A study in the New England Journal of Medicine on the outcome for babies with spina bifida who underwent in utero surgery is so uplifting it caught the attention of ABC News. Children with spina bifida can experience brain and nerve damage including paralysis from a condition where the spine fails to close. A baby born with spina bifida is likely to have surgery shortly after birth to close the spine.
But, now medicine has found a better way to repair the spine — by removing the baby from the mother’s womb at about 19-25 weeks, repairing the spine, and placing the baby back into the womb. The mother generally gives birth by C-section.
In the study, children with spina bifida were followed so that outcomes could be compared between children who had in utero surgery and those who had surgery post-birth. The study reports that 40% of the children who had in utero surgery needed a shunt placed in the brain, compared to 82% of those who had post-birth surgery. “The fetal surgery group scored higher on combined tests of mental development and motor skills at 2 1/2 years, though there was no difference in congnitive function alone,” the report states. “Forty-two percent of the toddlers in the fetal surgery group could walk without crutches or other support versus 21percent in the other group.” In addition, fetal surgery children were 30% less like to need follow-up surgeries.
Dr. Scott Adzick, first author of the study, told ABC News, “This is a big breakthrough. For the first time we can show a clear cut benefit, treating a non life threatening malformation by repairing it before birth.” One of the children featured in the news story who had in utero surgery is now 10 and walks without crutches or a wheelchair.
What a novel idea — treating the unborn baby as the separate patient he or she actually is. We agree with Dr. Adzick who says “I don’t think it gets better than that.”
Read the ABC News article here.