Fetal open spinal dysraphism repair through a mini-hysterotomy: Influence of gestational age at surgery on children's ability to walk

Prenat Diagn. 2021 Dec;41(13):1634-1642. doi: 10.1002/pd.6051. Epub 2021 Oct 26.


Objective: To analyze the impact of gestational age (GA) at the time of fetal open spinal dysraphism (OSD) repair through a mini-hysterotomy on the ability of children to walk.

Methods: Children who underwent in utero repair of OSD and had formal neurological assessment after 2.5 years of age were compared regarding their ability to walk in relation to pre-surgical predictors.

Results: Sixty-nine children fulfilled the inclusion criteria. Among them, 63.7% (44/69) were able to walk with or without orthesis. Fetal OSD correction performed earlier in gestation (from 19.7 to 26.9 weeks) was associated with a higher probability of walking with or without orthesis (p = 0.033). The median GA at delivery was 35.3 weeks. Multivariate binary logistic regression showed that the upper anatomical level of the OSD (<L4 or > L5) (p < 0.004; OR: 10.31 [95% CI: 2.07-51.28]) and GA at the time of fetal surgery (p = 0.026; OR = 0.68 [95% CI: 0.48-0.95]) were independent predictors of the postnatal ability to walk with or without orthesis.

Conclusion: Fetuses with OSD who were operated on earlier in pregnancy (range: 19.7-26.9 weeks), were more likely to walk with or without orthesis.

MeSH terms

  • Adult
  • Child
  • Female
  • Fetal Therapies / methods
  • Fetal Therapies / standards
  • Fetal Therapies / statistics & numerical data
  • Gestational Age*
  • Humans
  • Hysterectomy / methods
  • Hysterectomy / standards*
  • Hysterectomy / statistics & numerical data
  • Pregnancy
  • Retrospective Studies
  • Spinal Dysraphism / complications
  • Spinal Dysraphism / surgery*
  • Walking / statistics & numerical data*