February 15, 2011
Big Benefits For Surgery in the Womb
(Ivanhoe Newswire) -- Mother's carrying babies with spina bilfida could see major benefits by having surgery in the womb.
Spina bifida, is a birth defect that affects 1,500 of the babies born in the U.S. each year. The bone around the spine doesn't form properly, causing part of the spinal cord to stick out of the baby's back.
According to this study, about 10% of babies born with the defect die after birth. Since there is no cure for the defect, some parents choose to end the pregnancy. If the pregnancy is not terminated parents are left with two options: operate on the newborn after birth or operate on the baby while it's still in the womb. This new study examined the second option.
A clinical trial was conducted at Vanderbilt University Medical Center in Nashville, the Children's Hospital of Philadelphia and the University of California, San Francisco. The trial goal was to enroll 200 patients, but researchers say the results were so good the study was ended early.
The study reported data on 158 patients who were followed at least one year after surgery. Researchers found that after 30 months, children who had their spinal surgery in utero had better motor function. Forty-two percent of the children in the prenatal surgery group could walk without crutches compared with the 21 percent of children operated on after birth. Researchers also found that brain malformations were reversed in one-third of the prenatal patients.
"This is not a cure," Dr. Scott Adzick, lead author of the study and the chief of pediatric surgery at the Children's Hospital of Philadelphia, was quoted as saying. But, he said, the results of this clinical trial show that prenatal repair surgery is a viable option.
Doctors say the surgery should be done as early as possible because the longer the spinal cord is exposed to amniotic fluid, the more it can be damaged.
As with any surgery there are certain risks and complications to be aware of. Researchers say 80 percent of the babies in the prenatal surgery group were born somewhat premature and the mothers were at increased risk to have their uterus rupture. This risk carries over to future pregnancies and as a result, mother's who have this surgery will need to deliver future babies by C-section.
SOURCE: New England Journal of Medicine, February 2011