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

    California Republicans Mull Choices in Presidential Race

    Ted Cruz tells state's Republican Convention delegates campaign will be 'battle on the ground, district by district by district,' ahead of June 7 primary

    Video Kurdish Football Team Helps War-Torn City Cope

    With conflict still raging across much of Turkey’s predominantly Kurdish southeast, many Kurds are trying to escape turmoil by focusing on success of football team Amedspor

    South African Company Designs Unique Solar Cooker

    Two-man team of solar power technologists introduces Sol4, hot plate that heats up so fast it’s like cooking with gas or electricity

    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.
    Turkish Kurd Islamist Rally Stokes Tensionsi
    X
    April 29, 2016 12:28 AM
    In a sign of the rising power of Islamists in Turkey, more than 100,000 people recently gathered in Diyarbakir, the main city in Turkey’s predominantly Kurdish southeast, to mark the birthday of the Prophet Muhammad. The gathering highlighted tensions with the pro-secular Kurdish nationalist movement. Dorian Jones reports from Diyarbakir.
    Video

    Video Turkish Kurd Islamist Rally Stokes Tensions

    In a sign of the rising power of Islamists in Turkey, more than 100,000 people recently gathered in Diyarbakir, the main city in Turkey’s predominantly Kurdish southeast, to mark the birthday of the Prophet Muhammad. The gathering highlighted tensions with the pro-secular Kurdish nationalist movement. Dorian Jones reports from Diyarbakir.
    Video

    Video Pakistani School Helps Slum Kids

    Master Mohammad Ayub runs a makeshift school in a public park in Islamabad. Thousands of poor children have benefited from his services over the years, but, as VOA's Ayesha Tanzeem reports, roughly 25 million school-age youths don't get an education in Pakistan.
    Video

    Video Florida’s Weeki Wachee ‘Mermaids’ Make a Splash

    Since 1947, ‘mermaids’ have fascinated tourists at central Florida’s Weeki Wachee Springs State Park with their fluid movements and synchronized ballet. Performing underwater has its challenges, including cold temperatures and a steady current, as VOA’s Lin Yang and Joseph Mok report.
    Video

    Video Somali, African Union Forces Face Resurgent Al-Shabab

    The Islamic State terror group claimed its first attack in Somalia earlier this week, though the claim has not been verified by forces on the ground. Meanwhile, al-Shabab militants have stepped up their attacks as Somalia prepares for elections later this year. Henry Ridgwell reports there are growing frustrations among Somalia’s Western backers over the country’s slow progress in forming its own armed forces to establish security after 25 years of chaos.
    Video

    Video Bangladesh Targeted Killings Spark Wave of Fear

    People in Bangladesh’s capital are expressing deep concern over the brutal attacks that have killed secular blogger, and most recently a gay rights activist and an employee of the U.S. embassy. Xulhaz Mannan, an embassy protocol officer and the editor of the country’s only gay and transgender magazine Roopban; and his friend Mehboob Rabbi Tanoy, a gay rights activist, were hacked to death by five attackers in Mannan’s Dhaka home earlier this month.
    Video

    Video Documentary Tells Tale of Chernobyl Returnees

    Ukraine this week is marking the 30th anniversary of the world's worst nuclear accident, at the Chernobyl nuclear power plant. Soviet officials at first said little about the accident, but later evacuated a 2,600-square-kilometer "exclusion zone." Some people, though, came back. American directors Holly Morris and Anne Bogart created a documentary about this faithful and brave community. VOA's Tetiana Kharchenko reports from New York on "The Babushkas of Chernobyl." Carol Pearson narrates.
    Video

    Video Nigerians Feel Bite of Buhari Economic Policy

    Despite the global drop in the price of oil, Nigerian President Muhammadu Buhari has refused to allow the country's currency to devalue, leading to a shortage of foreign exchange. Chris Stein reports from Lagos businessmen and consumers are feeling the impact as the country deals with a severe fuel shortage.
    Video

    Video  Return to the Wild

    There’s a growing trend in the United States to let old or underused golf courses revert back to nature. But as Erika Celeste reports from one parcel in Grafton, Ohio, converting 39 hectares of land back to green space is a lot more complicated than just not mowing the fairway.
    Video

    Video West Urges Unity in Libya as Migrant Numbers Soar

    The Italian government says a NATO-led mission aimed at stemming the flow of migrants from Libya to Europe could be up and running by July. There are concerns that the number of migrants could soar as the route through Greece and the Balkans remains blocked. Western powers say the political chaos in Libya is being exploited by people smugglers — and they are pressuring rival groups to come together under the new unity government. VOA's Henry Ridgwell reports.
    Video

    Video Russia’s TV Rain Swims Against Tide in Sea of Kremlin Propaganda

    Russia’s media freedoms have been gradually eroded under President Vladimir Putin as his government has increased state ownership, influence, and restrictions on critical reporting. Television, where most Russians get their news, has been the main target and is now almost completely state controlled. But in the Russian capital, TV Rain stands out as an island in a sea of Kremlin propaganda.

    Special Report

    Adrift The Invisible African Diaspora