birth defect spine

Surgery on fetuses with spina bifida reduces complications after birth

WASHINGTON, Feb.11 (Tantao News) – A new study from the US National Institutes of Health (NIH) shows that prenatal surgery on fetuses with spina bifida, a common birth defect of the spine, reduces the rate of disability after these children are born and increases the chances that a child will be able to walk without crutches or other devices.

This study enrolled pregnant women carrying a child with myelomeningocele, the most serious form of spina bifida, in which the spinal cord protrudes through an opening in the spine. The condition occurs in 3.4 of every 10,000 births, and 10% percent of affected infants die. In surviving infants, it often results in weakness or paralysis below the location of the spinal defect, including loss of bladder and bowel control and the ability to walk unassisted.

Study participants were assigned to one of two groups. The first group underwent prenatal surgery to close the spinal defect in the fetus before their 26th week of pregnancy. The second group had the surgery performed on the child after birth, which is the traditional approach.

This study was originally planned to enroll 200 expectant mothers. However, the enrollment was stopped after the enrollment of 183 women, because the benefits of the surgery were clearly demonstrated in the children who underwent prenatal surgery.

But there were some risks associated with this prenatal surgery including the increased likelihood of a premature birth. Infants born early are generally at increased risk for breathing difficulties. Also, mothers who underwent the surgery during their pregnancies were at risk for a thinning or tearing at the incision in the uterus.

The study research team advised caution in adopting this approach because the surgery is highly specialized and it is best undertaken in facilities with staff having experience in the procedure.