The study, published in the New England Journal of Medicine, shows that the fetal surgery works and can have benefits for the newborns, which may outweigh the risks for the mother, according to the report. The first fetal surgery was performed at UCSF 30 years ago. During the spina bifida trial, which involved 183 mothers and three facilities, researchers divided participants randomly into prenatal or postnatal surgery groups.
Spina bifida is a common birth defect in newborns which can cause severe complications such as paralysis. During the study, 68 percent of the babies who had fetal surgery needed a shunt to drain spinal fluid by the time they were one year old, compared with 98 percent of the babies who received postnatal surgery. By the time they were 2 ½ year olds, 42 percent of the children who had prenatal surgery were able to walk without orthotics or other devices, compared with 21 percent of the children who received the postnatal surgery.
“This is a huge game-changer for fetal surgery,” said Dr. Farmer in the report. “The study shows that it can be done pretty safely, and it will open the door for other patients and other diseases. It really does validate the original hypothesis, 30 years ago, that you could improve the outcomes for these children if you operated before birth.”
To perform the prenatal surgery on a fetus between 19 and 26 weeks old, surgeons make a small incision in the mother’s stomach and cut into the uterus without disturbing the placenta. The fetus is maneuvered so the back is visible and allows the neurosurgeon to maneuver the cord in the proper place and close the incision.
Of the 78 mothers who underwent the surgery, seven needed blood transfusion during delivery, compared with just one in the nonsurgical group. The surgical group mothers were also three times more likely to go into spontaneous labor.
Read the San Francisco Chronicle report on fetal surgery.
Read other coverage on spine surgery:
– Study Finds Spine Surgeons Agree on When to Perform Surgery, Disagree on the Appropriate Procedure
– Louisiana Spine Surgeon to Present Study on Stem Cell Treatment
– Study: Spine Surgeons Often Fail to Identify Psychological Distress in Patients
