","sequence":"additional","affiliation":[{"name":"Departments of Plastic Surgery,"},{"name":"The Fetal Center at Vanderbilt, Vanderbilt University Medical Center, Nashville;"},{"name":"The Surgical Outcomes Center for Kids, Monroe Carell Jr. Children\u2019s Hospital at Vanderbilt, Nashville; and"},{"name":"Division of Pediatric Neurosurgery, Monroe Carell Jr. Children\u2019s Hospital at Vanderbilt, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephane A.","family":"Braun","sequence":"additional","affiliation":[{"name":"Departments of Plastic Surgery,"},{"name":"The Fetal Center at Vanderbilt, Vanderbilt University Medical Center, Nashville;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Fetal Diagn Ther","first-page":"271","article-title":"Fetal spina bifida repair\u2014current trends and prospects of intrauterine neurosurgery","volume":"23","author":"Fichter MA","year":"2008","unstructured":"Fichter MA, Dornseifer U, Henke J,  Fetal spina bifida repair\u2014current trends and prospects of intrauterine neurosurgery. 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