News / Health

    Delicate Surgery Reduces Complications of Devastating Birth Defect

    Jessica Berman

    Delicate fetal surgery performed in the womb can prevent or minimize the disabling complications of a birth defect called spina bifida, in which the newborn's spinal cord does not fully form or, in the worst cases, grows exposed outside the baby’s back.  The deformity has meant life in a wheelchair for many children.  But the pioneering surgical procedure promises to help spina-bifida children avert that fate and lead more normal lives.

    The fetal surgery has been undergoing  human clinical trials with a team of doctors, led by Scott Adzick, chief surgeon at Children’s Hospital of Philadelphia, in the eastern U.S. state of Pennsylvania.  The delicate procedure they have been perfecting involves lifting the womb containing the fetus out of the mother at between 20 and 26 weeks of pregnancy, and operating on the fetus to repair the deformed spinal cord.  

    Katherine Mulligan of Cincinnati, Ohio underwent the procedure at Children's Hospital when she was pregnant with her son Sean, who is now 10.   She says before the procedure, her son’s prognosis was bleak. "A doctor [had] told us he would be in a wheelchair, we would have bowel and bladder problems, he would need a shunt due to hydrocephalus (water on the brain).  And today,  he plays basketball, baseball, soccer, tennis, swimming, does it all.  We still cannot get over how lucky we were.  Our life would be very, very different if it weren't for [Children’s Hospital of Philadelphia] and fetal surgery," she said.

    Spurred on by the success of cases like the Mulligan's, surgeon Scott Adzick led teams of investigators at CHOP, at Vanderbilt University in Tennessee and at the University of California-San Francisco, through 183 surgeries during the past eight years, on pregnant women whose fetuses had the severest form of spina bifida, called myelomeningocele.  

    Women who underwent the prenatal surgery were delivered by Caesarean section at 37 weeks.  The outcomes for their babies were compared to the health of infants who were delivered by C-section at 37 weeks, and had their spines surgically repaired within 24 hours of delivery.  

    Among children who were examined at one year after birth and again at 30 months, Adzick says those who had the surgery in utero fared significantly better than newborns who had the repair procedure done after delivery. "Although the ability to walk depends upon the spina bifida lesion somewhat, at 30 months of age children in the prenatal repair group were much more likely to walk independently; 42 percent compared to children in the post-natal repair group, [only]  21 percent," he said.

    Also, at one year, twice as many children in the post-natal surgery group required a shunt, or valve, to relieve pressure from fluid accumulations on the brain, compared to children who had their spines repaired in the womb.

    Because of its success, the eight-year trial was stopped early at the end of 2010 and Adzick and other surgeons were given permission to perform the fetal operation routinely.

    Adzick believes infants who underwent prenatal surgery fared better because he says the womb can be as toxic as it is nurturing to a fetus with spina bifida. "You have this exposed, unprotected spinal cord, even in utero, [brushing] up against the walls of the womb or the walls of the uterus which causes trauma as well.  So, by doing the operation before birth, you are protecting it.  You are putting  tissue layers between the developing spinal cord and the inter-uterine environment," he said.

    Adzick adds that the amniotic fluid inside the womb - in which the developing fetus is floating - contains fetal urine, which can be corrosive to the exposed spinal cord.

    Researchers now want to see if they can identify which babies would benefit the most from prenatal surgery by looking at the leg movements of the fetus.  Adzick says researchers also want  to develop a plastic material they can inject into the womb to patch the exposed spinal cord lesion of a fetus with spinal bifida.

    The surgeons hope their success with in-utero spina bifida repairs will help to broaden the application of fetal surgery to other serious, and more life-threatening fetal birth defects.

    A study describing the delicate fetal surgery is published this week in the New England Journal of Medicine.

    You May Like

    Video How Aleppo Rebels Plan to Withstand Assad's Siege

    Rebels in Aleppo are laying plans to withstand a siege by Syrian President Bashar al-Assad’s forces in likelihood the regime cuts a final main supply line running west of city

    Scientists Detect Gravitational Waves in Landmark Discovery

    Researchers likened discovery to difference between looking at piece of music on paper and then hearing it in real life

    Prince Ali: FIFA Politics Affected International Fixtures

    Some countries faced unfavorable treatment for not toeing political line inside soccer world body, Jordanian candidate to head FIFA says

    This forum has been closed.
    Comments
         
    There are no comments in this forum. Be first and add one

    Featured Videos

    Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
    NATO to Target Migrant Smugglersi
    X
    Jeff Custer
    February 11, 2016 4:35 PM
    NATO has announced plans to send warships to the Aegean Sea to target migrant smugglers in the alliance's most direct intervention so far since a wave of people began trying to reach European shores.
    Video

