Spina bifida affects roughly 1,500 babies born each year in the United States.
It is a scary (for parents especially) but treatable neurological condition affecting the spine and the spinal cord. Most adolescents and young adults who are treated live happy, successful lives, despite some mobility issues and potential inconvenience from secondary conditions.
Now, thanks to advancing medical technologies surgeons in New Orleans are now able to intervene before birth, performing surgery in-utero to repair the spinal column before the child is born.
Diagnosis of Spina Bifida
Spina Bifida is diagnosed during pregnancy thanks to prenatal tests designed for the purpose.
If the condition is not revealed through routine blood testing, it may appear on images produced during an ultrasound exam. This test, which is safe for both mother and baby, is considered very effective in detecting spina bifida and determining the severity of the condition.
A third test, amniocentesis, which is no longer performed as routinely as it once was, is also effective in diagnosing the condition.
Fetal Repair of Spina Bifida
For many years, children with spina bifida would be born with an “open” spinal column.
In children born with spina bifida, the bones that protect the spinal cord do not form exactly as they should, which can result in damage to the nervous system. The severity of the defect depends on the size and location of the spinal opening and on the degree of subsequent damage to the spinal cord and other structures.
While the causes are not known, the results were often disabling. Today, however, pre-natal surgical intervention is making a huge difference in the quality of life for infants born with spina bifida.
A study of prenatal versus postnatal repair revealed that fetal surgery for spina bifida “greatly reduces the need to divert fluid from the brain, improves mobility and improves the chances that a child will be able to walk independently.”
Spina Bifida in New Orleans
Today, though fetal repair of spina bifida is considered the standard of care, it remains a complex and challenging procedure, requiring the most expert, comprehensive care for both mother and fetus.
Oschner Health Center in New Orleans is one of just 15 hospitals nationwide offering the procedure, which was first performed here by a group of surgeons led by Dr. Cliff Moore and Dr. Chong Bui, with Dr. Hugo St. Hilaire collaborating.
Oschner is the only hospital in Louisiana, Mississippi, or Alabama to offer this cutting-edge option to expecting families.
Why Fetal Repair for Spina Bifida?
NOLA Craniofacial recommends in-utero surgery at the appropriate time during pregnancy to correct or repair the spinal cord and column prior to the birth of the child.
Why would you risk such a complex operation on an unborn child?
We recommend this procedure because it offers:
- Improved neurological function.
- Reduced chance of chronic incontinence.
- Increased chance that the child will be able to walk independently.
- Improved kidney function (avoiding associated complications at birth).
- Reduced chance of hydrocephalus* (fluid in the brain).
Note: children born with spina bifida often require a ventricular shunt, a surgically placed tube that allows fluid in the brain to drain as needed. The presence of this tube—which extends from the brain to the belly and must be in place for life—can invite late complications, especially as they sometimes need to be replaced as the child grows.
After Surgery for Spina Bifida
Mothers who opt for fetal surgery to correct spina bifida will remain in the hospital for a short period of time for monitoring. Members of the Oschner fetal surgery team, including Dr. St. Hilaire, are there every step of the way, and her care thereafter is overseen by a high-risk OBGYN such as Dr. Moore.
Of note, the surgical incision looks much like the scar one might expect from delivery by Caesarian section and, indeed, most if not all of children are delivered through the same incision—whole, healed, and with the best chance of a full, happy life ahead of them.