Spina Bifida Babies and Surgery in the Womb

Performing surgery on babies with the most severe type of spina bifida when they are still in the womb, doubles the chance that they will be able to walk someday according to a recent federally funded study reported recently in the New England Journal of Medicine.

Spina bifida is a Latin term which means "split spine." Spina bifida is a birth defect caused when one or more of the vertebral arches of the spine fails to close. This results in a malformation of the spinal cord. These malformations fall into three categories: spina bifidaocculta, meningocele, and myelomeningocele.

Occulta is the mildest form. There are usually no symptoms. Affected babies have a gap in one or more vertebrae of the spine. They may have a dimple, hairy patch or dark spot over the affected area. The spinal cord is normal and usually no treatment is needed.

Meningocele is the rarest form. A fluid filled sac (cyst) pokes through the open part of the spine. The sac contains the membranes that protect the spinal cord, but not the spinal nerves. The cyst is removed surgically usually resulting in normal development.

Myelomeningocele is the most severe form of spina bifida. The cyst holds the membranes, the spinal nerve roots and often the cord itself. There can be a fully exposed section of the spinal cord and nerves without a cyst. Affected babies are at high risk of infection until the back is closed surgically. In spite of surgery these babies will have some paralysis, and bowel and bladder control problems. In general the higher up the cyst is on the back, the more severe the paralysis.

Any woman can have a spina bifida baby. However if a couple has had one spina bifida baby, there is a 4% chance of having another one. Spina bifida can also occur in combination with other birth defects.

The causes of spina bifida are unknown, but scientists believe both genetic and environmental factors play a part. Women who are obese, diabetic, or have been treated with anti-seizure medications are more at risk. Studies show that women can decrease the risk of spina bifida by increasing their intake of folic acid.

When a baby is born with spina bifida, surgeons have been inserting the spinal cord back into the spinal column as soon as possible, and then sealing the column.

However there is good news and a better way. A new method of doing this procedure while the baby is still in the womb doubles the chance the baby will be able to walk.

The in-womb surgery also reduces the chance that the baby will need a shunt or a tube surgically implanted after birth to drain fluid from the brain. The surgery can be done about 19-26 weeks into the pregnancy.

There are some risks however. Membranes can be broken during the procedure resulting in premature birth. All mothers having this procedure must give birth by Caesarean section in the future.

The study was conducted at the Children's Hospital in Philadelphia, Vanderbilt University in Nashville and the University of California in San Francisco.

Sources:

http://www.marchofdimes.com/birthdefects-spinabifida.html

http://www.dailystrength.org/c/Spina-Bifada/support-group

St. Pete Times