Incredible Surgeries Illustrated: Fetal Surgery for Spina Bifida





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Published on Apr 26, 2019

An illustrated explanation of fetal surgery for spina bifida. https://www.chop.edu/fetalsurgerymmc

Spina bifida is a birth defect in which an area of the spinal column doesn’t form properly, leaving a section of the spinal cord and spinal nerves exposed through an opening in the back. It is the most common birth defect of the central nervous system, affecting about 1,500 babies born each year in the United States. The two main spina bifida treatment options are fetal surgery during pregnancy or surgery on the baby right after birth.

Mothers carrying babies diagnosed with spina bifida need to know they are getting the most accurate information from an experienced, caring team. Since 1995, Children’s Hospital of Philadelphia’s (CHOP) Center for Fetal Diagnosis and Treatment has been at the forefront of understanding, diagnosing and treating myelomeningocele (MMC), the most severe form of spina bifida, before birth.

Open fetal surgery for myelomeningocele is a delicate procedure where fetal surgeons open the uterus and close the opening in the baby’s back while still in the womb. The procedure was pioneered by N. Scott Adzick, MD, MMM, and the team at the Center for Fetal Diagnosis and Treatment. The team has performed more than 350 fetal surgeries on babies with MMC, maintaining optimal patient safety and following high standards for prenatal myelomeningocele repair to ensure the best possible outcomes for mother and baby.

Expectant mothers from all 50 states — and more than 60 countries — have traveled to Philadelphia for care at the center.

While fetal surgery is not a cure for spina bifida, more than 20 years of testing and trial proved that operating on the baby in the womb can lead to significantly better results than traditional repair after birth. Because spinal cord damage is progressive during gestation, prenatal repair of myelomeningocele may prevent further damage.

In 2011, center experts co-led the Management of Myelomeningocele Study (MOMS), a landmark nationwide controlled clinical trial that confirmed that fetal surgery for spina bifida greatly reduces the effects of hindbrain herniation, reduces the need to divert fluid from the brain, improves mobility and improves the chances that a child will be able to walk independently. These results, published in the New England Journal of Medicine, conclusively established the effectiveness of fetal surgery for spina bifida.


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