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UK's first spina bifida surgeries in the womb completed

29 October 2018
Appeared in BioNews 973

Surgeons have successfully repaired the spines of two fetuses with spina bifida, a spinal birth defect, for the first time in the UK.

Previously, fetuses with this disorder could only be treated abroad or could receive the procedure after birth.

'It's fantastic. Women now don't have to travel out of the UK,' said Professor Anna David, who coordinated the team of thirty surgeons based at University College London Hospital (UCLH) and Great Ormond Street Hospital. 'They can have their family with them. There are less expenses. So all good things.'

Spina bifida prevents bones and membranes from forming correctly around the spinal cord, leaving gaps through which nerves can be damaged and spinal fluid can leak to the brain. The condition can lead to paralysis and long-term disabilities in the lower limbs or impact brain development.

In 2011, a US trial showed that babies who had had surgery in the womb were 50 percent less likely to require a shunt to be inserted into their brains by the age of 12 months to drain the spinal fluid. This invasive procedure can cause complications such as meningitis. Babies who had been treated were also twice as likely to be walking at 30 months.

'There are some children who had grown up following fetal surgery who were walking, and you wouldn't expect them to be walking if they hadn't had it,' Professor David said.

The team have worked for three years to bring the procedure to the UK. They trained for the surgery at the University Hospitals Leuven in Belgium where more than 40 such operations have been carried out.

'Operating in the womb involves opening the uterus, exposing the spina bifida without delivering the baby, closing the defect and then repairing the uterus to leave the baby safely inside,' said lead fetal surgeon Professor Jan Deprest of UCLH and Leuven.

The procedure currently carries a risk of premature labour, damage to the uterus and infection. The team is now researching a less invasive 'fetoscopic' technique to minimise the risk of these complications.

SOURCES & REFERENCES
Surgeons repair babies' spinal cords in the womb in UK first
The Guardian |  24 October 2018
Surgery to correct spina bifida in womb is a medical first for Britain
The Times |  24 October 2018
Two unborn babies have spines repaired while still in womb in landmark UK surgery
The Independent |  24 October 2018
Two unborn babies' spines repaired in womb in UK surgery first
BBC News |  24 October 2018
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