It's a landmark in the controversial, 30-year-old field of fetal surgery: Surgeons are reporting success in treating a common, serious birth defect called spina bifida — before birth.
Spina bifida is a hole in the spine that sometimes allows a loop of the naked spinal cord to protrude outside the body. Such neural-tube defects are down 30 percent because more expectant mothers are taking folic acid pills and dietary supplements. But about 1,500 babies are born with spina bifida every year, and many are destined to have severe lifelong disabilities.
A new study, published online in the New England Journal of Medicine, shows that repairing the most severe form of spina bifida during pregnancy can reduce the paralysis and brain damage that often result when the defect isn't corrected until after birth.
The surgery is delicate and risky for both mother and fetus. Doctors must make a three-inch incision in the mother's uterus to expose the fetus, which is typically about four inches long at this stage.
They then put the exposed piece of spinal cord — between the size of a raisin and an almond — back where it belongs, and suture layers of tissue to keep it in place and prevent cerebrospinal fluid from leaking out.
