OP04.08: Preoperative cervical length in predicting preterm delivery in fetuses with open fetal microneurosurgery for intrauterine spina bifida repair

Abstract

To assess the utility of cervical length (CL) in predicting the risk of preterm delivery in fetuses with open fetal microneurosurgery for intrauterine spina bifida repair. Between January 2019 to February 2021, a cohort of singleton fetuses with confirmed open spina bifida were selected for intrauterine repair in our fetal surgery centre in Querétaro, México. Transvaginal CL was measured 24h before surgery. The utility of CL measurement to predict the risk of preterm delivery before 37, 34 and 30 weeks was assessed by logistic regression analysis. 247 singleton fetuses with confirmed open spina bifida were evaluated. Open fetal microneurosurgery for intrauterine spina bifida repair was successfully performed in 76 fetuses at on average 26.1 (range, 22.8-28.7) weeks. Preoperative mean CL measurement was 35.8 (range, 25.0-51.0) mm. Preterm delivery below 34 and 30 weeks was observed in 43.4% (33/76) and 17.1% (13/76), respectively. Preoperative CL was not associated with the risk of preterm delivery below 37 (OR = 1.03, 95% CI 0.94-1.13), 34 (OR =1.03, 95% CI 0.94-1.11), 32 (OR = 1.02 95% CI 0.92-1.12) and 30 (OR = 1.07 CI 0.96-1.20) weeks of gestation. Preoperative CL was not associated with the risk of delivery within the first week after fetal intervention OR = 1.13 (95% ICI 0.94-1.36). In pregnancies with open spina bifida selected for fetal surgery, preoperative cervical length was not associated with the risk of preterm delivery.