News / Health

Fetal Surgery Shown to Help Outlook for Spina Bifida Babies

Josh Tolboe, 3, (left) was diagnosed with spina bifida and gets around in a red walker
Josh Tolboe, 3, (left) was diagnosed with spina bifida and gets around in a red walker

Multimedia

Melinda Smith

Spina bifida is one of the most common and yet most severe of birth defects.  It affects the central nervous systems of between 300,000 and 400,000 babies around the world.  The most serious form of spina bifida occurs when the spinal cord protrudes through an opening in the spine.

Survivors often experience lifelong disabilities including paralysis, bladder and bowel problems, and excess fluid on the brain.  Traditionally, surgery to repair this condition is done after birth.  In recent decades, however, surgery to repair the opening has been done while the baby is in the womb. Now, a new study shows that some babies who undergo fetal surgery do better than those who do not.  Details of the study, were published Wednesday in the New England Journal of Medicine.

Three years ago, little Josh Tolboe faced a life full of physical obstacles.  His parents, McKay and Linda Tolboe, knew before his birth that he had Myelomeningocele, the severest form of a birth defect known as spina bifida.  Linda got the news first from her obstetrician.

"She sat there with me and she told me he had what's called spina bifida, bilateral club feet and hydrocephalus [excess fluid on the brain]," Linda Tolboe recalled.

The condition is typically diagnosed during pregnancy, either by ultrasound or some other form of advanced testing.  Eight days later, doctors placed a shunt in his head to relieve the fluid.  So far, Josh has had seven surgeries on his back and spine.

Josh is now three years old and gets around in a red walker.  His mother says another mother of a spina bifida child advised her to treat Josh the same way she treats his older brother Gavin.

"We don't help him in any way, unless he really needs it," Linda Tolboe added.  "We treat him like anybody else."

Fetal surgery to repair birth defects has been performed for at least 30 years.  But researchers wondered whether the prenatal procedure really could improve the outcome for those babies, and whether the risks for the baby and mother were worth overcoming.  The scientists now say a randomized clinical trial of 183 pregnant women carrying spina bifida babies proved to be so positive that the study was stopped after two phases.

The researchers studied results at one year of age after the prenatal surgery.  Fewer babies undergoing surgery in the womb had need for a shunt, compared to those who waited for surgery after birth.  At 30 months, there was improvement in mental development and motor function.

Dr. Catherine Spong of the National Institute of Child Health and Human Development says more of the children in the prenatal study could walk without braces or orthotics than those who underwent surgery after birth.

"In the prenatal surgery group, 40 percent of the babies were able to walk independently, compared to about only 21 percent in the postnatal surgery group," noted Spong.

Dr. Spong says at least one-third of the prenatal surgical patients no longer had what's called hindbrain herniation, in which the base of the brain is pulled into the spinal cord.

"You were able to replace the spinal cord and allow a more normal development of the baby's brain," Spong added.

While these conclusions sound so optimistic, the doctors say there still are important issues to consider, especially since a majority of these babies were born prematurely.

"There are a number of complications associated with pre-term delivery: respiratory distress, where the baby has had difficulty breathing, they need to be intubated [a breathing tube inserted], a number of complications, and certainly you saw those in those preterm babies," Spong explained.

When Linda Tolboe was carrying Josh, she and her husband turned down the chance to have surgery done while he was in the womb.  They said they were more concerned about the risk of premature birth, and opted instead for repairs to be made after delivery.   Would she have changed her mind, knowing what she knows now?

"If I would have known that, I probably would have done something and would have said 'well, let's do it.  Let's just see what happens with him,'" said Tolboe.

Dr.  Spong says she does not question parents' reluctance to have the surgery done before birth.  Before it is seriously considered, she says, make sure the doctors and hospital have a lot of expertise in caring for the baby and the mother.

You May Like

Karzai's Legacy: Missed Opportunities?

