title: Neurological outcomes in Chiari type II malformations and their correlation to morphological findings and fetal heart rate patterns: a retrospective study.
abstract: BACKGROUND
  Correlations among Chiari type II malformation (CMII) morphological findings, the proportion of fetal heart rate patterns corresponding to the quiet phase (QP), and neurological outcomes have yet to be investigated.
  
  
  RESULTS
  The correlations among the morphological findings (i.e., the degree of ventriculomegaly, myelomeningocele levels, and degree of cerebellar herniation), proportion of time spent in QP, and developmental quotients (DQs) were analyzed in 22 children. The proportion of time spent in QP was compared between children with poor neurological outcomes (n = 9) and those with good outcomes (n = 13). Pearson's correlations and the Mann-Whitney U-test were used to assess for statistical significance; P < 0.05 was considered statistically significant. No significant differences were observed between the DQs and morphological findings, but the DQs and the proportion of time spent in QP were significantly correlated (r = 0.287, P = 0.01). The proportion of time spent in QP was significantly different between children with poor outcomes and those with good outcomes (median, 11% [range, 0-32%] vs. 28% [range, 2-55%]; P = 0.006).
  
  
  CONCLUSIONS
  The proportion of fetal heart rate patterns corresponding to the QP might be a useful predictor of neurological outcomes in 2-year-old children with CMII.
authors.affiliation: Center for Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan. otera-y@ncchd.go.jp.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Otera
authors.affiliation: Department of Obstetrics and Gynecology, Kyushu University Hospital, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. morokuma@med.kyushu-u.ac.jp.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Morokuma
authors.affiliation: Department of Obstetrics and Gynecology, Kyushu University Hospital, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. kfuku@med.kyushu-u.ac.jp.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Fukushima
authors.affiliation: Center for Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan. anami1016@yahoo.co.jp.
authors.forename: Ai
authors.initials: A
authors.lastname: Anami
authors.affiliation: Department of Obstetrics and Gynecology, Kyushu University Hospital, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. yumoto@med.kyushu-u.ac.jp.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Yumoto
authors.affiliation: Center for Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan. itoh-yu@ncchd.go.jp.
authors.forename: Yushi
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Comprehensive Maternity and Perinatal Care Center, Kyushu University Hospital, Fukuoka, Japan. ochimasa@pediatr.med.kyushu-u.ac.jp.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ochiai
authors.affiliation: Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. khashgucci@gmail.com.
authors.forename: Kimiaki
authors.initials: K
authors.lastname: Hashiguchi
authors.affiliation: Research Center for Environmental and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan. wake@med.kyushu-u.ac.jp.
authors.forename: Norio
authors.initials: N
authors.lastname: Wake
authors.affiliation: Center for Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan. sagou-h@ncchd.go.jp.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Sago
authors.affiliation: Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. kkato@med.kyushu-u.ac.jp.
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Kato
mesh_terms: D001139:Arnold-Chiari Malformation / Q000473:pathology* / Q000503:physiopathology*; D002675:Child, Preschool; D004677:Encephalocele / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006325:Heart Atria / Q000473:pathology / Q000503:physiopathology; D006340:Heart Rate, Fetal / Q000502:physiology*; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008591:Meningomyelocele / Q000473:pathology / Q000503:physiopathology; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome