An unborn baby successfully underwent spinal cord surgery inside the mother’s womb in a groundbreaking procedure in Great Ormond Street Hospital in London. The surgeons performed the pioneering procedure at 24 weeks’ gestation after scans revealed the fetus had spina bifida.
A team of surgeons from University College London and Great Ormond Street Hospital for Children, along with Belgian colleagues, managed to repair the spinal cord and it is now hoped the baby will be born healthily in April.
Spina bifida can leave sufferers with walking difficulties and even paralysis because the spinal cord does not fully develop during pregnancy. Not having enough folic acid during pregnancy is one of the most important factors that can increase chances of having a child with spina bifida.
In this condition the spinal canal does not close completely in the womb, leaving the spinal cord exposed from an early stage in pregnancy. This results in changes to the brain, as well as severe permanent damage to the nerves on the lower half of the body.
During the procedure, an incision is made in the womb in a precise location to access the baby’s spine and stitch closed the gap caused by spina bifida. The uterus is then repaired to leave the baby safely within.
Closure of spina bifida in the womb using this method is an alternative to postnatal surgery that has been shown to improve short and medium-term outcomes. This is the fourth time such a procedure has been attempted in the UK. There were apparently three similar procedures attempted earlier in the country, but more technical details of those cases were not immediately available.
Initially the parents, Bethan Simpson and her husband Kieron, were told they could terminate the pregnancy or continue without any intervention. But at a subsequent appointment they were offered fetal surgery.
This fetal surgery had been performed for the first time in UK by the team from University College London Hospitals (UCLH), UCL and Great Ormond Street Hospital (GOSH) on the abnormally developed spinal cords of two babies in the womb marking one of their kind in the previous year.
The team repaired the defect in the spine of two babies with open spina bifida, in separate operations.
This specialist fetal surgery will give the baby a significantly better chance in life, as compared to postnatal surgery, as babies with spina bifida are very often incapable of walking, and they may require a series of operations to drain fluid from the brain (shunt placement) later in life.
“We are also researching the minimal access (fetoscopic) technique through the GIFT-Surg (Guided Instrumentation for Fetal Therapy and Surgery) Project framework and, if we can show it to have equal benefit, we will be offering this option to patients” said lead fetal surgeon Jan Deprest of UCLH and Leuven, in a media statement.
The UCLH and GOSH team has been training with Professor Deprest and his team in Belgium, where more than 40 operations, some on English patients from UCLH, have been conducted since 2012.
Ms Simpson, a nurse, said: “Sadly 80 per cent of babies in England are terminated when their parents get told their baby has this condition.
Though the risk of things going wrong exists, such prenatal surgery could become a better alternative to treat and save a life,” added the statement issued on hospital website.