Friday, February 11, 2011
Spina Bifida Surgery Breakthrough: Opens Fetal Surgery Door
1:07 PM | 
Posted by
Farooq |
Surgery on babies still in the womb has long largely been restricted to those who would not survive otherwise, but a breakthrough study is likely to lead to a surge of research into fetal surgery to treat birth defects. Surgeons found that repairing Spina Bifida- a debilitating spinal condition that 1500 babies are born with annually- in the womb helps avoid the brain damage and paralysis that often result when the condition isn't treated after birth.
The $22.5 million study, long awaited by experts and published online Wednesday in "The New England Journal of Medicine (NEJM)", is likely to galvanize interest in trying to address problems before birth, including operating on serious heart defects and bladder blockages, and potentially using fetal bone marrow or stem cell transplants for sickle cell anemia and immune disorders.
The researchers said the randomized clinical trial is the first that systematically evaluates the best treatment for myelomeningocele, the most serious form of Spina Bifida, where the bones of the spine do not fully form. It is also the first to prove definitively that fetal surgery can help certain patients before birth, they told the media.
During the surgery, doctors operate on a four-inch long fetus, putting a protruding, roughly raisin-size piece of spinal cord back inside the fetus's body. The study reviewed 183 pregnancies, and found that children who had the surgery before birth were twice as likely to walk unaided later: At age 3, 42% could walk, versus 21% who didn't have the prenatal operation. "This is the first time that fetal surgery has ever been attempted and validated for what we think of as a non-fatal birth defect," says one of the study authors. There were medical downsides for both mothers and infants (for instance, 80% of the babies who has the surgery were delivered prematurely, compared to 15% of those who didn't), but experts describe the study as a huge step in the right direction.
Senior author Dr Diana Farmer, Surgeon-in-chief at UCSF Benioff Children's Hospital, told the press that:
"For a young couple, finding out their developing child has a problem is one of the most devastating things that can happen."
"This landmark study offers real hope for improving the lives of children with Spina Bifida worldwide," she added, explaining that their findings now strengthen the idea that fetal surgery is a better option than waiting to treat them after they are born.
The $22.5 million study, long awaited by experts and published online Wednesday in "The New England Journal of Medicine (NEJM)", is likely to galvanize interest in trying to address problems before birth, including operating on serious heart defects and bladder blockages, and potentially using fetal bone marrow or stem cell transplants for sickle cell anemia and immune disorders.
The researchers said the randomized clinical trial is the first that systematically evaluates the best treatment for myelomeningocele, the most serious form of Spina Bifida, where the bones of the spine do not fully form. It is also the first to prove definitively that fetal surgery can help certain patients before birth, they told the media.
During the surgery, doctors operate on a four-inch long fetus, putting a protruding, roughly raisin-size piece of spinal cord back inside the fetus's body. The study reviewed 183 pregnancies, and found that children who had the surgery before birth were twice as likely to walk unaided later: At age 3, 42% could walk, versus 21% who didn't have the prenatal operation. "This is the first time that fetal surgery has ever been attempted and validated for what we think of as a non-fatal birth defect," says one of the study authors. There were medical downsides for both mothers and infants (for instance, 80% of the babies who has the surgery were delivered prematurely, compared to 15% of those who didn't), but experts describe the study as a huge step in the right direction.
Senior author Dr Diana Farmer, Surgeon-in-chief at UCSF Benioff Children's Hospital, told the press that:
"For a young couple, finding out their developing child has a problem is one of the most devastating things that can happen."
"This landmark study offers real hope for improving the lives of children with Spina Bifida worldwide," she added, explaining that their findings now strengthen the idea that fetal surgery is a better option than waiting to treat them after they are born.
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