Evidence map›Paper›PMID 41903159›Full record

ArticlePrenatal diagnosis2026

Fetal Instability and Resuscitative Management During Fetal Intervention: A Retrospective, Descriptive Analysis of 245 Fetal Cardiac and Spina Bifida Procedures.

Claire A Naus, Betul Yilmaz Furtun, Jessian L Munoz, Rebecca M Johnson, Carolyn A Altman, Michael A Belfort, Luc Joyeux, Alice King, David G Mann, Shaine Morris and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Prenatal diagnosis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Claire A NausDepartment of Anesthesiology, Perioperative, and Pain Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.ORCID https://orcid.org/0000-0002-7818-356X
Betul Yilmaz FurtunDivision of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.ORCID https://orcid.org/0000-0002-9600-7498
Jessian L MunozDepartment of Obstetrics and Gynecology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.
Rebecca M JohnsonDepartment of Obstetrics and Gynecology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.ORCID https://orcid.org/0000-0003-0517-5769
Carolyn A AltmanDivision of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.
Michael A BelfortDepartment of Obstetrics and Gynecology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.
Luc JoyeuxDivision of Pediatric Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
Alice KingDivision of Pediatric Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
David G MannDepartment of Anesthesiology, Perioperative, and Pain Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
Shaine MorrisDivision of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.ORCID https://orcid.org/0000-0002-8056-0934
Athar M QureshiDivision of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.
Magdalena Sanz CortesDepartment of Obstetrics and Gynecology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.
William E WhiteheadDepartment of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
Caitlin D SuttonDepartment of Anesthesiology, Perioperative, and Pain Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.ORCID https://orcid.org/0000-0002-7622-6386

Funding

Graeme McDaniel Foundation
6 · The paper itself

Abstract

objectiveThe heterogeneity of fetal surgery has led to variability in the nature and frequency of fetal instability. Understanding these differences is critical for optimizing management.

methodsWe reviewed all fetal atrial septal interventions (FASI) and fetoscopic myelomeningocele (fMMC) repairs with fetal instability performed at our institution between March 2012 and April 2025. We described and compared the frequency, timing, etiology, and management of fetal instability.

resultsDuring the study period, 28 unique patients underwent 35 FASI procedures, and 210 patients underwent fMMC repair. Fetal instability occurred in 51 of 245 cases (20.8%), with rates varying significantly by procedure type (30/35 FASI, 85.7% vs. 21/210 fMMC, 10.0%, p < 0.01). The causes of fetal instability requiring resuscitation differed by procedure. In FASI, all instability was procedure-related, whereas instability during fMMC repairs was most often related to the uterine environment. Invasive resuscitative interventions (e.g., pericardiocentesis) were used exclusively in FASI. In fMMC repair, less invasive interventions (e.g., repositioning) were more commonly employed.

conclusionsFetal instability is common during fetal interventions, with higher rates and more invasive resuscitation during FASIs compared with fMMC repairs. The causes and interventions employed vary by procedure type, highlighting the need for tailored intraoperative strategies.

Indexed as

Fetal TherapiesFetoscopyHeart Septal Defects, AtrialResuscitationSpinal DysraphismAdultFemaleHumansMeningomyelocelePregnancyRetrospective Studies

Identifiers

PMID41903159
PMCPMC13255165

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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.