A team from University College London Hospitals (UCLH), UCL and Great Ormond Street Hospital (GOSH) has operated on the abnormally developed spinal cords of two babies in the womb, in what are the first surgeries of their kind in the UK.
The team repaired the defect in the spine of two babies with open spina bifida, in separate operations this summer. Mums and babies are recovering well.
The operations brought together researchers from UCL working with NHS clinicians from UCLH and GOSH in partnership with University Hospitals Leuven in Belgium to carry out the operations in the UK for the first time.
Until now, mums could choose to have the fetal surgery abroad or have postnatal surgery after the baby is born, which is the current practice in the UK.
This specialist fetal surgery will give the baby a significantly better chance in life, as compared to postnatal surgery, as babies with spina bifida are very often incapable of walking, and may require a series of operations to drain fluid from the brain (shunt placement) later in life.
“In spina bifida, the spinal canal does not close completely in the womb, leaving the spinal cord exposed from an early stage in pregnancy. This results in changes to the brain, as well as severe permanent damage to the nerves on the lower half of the body,” said lead neurosurgeon Dominic Thompson of GOSH.
“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 Jan Deprest of UCLH and Leuven.
“Closure of spina bifida in the womb using this method is an alternative to postnatal surgery, and has been shown to improve short and medium-term outcomes. While neither intervention is fully curative, in fetal surgery, the defect is closed earlier, which prevents damage to the spinal cord in the last third of pregnancy. We are also researching the minimal access (fetoscopic) technique through the GIFT-Surg Project framework and, if we can show it to have equal benefit, we will be offering this option to patients.