Afghanistan's president leaves behind a much different nation than the one he inherited, yet his legacy from 13 years in power is getting mixed reviews More

US Urges Restraint in Hong Kong Protests

Protesters angered by Beijing's decision to only approve candidates that it sanctions for Hong Kong's leadership elections in 2017 More

Archive of Forgotten UCLA Speeches Offers Snapshot of History

Recordings of prominent voices in social change, politics, science and literature from 1960s, early 1970s now available on YouTube More

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.
Treasure Hunters Seek 'Hidden Treasure' in Central Kenyai
X
Gabe Joselow
September 29, 2014 6:20 PM
Could a cave in a small village in central Kenya be the site of buried treasure? A rumor of riches, left behind by colonialists, has some residents dreaming of wealth, while others see it as a dangerous hoax. VOA's Gabe Joselow has the story.
Video

Video Treasure Hunters Seek 'Hidden Treasure' in Central Kenya

Could a cave in a small village in central Kenya be the site of buried treasure? A rumor of riches, left behind by colonialists, has some residents dreaming of wealth, while others see it as a dangerous hoax. VOA's Gabe Joselow has the story.
Video

Video Iran's Rouhani Skeptical on Syria Strikes

Iranian President Hassan Rouhani expressed skepticism Friday that U.S.-led airstrikes in Iraq and Syria could crush Islamic State militants. From New York, VOA’s Margaret Besheer reports the president was also hopeful that questions about Iran’s nuclear program could be resolved soon.
Video

Video US House Speaker: Congress Should Debate Authorization Against IS

As wave after wave of U.S. airstrikes target Islamic State militants, the speaker of the Republican-controlled House of Representatives says he would be willing to call Congress back into session to debate a formal, broad authorization for the use of military force. VOA’s Michael Bowman reports from Washington, where legislators left town 10 days ago for a seven-week recess.
Video

Video Ebola Patients Find No Treatment at Sierra Leone Holding Center

At a holding facility in Makeni, central Sierra Leone, dozens of sick people sit on the floor in an empty university building. They wait in filthy conditions. It's a 16-hour drive by ambulance to Kailahun Ebola treatment center. Adam Bailes was there and reports on what he says are some of the worst situations he has seen since the beginning of this Ebola outbreak. And he says it appears case numbers may already be far worse than authorities acknowledge.
Video

Video Identifying Bodies Found in Texas Border Region

Thousands of immigrants have died after crossing the border from Mexico into remote areas of the southwestern United States in recent years. Local officials in south Texas alone have found hundreds of unidentified bodies and buried them in mass graves in local cemeteries. Now an anthropologist and her students at Baylor University have been exhuming bodies and looking for clues to identify them. VOA’s Greg Flakus has more from Waco, Texas.
Video

Video Ebola Robs Liberians of Chance to Say Good-Bye to Loved Ones

In Liberia, where Ebola has killed more than 1,500 people, authorities have worked hard to convince people to allow specialized burial teams to take away dead bodies. But these safety measures, while necessary, make it hard for people to say good bye to their loved ones. VOA's Anne Look reports on the tragedy from Liberia.
Video

Video Reconstruction? What Reconstruction? Life After War in Gaza

It’s been a month since Israel and the Palestinians agreed to a ceasefire to end 52 days of an air and tank war that left 60,000 homes in Gaza damaged or destroyed and 110,000 homeless. Sharon Behn reports that lack of reconstruction is leading to despair.
Video

Video US, Saudi Arabia and UAE Hit Islamic State's Oil Revenue

The United States, Saudi Arabia and the United Arab Emirates have bombed oil facilities operated by Islamic State militants in Syria. It was a truly collaborative effort, with the two Arab countries dropping the majority of the bombs. The 12 refineries targeted were estimated to generate as much as $2 million per day for the terrorist group. VOA Pentagon correspondent Carla Babb has the story.
Video

Video Russia's Food Sanctions Raise Price Worries, Hopes for Domestic Production

Russia retaliated against Western sanctions imposed for its actions in Ukraine by halting food imports from the West. The temporary import ban on food from Australia, the European Union, Norway and North America has Russian consumers concerned that they could face a sharp increase in food prices. But in an ironic twist, the restrictions aimed at the Kremlin have made Russia's domestic food producers hopeful this can boost their business. VOA's Daniel Schearf reports from Moscow.
Video

Video Washington to Pyongyang: 'Shut This Evil System Down'

U.S. Secretary of State John Kerry is calling on North Korea to shut down prison camps and other human rights abuses following a United Nations Commission of Inquiry into "widespread and systematic human rights violations." VOA State Department Correspondent Scott Stearns reports from the United Nations.
Colonel Steve ‘Spiros’ Pisanos left Greece and came to the U.S. to learn to fly. He flew fighters for the Allies in World War II, narrowly escaping death multiple times.Colonel Steve ‘Spiros’ Pisanos left Greece and came to the U.S. to learn to fly. He flew fighters for the Allies in World War II, narrowly escaping death multiple times.

AppleAndroid