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Poster Session 3

Category: Fetal Intervention

Poster Session 3

(786) Risk Factors for Preterm Prelabor Rupture of Membranes after Fetoscopic Spina Bifida Repair

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Felicia V. LeMoine, MD (she/her/hers)

Fetal Intervention Fellow
Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States

Coauthor(s)

Neha Agarwal, MD

Resident Physician
University of Texas Health Science Center at Houston
UT Health Houston, Texas, United States
SZ

Sen Zhu, PhD

UTHealth Houston Fetal Institute; Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Sami Backley, MD

Clinical Fellow PGY 9
Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
EG

Elisa Garcia, MPH, RN

UTHealth Houston Fetal Institute; Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
SC

Stephanie Conaway

UTHealth Houston Fetal Institute; Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
AS

Ashley Salazar, DNP

UTHealth Houston Fetal Institute; Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
LM

Lovepreet Mann, MBBS (she/her/hers)

UTHealth Houston Fetal Institute; Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
SF

Stephen A. Fletcher, MD

Neurosurgery, Pediatric Neurosurgery
Division of Pediatric Neurosurgery, Department of Pediatric Surgery, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Kuojen Tsao, MD

Professor
Division of Pediatric General & Thoracic Surgery, Department of Pediatric Surgery, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
MA

Mary Austin, MD

Division of Pediatric General & Thoracic Surgery, Department of Pediatric Surgery, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
EB

Eric Bergh, MD

Associate Professor
Maternal Fetal Medicine, Nemours Children's Health
Wilmington, Delaware, United States
Jimmy Espinoza, MD, MSc

Professor
UTHealth Houston Fetal Institute; Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Anthony Johnson, DO

Professor
UTHealth Houston Fetal Institute; Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
JR

Jerrie S. Refuerzo, MD

Professor
Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
SL

Suzanne Lopez, MD

Professor
Division of Neonatal-Perinatal Medicine, Department of Pediatrics, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
DS

David I. Sandberg, MD

Neurosurgery
Division of Pediatric Neurosurgery, Department of Pediatric Surgery, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
DL

Dejian Lai, PhD

Professor
Department of Biostatistics, School of Public Health at UTHealth Houston
Houston, Texas, United States
Ramesha Papanna, MD, MPH

Professor
University of Texas Health Science Center in Houston, McGovern Medical School
Houston, Texas, United States

Objective:
Preterm prelabor rupture of membranes (PPROM) is a persistent complication of in-utero spina bifida repair despite the transition to a minimally-invasive, fetoscopic approach. We evaluated the relationship between maternal and perioperative characteristics and PPROM among pregnancies that underwent fetoscopic spina bifida repair.

Study Design:
A secondary analysis of a prospective cohort study was conducted on cases of fetoscopic spina bifida repair completed between 2020 and 2025 (NCT#04243889 & #06042140). Maternal and perioperative factors were compared between cases with and without PPROM using appropriate two-sample t tests, χ2 test, and Fisher’s exact test, where applicable. Multiple logistic regression was performed to identify maternal and perioperative factors associated with PPROM.

Results:
Twenty-nine of 99 (29.3%) cases resulted in PPROM. The mean gestational age (GA) at PPROM was 32.4 ± 2.5 weeks. The PPROM group had earlier GA at delivery (33.4 ± 1.9 versus 35.7 ± 2.7 weeks, p < 0.001) and lower rates of gestational hypertension (0% versus 21.4%, p < 0.001) than the group without PPROM. Maternal and perioperative characteristics and obstetric outcomes were otherwise similar between groups. Multiple logistic regression demonstrated no significant relationship between maternal nor perioperative characteristics and PPROM.

Conclusion:
No single clinical factor offers significant predictive value for PPROM. Further research is warranted to identify underlying biochemical mechanisms that may influence the risk of PPROM after fetoscopic intervention.