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Spina bifida: Baby with open back still operated on in the womb

Spina bifida: Baby with open back still operated on in the womb



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Unborn child in the womb operated on the open back
In Heidelberg, doctors have already operated on an unborn child in the womb on the open back. The defect known as spina bifida aperta can, among other things, lead to the affected children later being severely impaired in their motor skills and developing a so-called water head.

Child undergoes surgery in the womb
At the Heidelberg University Hospital, doctors operated on a child in the womb on the open back (spina bifida aperta) using a procedure that is unique in Europe. The baby was able to develop in the mother's womb for another eleven weeks after the procedure before being born on Tuesday, August 9, by caesarean section.

Unborn remained attached to the umbilical cord
The Medical Director of the University Women's Clinic in Heidelberg, Professor Dr. Christof Sohn said in a message: “For the intervention during pregnancy we opened the uterus like a caesarean section. The child was carefully lifted out a little and remained connected to the umbilical cord. "

Affected people often develop a water head
As explained in the communication, the defect called spina bifida aperta occurs between the 20th and 28th day of pregnancy if the vertebral bodies and often the skins that surround the spinal cord do not close. Depending on the extent and location of the defect, the affected children later have severe impairments in their motor skills and often develop a so-called water head, in which brain water accumulates within the skull. The disorders can also lead to paralysis.

One in 1,000 children are born with their backs open
The professional association of pediatricians (BVKJ) writes on its website "kinderaerzte-im-netz.de" that in Central Europe about one in 1,000 children are born with an open back. This means that girls are affected more often than boys. Because an open back often occurs in some families, one suspects genetic causes.

Different risk factors
A lack of folic acid, vitamin B9, or a disturbance of the folic acid metabolism apparently also plays a role in the first weeks of pregnancy. Women who want to have children should therefore take folic acid prophylactically. Taking certain active ingredients, such as valproic acid for epilepsy or fever in early pregnancy, gestational diabetes or obesity in the mother, are also considered risk factors.

Most of the affected children are treated after birth
Most children are only treated with an open back after birth, but there have also been prenatal interventions. Experience has already been gained in the United States. "The study results from the USA impressively demonstrate the great advantage of open fetal surgery on the spina bifida," said pediatric neurosurgeon Dr. Heidi Bächli, who operated on the child's back in Heidelberg. "The children suffer less from a water head, the cerebellum moves less into the spinal canal and the extent of paralysis can be significantly reduced."

Best possible start in life
The boy's spine had not completely formed around the spinal cord and nerves. "The early operation allowed the boy to develop successfully in the womb without further damage to the spinal cord," explained Dr. Bachli. “The spinal cord, hard meninges and skin were closed layer by layer during the operation. This is how we gave the baby the best possible start in life: the risk of a water head was reduced and serious damage to the spinal cord was largely prevented, ”explained Professor Andreas Unterberg from the Neurosurgical University Clinic in Heidelberg.

The mother and baby are expected to be released from the clinic soon
The significant changes in the child's brain that were recognizable by ultrasound had regressed during pregnancy. "This is a huge success that was only possible through intensive interdisciplinary cooperation," said Professor Sohn. According to media reports, the baby is developing splendidly. The mother and child are due to be released from the hospital next Sunday. (ad)

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Video: Fixing Spina Bifida in the Womb (August 2022).