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Spinal surgery first performed on two babies in the uterus in the UK



Previously, British mothers had to decide whether to travel abroad to complete this operation or wait for their child to be born.

The 30-member team was completed this summer by two researchers from University College London (UCL), clinicians from UCL Hospital, UCL and Great Ormond Street Hospital (GOSH) and University Hospital Leuven in Belgium

Treatment for Spina Bifida – a problem with the development of the spinal cord, which leaves a gap or a split in the spine – before birth gives babies a better chance in life than surgery after birth, as the team, as babies born with spina bifida are often not able to go and possibly need a number of other operations later in life, such as shunt placement (surgery to drain fluid from the brain).

Spina bifida can be caused by low intake of folic acid and certain medications by women during pregnancy but genetics also plays a role. Six out of 1
0,000 births in the UK are affected by spina bifida.
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"In spina bifida the spinal canal does not close completely in the womb and leave the spinal cord untouched from an early stage of pregnancy to changes in the brain as well as severe permanent damage to the nerves in the lower body, "said the leading neurosurgeon. Dominic Thompson of GOSH.

Closure of spina bifida while a baby is still in the "It has been shown that cervical cancer improves the short- and medium-term goals," added the lead fetal neurosurgeon dr. Jan Deprest from UCLH added. "While no interventions are curative, the defect in fetal surgery is closed earlier, preventing spinal cord injury in the last trimester of pregnancy."

This operation makes a cut that is slightly larger than a cesarean section, the uterus opens to expose the spine and close the defect, then repair the uterus in baby.

Babies are then discharged by caesarean section after approximately 37 weeks.

The operation has been performed more than 40 times since 2012 in Belgium, where the UK team was trained and some patients were English women. It was Pioneer i at the Philadelphia Children's Hospital by Dr. Ing. N. Scott Adzick's team. The US hospital has completed over 320 such procedures since 2011.

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Treatment was only now being offered for the first time in the UK, mainly due to the "number of procedural and ethical and training issues for the fetal surgery, "Thompson told CNN. The delay reflects the amount of training and infrastructure necessary for the safe operation of the operation, said the surgeon.

Another factor that slowed down the onset is the nature of this operation, which affects two patients, the child and the mother, and could therefore involve risks to the mother.

The British team has been working for three years to bring the fetal surgery to the UK. Professor Anna David of UCL Hospital explained that the decision to perform the procedure in the UK was based on a large US study demonstrating that a prenatal surgery to correct spina bifida with a 50% reduction in the need for a surgical shunt Placement was associated with newborns and improvement of motor functions at the age of 30 months.

"Reducing the need for shunts is particularly important," said Professor Paolo De Coppi of the UCL's Great Ormond Street Institute for Child Health, "suggesting that long-term follow-up of prenatal children in the womb suggests brain function, mobility, and Total independence in non-ranked children aged 5 years was higher than in children. "

Not all babies with this condition benefit from fetal repair, which is considered by physicians. Thompson said that, as with all operations, the benefits and risks must be taken into account. Some of the risks of this surgery include damage to the uterus or uterus, premature birth and infection.

"Not all [cases] are suitable, we select those for which the benefit is greatest and the risk is justified," he said. Cases such as mothers who carry more than one child are not suitable for the operation; Babies with other congenital malformations or additional malformations will also not be admitted for fetal surgery.

About eight babies are born each day in the United States, according to the US Spina Bifida Association.

"The problem with spina bifida is that children are born with a range of disabilities," said Thompson. But, "by doing the surgery before the child is born some of the problems of spina bifida – it seems we can reverse them."

CNN's Meera Senthilingam contributed to this report.


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