Are Cervical Length and Fibronectin Predictors of Preterm Birth after Fetal Spina Bifida Repair? A Single Center Cohort Study
Background: A remaining risk of fetal spina bifida (fSB) repair is preterm delivery. This study assessed the value of preoperative cervical length (CL), CL dynamics (∆CL) and fetal fibronectin (fFN) tests to predict obstetric complications and length of stay (LOS) around fSB repair. Methods: 134 pat...
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MDPI AG
2022-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/1/123 |
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| author | Ladina Vonzun Ladina Rüegg Julia Zepf Ueli Moehrlen Martin Meuli Nicole Ochsenbein-Kölble |
| author_facet | Ladina Vonzun Ladina Rüegg Julia Zepf Ueli Moehrlen Martin Meuli Nicole Ochsenbein-Kölble |
| author_sort | Ladina Vonzun |
| collection | DOAJ |
| description | Background: A remaining risk of fetal spina bifida (fSB) repair is preterm delivery. This study assessed the value of preoperative cervical length (CL), CL dynamics (∆CL) and fetal fibronectin (fFN) tests to predict obstetric complications and length of stay (LOS) around fSB repair. Methods: 134 patients were included in this study. All patients had CL measurement and fFN testing before fSB repair. ∆CL within the first 14 days after intervention and until discharge after fSB repair were compared in groups (∆CL ≥ 10 mm/<10 mm; ≥20 mm/<20 mm). CL before surgery, ∆CL’s, and positive fFN tests were correlated to obstetric complications and LOS. Results: Mean CL before surgery was 41 ± 7 mm. Mean GA at birth was 35.4 ± 2.2 weeks. In the group of ∆CL ≥ 10 mm within the first 14 days after intervention, LOS was significantly longer (<i>p</i> = 0.02). ∆CL ≥ 10 mm until discharge after fSB was associated with a significantly higher rate of GA at birth <34 weeks (<i>p</i> = 0.03). The 3 positive fFN tests before fSB repair showed no correlation with GA at birth. Conclusion: Perioperative ∆CL influences LOS after fetal surgery. ∆CL ≥ 10 mm until discharge after fSB repair has a 3-times higher rate of preterm delivery before 34 weeks. Preoperative fFN testing showed no predictive value for preterm birth after fSB repair and was stopped. |
| first_indexed | 2024-03-11T09:57:03Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T09:57:03Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-95d54615b9674775baec8e05bb1e39cb2023-11-16T15:41:44ZengMDPI AGJournal of Clinical Medicine2077-03832022-12-0112112310.3390/jcm12010123Are Cervical Length and Fibronectin Predictors of Preterm Birth after Fetal Spina Bifida Repair? A Single Center Cohort StudyLadina Vonzun0Ladina Rüegg1Julia Zepf2Ueli Moehrlen3Martin Meuli4Nicole Ochsenbein-Kölble5Department of Obstetrics, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, SwitzerlandDepartment of Obstetrics, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, SwitzerlandDepartment of Obstetrics, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, SwitzerlandFaculty of Medicine, University of Zurich, Rämistrasse 71, 8091 Zurich, SwitzerlandFaculty of Medicine, University of Zurich, Rämistrasse 71, 8091 Zurich, SwitzerlandFaculty of Medicine, University of Zurich, Rämistrasse 71, 8091 Zurich, SwitzerlandBackground: A remaining risk of fetal spina bifida (fSB) repair is preterm delivery. This study assessed the value of preoperative cervical length (CL), CL dynamics (∆CL) and fetal fibronectin (fFN) tests to predict obstetric complications and length of stay (LOS) around fSB repair. Methods: 134 patients were included in this study. All patients had CL measurement and fFN testing before fSB repair. ∆CL within the first 14 days after intervention and until discharge after fSB repair were compared in groups (∆CL ≥ 10 mm/<10 mm; ≥20 mm/<20 mm). CL before surgery, ∆CL’s, and positive fFN tests were correlated to obstetric complications and LOS. Results: Mean CL before surgery was 41 ± 7 mm. Mean GA at birth was 35.4 ± 2.2 weeks. In the group of ∆CL ≥ 10 mm within the first 14 days after intervention, LOS was significantly longer (<i>p</i> = 0.02). ∆CL ≥ 10 mm until discharge after fSB was associated with a significantly higher rate of GA at birth <34 weeks (<i>p</i> = 0.03). The 3 positive fFN tests before fSB repair showed no correlation with GA at birth. Conclusion: Perioperative ∆CL influences LOS after fetal surgery. ∆CL ≥ 10 mm until discharge after fSB repair has a 3-times higher rate of preterm delivery before 34 weeks. Preoperative fFN testing showed no predictive value for preterm birth after fSB repair and was stopped.https://www.mdpi.com/2077-0383/12/1/123fetal surgeryspina bifidacervical lengthfibronectin testpreterm birthPPROM |
| spellingShingle | Ladina Vonzun Ladina Rüegg Julia Zepf Ueli Moehrlen Martin Meuli Nicole Ochsenbein-Kölble Are Cervical Length and Fibronectin Predictors of Preterm Birth after Fetal Spina Bifida Repair? A Single Center Cohort Study Journal of Clinical Medicine fetal surgery spina bifida cervical length fibronectin test preterm birth PPROM |
| title | Are Cervical Length and Fibronectin Predictors of Preterm Birth after Fetal Spina Bifida Repair? A Single Center Cohort Study |
| title_full | Are Cervical Length and Fibronectin Predictors of Preterm Birth after Fetal Spina Bifida Repair? A Single Center Cohort Study |
| title_fullStr | Are Cervical Length and Fibronectin Predictors of Preterm Birth after Fetal Spina Bifida Repair? A Single Center Cohort Study |
| title_full_unstemmed | Are Cervical Length and Fibronectin Predictors of Preterm Birth after Fetal Spina Bifida Repair? A Single Center Cohort Study |
| title_short | Are Cervical Length and Fibronectin Predictors of Preterm Birth after Fetal Spina Bifida Repair? A Single Center Cohort Study |
| title_sort | are cervical length and fibronectin predictors of preterm birth after fetal spina bifida repair a single center cohort study |
| topic | fetal surgery spina bifida cervical length fibronectin test preterm birth PPROM |
| url | https://www.mdpi.com/2077-0383/12/1/123 |
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