| Can prenatal ultrasound findings predict ambulatory status in fetuses with open spina bifida? | |
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MedLine Citation:
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PMID: 11717624 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine whether prenatal sonographic findings in fetuses with open spina bifida can predict ambulatory potential and the need for postnatal shunt placement. STUDY DESIGN: Ongoing pregnancies complicated by isolated open spina bifida from January 1996 to March 2000 were studied retrospectively. Static images and reports generated every 3-4 weeks from diagnosis until delivery were reviewed for lesion level and type, ventricular width, and lower extremity appearance. Operative summaries as well as neonatal and pediatric charts were reviewed. Ambulatory was defined in infants > or =2 years old as walking with or without appliances. In those <2 years of age, ambulatory was defined as at least 4/5 lower extremity muscle strength. RESULTS: Thirty-three cases of isolated open spina bifida were identified. Lower (more caudal) lesion levels and smaller ventricular size were associated with ambulatory status in univariate analyses (P <.001, P =.003, respectively). No infant with a thoracic lesion was ambulatory (n = 11); all had ventriculomegaly diagnosed prenatally and all required shunt placement. In contrast, all infants with L4-sacral lesions (n = 10) were ambulatory, and 60% had ventriculomegaly diagnosed prenatally. Of patients with L1-L3 lesions (n = 12), 50% were ambulatory. In this group, ambulatory potential could not be determined by the presence of ventriculomegaly, ventricular size, or the presence of club foot. In the entire cohort, no infant with a myeloschisis was ambulatory, and all infants except one with a sacral lesion required postnatal shunt placement. CONCLUSIONS: Sonographic determination of lesion level and type is useful in predicting the ambulatory potential of fetuses with open spina bifida. |
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Authors:
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J R Biggio; J Owen; K D Wenstrom; W J Oakes |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: 185 ISSN: 0002-9378 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 2001 Nov |
Date Detail:
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Created Date: 2001-11-21 Completed Date: 2001-12-19 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 1016-20 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Reproductive Genetics, University of Alabama at Birmingham, 35249-7333, USA. jbiggioj@uab.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cerebrospinal Fluid Shunts Female Forecasting Humans Infant, Newborn Pregnancy Prospective Studies Spinal Dysraphism / physiopathology*, surgery, ultrasonography* Ultrasonography, Prenatal* Walking* |
| Comments/Corrections | |
Comment In:
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Am J Obstet Gynecol. 2002 Jul;187(1):256; author reply 256
[PMID:
12114925
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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