In a remarkable surgery, doctors in the UK repaired the spinal cord of a 24-week-old unborn child still inside its mother’s womb.
A Successful Fetal Surgery
Bethan Simpson, 26, was 20 weeks into her pregnancy when a routine scan detected an abnormality, which later led to the discovery of spina bifida in her unborn child, a condition where the fetus’ spinal cord does not fully develop in the womb.
Spina bifida can have a devastating effect on a person’s ability to walk, can lead to incontinence, and, in some cases, can cause lasting brain damage. In about 80% of cases in the UK, the pregnancy is terminated after a diagnosis.
Mrs. Simpson opted for surgery instead.
An international team of doctors successfully performed the surgery last December on the 24-week-old unborn child to repair her spinal cord, before placing her back inside Mrs. Simpson’s womb for the remainder of the pregnancy.
This type of surgery involves exposing the back of the fetus and positioning it to allow surgeons access to the affected region of the spinal cord, which they can then attempt to repair and reposition as necessary to hopefully prevent further damage to the nerves.
This is only the fourth time such an operation, which lasted about four hours, has been performed in the UK. Doctors from Belgium and the UK performed the surgery at the University College Hospital in London in December. The baby is due in April and the NHS has approved the surgery for all parents beginning later this year.
“We Had To Do It”
In a Facebook post, Mrs. Simpson, a nurse from Burnham, Essex, wrote, “Our midwife made an appointment [after the 20-week scan] in London. Fast forward 48 hours, we were in London having scans on her head and spine.
“With that we were told our little girl had spina bifida. We were offered continuing pregnancy, ending pregnancy or a new option called fetal surgery – fixing her before she is born. We had to do it.
“Our lives were such a rollercoaster for the next few weeks.”
Dominic Thompson, the lead Neurosurgeon for the surgery, said, “Until now, when people got this devastating news there were two options - continue with the pregnancy or termination. This now offers a third option.
"It is not a cure. But there is quite clear evidence through critical trials that the outlook can be a lot better with surgery early on.
For Mrs. Simpson and her husband, Kieron, opting for the surgery was a “no brainer.”
“[I] couldn't justify terminating a child I could feel kicking,” Mrs. Simpson said.
Spina bifida, literally “split spine” occurs when the neural tube, the part of the fetus that develops into the brain and spinal cord, either doesn’t develop or doesn't close properly. The neural tube closes in about four weeks after conception.
This leaves the delicate and essential nerves of the spine exposed and susceptible to damage.
The most severe cases of spina bifida can leave the spinal canal of the infant exposed which creating a sac along the baby’s back. In all cases, surgeons can attempt to fix the opening in the spine after the baby is born, but in many cases, nerve damage has already occurred.
As of now, it isn’t known what causes spina bifida, which happens in 4 out of 10,000 pregnancies.