Evidence map›Paper›PMID 39425664›Full record

ArticlePrenatal diagnosis2024

Contemporary Outcomes of a National Fetal Spina Bifida Surgery Service.

Charlotte C Kik, Yada Kunpalin, Abhaya V Kulkarni, Abby Varghese, Nimrah Abbasi, Greg Ryan, Philip L J Dekoninck, Paige T Church, Armaan Malhotra, Kamini Raghuram and 2 more

Abstract read
In one paragraph

Article in Prenatal diagnosis, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Charlotte C KikFetal Medicine Unit, Department of Obstetrics and Gynaecology, Mount Sinai Hospital and University of Toronto, Toronto, Canada.ORCID 0000-0002-9667-8486
Yada KunpalinFetal Medicine Unit, Department of Obstetrics and Gynaecology, Mount Sinai Hospital and University of Toronto, Toronto, Canada.
Abhaya V KulkarniDivision of Neurosurgery, Department of Surgery, Hospital for Sick Children and University of Toronto, Toronto, Canada.
Abby VargheseDepartment of Urology, Hospital for Sick Children and University of Toronto, Toronto, Canada.
Nimrah AbbasiFetal Medicine Unit, Department of Obstetrics and Gynaecology, Mount Sinai Hospital and University of Toronto, Toronto, Canada.
Greg RyanFetal Medicine Unit, Department of Obstetrics and Gynaecology, Mount Sinai Hospital and University of Toronto, Toronto, Canada.
Philip L J DekoninckDepartment of Obstetrics and Gynaecology, Division of Obstetrics and Fetal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.ORCID 0000-0002-4457-0940
Paige T ChurchSpina Bifida Clinic, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
Armaan MalhotraDivision of Neurosurgery, Department of Surgery, Hospital for Sick Children and University of Toronto, Toronto, Canada.
Kamini RaghuramDepartment of Pediatrics, Mount Sinai Hospital and University of Toronto, Toronto, Canada.
Edmond KellyDepartment of Pediatrics, Mount Sinai Hospital and University of Toronto, Toronto, Canada.
Tim Van MieghemFetal Medicine Unit, Department of Obstetrics and Gynaecology, Mount Sinai Hospital and University of Toronto, Toronto, Canada.ORCID 0000-0002-3034-6905

Funding

Erasmus Trust FundMount Sinai HospitalSophia Children's Hospital FundSophia Foundation CAM 19-11Ter Meulen FundUniversity of Toronto
6 · The paper itself

Abstract

objectiveTo assess contemporary outcomes of fetuses who underwent open fetal spina bifida surgery in Canada.

methodsOur clinical program prospectively collected outcomes of all consecutive fetuses who underwent open fetal spina bifida closure at the Ontario Fetal Center in Toronto and who were at least 1 year of age at the time of postnatal follow-up. We gathered information on the need for hydrocephalus treatment, motor function, bladder function, as well as neurodevelopment (Ages and Stages Questionnaire and Bayley's scales of infant development). Developmental outcomes were categorized as "Typical Development," "Possible Delay," or "Significantly Delayed."

resultsBetween 2017 and 2022, 41 fetuses underwent open fetal spina bifida closure. Twenty-four patients (58.5%) responded to the questionnaire at a median age of 46.5 months. Eight children (33.3%) required CSF diversion procedures. Bladder management included clean intermittent catheterization (43.5%), spontaneous voiding (34.8%), or both (21.7%), with 43.5% needing medication for overactive bladder. All patients could sit independently, with 50% walking outside and 50% crawling indoors. Among those walking outdoors (50%), 25% did so without orthotics or aid, 58.3% with orthotics, and 16.7% required additional walking aids. Most children demonstrated typical communication and problem-solving skills (79.2%), while gross motor development was significantly delayed in 91.7% of cases. Fine motor skills varied, with 56.5% showing typical development and 34.8% possibly experiencing delays.

conclusionsThis study showed a mixed developmental profile among patients who underwent open fetal spina bifida repair, consistent with the MOMs trial findings.

Indexed as

Spinal DysraphismAdultChild, PreschoolFemaleHumansHydrocephalusInfantMalePregnancyProspective StudiesTreatment Outcome

Identifiers

PMID39425664
PMCPMC11628204

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.