| Title |
Early elective delivery for fetal ventriculomegaly: are neurosurgical and medical complications mitigated by this practice?
|
|---|---|
| Published in |
Child's Nervous System, December 2017
|
| DOI | 10.1007/s00381-017-3662-0 |
| Pubmed ID | |
| Authors |
Clinton D. Morgan, Travis R. Ladner, George L. Yang, Marjorie N. Moore, Russell D. Parks, William F. Walsh, John C. Wellons, Chevis N. Shannon |
| Abstract |
Antenatally diagnosed ventriculomegaly (VM) requires the balance of risks of neurological injury with premature delivery. The purpose of this study was to evaluate outcomes related to early elective delivery due to fetal VM at our institution. We retrospectively assessed 120 babies (2008-2012) with antenatally diagnosed fetal VM. Inclusion criteria for ("early") cohort were (1) elective delivery occurred for expedited neurosurgical intervention between 32 and 36 weeks EGA and (2) fetal VM noted on official antenatal ultrasound. The comparative "near term" cohort differed only in that delivery occurred at 37+ weeks EGA. Statistical significance for comparative analyses set a priori at p < 0.05. Babies electively delivered early had a lower birthweight (p < 0.0001), greater ventricle width (p < 0.0001), and underwent initial CSF diversion sooner (p = 0.014). The early cohort (n = 22), compared to near term (n = 50), had a lower birthweight (p < 0.0001), greater ventricle width (p < 0.0001), and underwent initial CSF diversion sooner (p = 0.014). The early cohort required more repeat procedures: (45 vs. 22% p = 0.021), and VPS removals after VPS infections (41 vs. 12%, p = 0.010). Additionally, newborn respiratory failure (32 vs. 6%, p = 0.037) was more common. Finally, of four babies who died in the early cohort, 2/4 died for prematurity-associated pulmonary hypoplasia. While early elective delivery for fetal VM expedites intervention for rapidly expanding ventricles, few benefits were identified. Our study concluded those infants that were delivered earlier had increased VPS infections, repeat neurosurgical procedures, and medical co-morbidities. A multi-institutional prospective observational study would be needed in order to confirm the clinical implications of such practice. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Science communicators (journalists, bloggers, editors) | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 23 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 23 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 4 | 17% |
| Student > Doctoral Student | 3 | 13% |
| Lecturer | 1 | 4% |
| Student > Ph. D. Student | 1 | 4% |
| Researcher | 1 | 4% |
| Other | 1 | 4% |
| Unknown | 12 | 52% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 8 | 35% |
| Neuroscience | 2 | 9% |
| Computer Science | 1 | 4% |
| Economics, Econometrics and Finance | 1 | 4% |
| Nursing and Health Professions | 1 | 4% |
| Other | 0 | 0% |
| Unknown | 10 | 43% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 December 2017.
All research outputs
#18,577,751
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Outputs from Child's Nervous System
#1,448
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#325,770
of 437,935 outputs
Outputs of similar age from Child's Nervous System
#54
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