Ultraschall Med 2022; 43(S 01): S22
DOI: 10.1055/s-0042-1749542
Abstracts
Pränatalmedizin

Cervical length measurements and fibronectin test in prediction of preterm birth around fetal spina bifida repair

Autor 1 2
ladina Vonzun
1   Institutsangabe, Ort; 1Department of Obstetrics, University Hospital Zurich
2   University of Zurich
4   Center for Fetal Surgery, Diagnosis and Therapy
,
Ladina Ruegg
1   Institutsangabe, Ort; 1Department of Obstetrics, University Hospital Zurich
2   University of Zurich
,
Julia Zepf
1   Institutsangabe, Ort; 1Department of Obstetrics, University Hospital Zurich
2   University of Zurich
,
Ueli Moehrlen
2   University of Zurich
3   Department of Pediatric Surgery, University Children's Hospital Zurich
4   Center for Fetal Surgery, Diagnosis and Therapy
,
Martin Meuli
4   Center for Fetal Surgery, Diagnosis and Therapy
,
Nicole Ochsenbein-Koelble
1   Institutsangabe, Ort; 1Department of Obstetrics, University Hospital Zurich
2   University of Zurich
4   Center for Fetal Surgery, Diagnosis and Therapy
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Introduction Open fetal spina bifida (fSB) repair showed to improve neonatal outcome in comparison to postnatal closure in selected cases. Nevertheless, this procedure is associated with obstetric risks. The goal of this study was to assess the value of cervical length (CL) measurements and fibronectin (FFN) tests to predict preterm birth, premature rupture of membranes (PPROM), chorioamniotic membrane separation (CMS) and duration of hospitalization after fetal surgery.

Material and Methods In this prospective study, 136 consecutive women that underwent open fSB repair between 2010 and 2020 at the Zurich Center for Fetal Diagnosis and Therapy received a FFN test before, as well as a CL measurement before and after fetal surgery. These parameters as well as the CL dynamics where compared to the occurrence of obstetric complications such as PPROM, CMS, preterm birth and duration of hospitalization.

Results No significant association between the CL before surgery and the gestational age (GA) at birth was observed (p=0.8). Perioperative CL dynamics were not correlated to GA at birth (p=0.8), PPROM, CMS (p=0.4) or duration of hospitalization (p=0.2). FFN test were positive in three (2%) cases, of which in two cases delivery took place at 37 weeks GA. No correlation between positive FFN test and short CL before fSB repair was observed.

Conclusion Neither CL before surgery nor perioperative dynamic of CL influence GA at birth, PPROM, CMS rates or duration of hospitalization after the fetal intervention. Preoperative FFN test showed no predictive value for preterm birth after fSB repair, consequently its implementation was suspended at our center.



Publication History

Article published online:
20 June 2022

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