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Ventricle Width and Cerebrospinal Fluid Diversion Rate after Open Fetal Spina Bifida Repair: A 4-Year Follow-Up

Year: 2026

Type: article

Abstract: INTRODUCTION: The objective of this study was to assess the postnatal cerebrospinal fluid diversion (CSFD) rates and associated prenatal risk factors (RFs) in patients with open fetal spina bifida (fSB) repair over a 4-year follow-up. METHODS: In 185 patients, CSFD rate was determined at 1 year and incremental risk (IR) for CSFD at 2 and 4 years. Characteristics of children without CSFD were compared to those with CSFD, and multiple regression analysis evaluated RF. RESULTS: Sixty-four children (35%) needed CSFD within the first year. These children had larger head circumference (HC) at screening (p = 0.001) and before delivery (p < 0.001) and larger ventricles at screening (Vp screening) and before delivery (Vp delivery) (each p < 0.001). Multiple regression identified only Vp screening, Vp delivery, and their delta as independent RF for CSFD. Vp values were higher in children needing CSFD within the first year compared with years 2-4 (p < 0.001 and p = 0.01), and larger Vp was associated with earlier CSFD in the first year (p = 0.02). IR for CSFD declined over follow-up. CONCLUSION: The 1-year CSFD rate after open fSB repair was 35%, with decreasing IR through year four. Larger Vp at screening, before delivery, and their delta were independent RF for CSFD, while HC was not.

Source: Fetal Diagnosis and Therapy

DOI: 10.1159/000552456