    Video NATO to Target Migrant Smugglers

    NATO has announced plans to send warships to the Aegean Sea to target migrant smugglers in the alliance's most direct intervention so far since a wave of people began trying to reach European shores.
    Video

    Video Russia's Catholics, Orthodox Hopeful on Historic Pope-Patriarch Meeting

    Russia's Catholic minority has welcomed an historic first meeting Friday in Cuba between the Pope and the Patriarch of Russia's dominant Orthodox Church. The Orthodox Church split with Rome in 1054 and analysts say politics, both church and state, have been driving the relationship in the centuries since. VOA's Daniel Schearf reports from Moscow.
    Video

    Video Used Books Get a New Life on the Streets of Lagos

    Used booksellers are importing books from abroad and selling them on the streets of Africa's largest city. What‘s popular with readers may surprise you. Chris Stein reports from Lagos.
    Video

    Video After NH Primaries All Eyes on South Carolina

    After Tuesday's primary in New Hampshire, US presidential candidates swiftly turned to the next election coming up in South Carolina. The so-called “first-in-the-South” poll may help further narrow down the field of candidates. Zlatica Hoke reports.
    Video

    Video US Co-ed Selective Service Plan Stirs Controversy

    Young women may soon be required to register with the U.S. Selective Service System, the U.S. government agency charged with implementing a draft in a national emergency. Top Army and Marine Corps commanders told the Senate Armed Services Committee recently that women should register, and a bill has been introduced in Congress requiring eligible women to sign up for the military draft. The issue is stirring some controversy, as VOA’s Bernard Shusman reports from New York.
    Video

    Video Lessons Learned From Ebola Might Help Fight Zika

    Now that the Ebola epidemic has ended in West Africa, Zika has the world's focus. And, as Carol Pearson reports, health experts and governments are applying some of the lessons learned during the Ebola crisis in Africa to fight the Zika virus in Latin America and the Caribbean.
    Video

    Video Smartphone Helps Grow Vegetables

    One day, you may be using your smartphone to grow your vegetables. A Taipei-based company has developed a farm cube — a small, enclosed ecosystem designed to grow plants indoors. The environment inside is automatically adjusted by the cube, but it can also be controlled through an app. VOA's Deborah Block has more on the gardening system.
    Video

    Video Illinois Voters Have Mixed Emotions on Obama’s Return to Springfield

    On the ninth anniversary of the launch of his quest for national office, President Barack Obama returned to Springfield, Illinois, to speak to the Illinois General Assembly, where he once served as state senator. His visit was met with mixed emotions by those with a front-row seat on his journey to the White House. VOA's Kane Farabaugh reports.
    Video

    Video Exhibit Turns da Vinci’s Drawings Into Real Objects

    In addition to being a successful artist, Renaissance genius Leonardo da Vinci designed many practical machines, some of which are still in use today, although in different forms. But a number of his projects were never realized — until today. VOA’s George Putic reports.
    Video

    Video Heated Immigration Debate Limits Britain’s Refugee Response

    Compared to many other European states, Britain has agreed to accept a relatively small number of Syrian refugees. Just over a thousand have arrived so far -- and some are being resettled in remote corners of the country. Henry Ridgwell reports on why Britain’s response has lagged behind its neighbors.
    Video

    Video Russia's Car Sales Shrink Overall, But Luxury and Economy Models See Growth

    Car sales in Russia dropped by more than a third in 2015 because of the country's economic woes. But, at the extreme ends of the car market, luxury vehicles and some economy brands are actually experiencing growth. VOA's Daniel Schearf reports from Moscow.
    Video

    Video Jordanian Theater Group Stages Anti-Terrorism Message

    The lure of the self-styled “Islamic State” has many parents worried about their children who may be susceptible to the organization’s online propaganda. Dozens of Muslim communities in the Middle East are fighting back -- giving young adults alternatives to violence. One group in Jordan is using dramatic expression a send a family message. Mideast Broadcasting Network correspondent Haider Al Abdali shared this report with VOA. It’s narrated by Bronwyn Benito
    Video

    Video Civil Rights Pioneer Remembers Struggle for Voting Rights

    February is Black History Month in the United States. The annual, month-long national observance pays tribute to important people and events that shaped the history of African Americans. VOA's Chris Simkins reports how one man fought against discrimination to help millions of blacks obtain the right to vote
    Video

    Video Helping the Blind 'See' Great Art

    There are 285 million blind and visually impaired people in the world who are unable to enjoy visual art at a museum. One New York photographer is trying to fix this situation by making tangible copies of the world’s masterpieces. VOA correspondent Victoria Kupchinetsky was there as visually impaired people got a feel for great art. Joy Wagner narrates her report.