Pre-natal spina bifida operation: definite benefits for babies

Carolyn Moynihan
10 Feb 2011
Reproduced with Permission

Pre-natal diagnosis of birth defects is a practice that rings alarm bells for many of us because it the sequel is so often abortion. But for some fetal disorders there is another possibility: corrective surgery.

The first fetal surgery was performed in the United States 30 years ago, and in 1997 the first operation to treat spina bifida before birth. Over the next six years there were 200 such operations for spina bifida, although there had been no formal trial to establish how much babies benefited from it.

Now, an eight-year study has confirmed that there are definite benefits to babies. The San Francisco Chronicle reports:

In the study, 68 percent of the babies who had fetal surgery needed a shunt by the time they were 1 year old, compared with 98 percent of babies who had postnatal surgery. By age 2 1/2, 42 percent of children who had the prenatal surgery were able to walk without orthotics or other devices, compared with 21 percent of the postnatal surgery children.

However, there are increased risks for mothers following the two-hour operation:

Among the 78 mothers who had the surgery, seven needed a blood transfusion during delivery, compared with just one mother in the nonsurgical group. The mothers who had surgery also were three times more likely to go into spontaneous labor. All of the women who had surgery will have to deliver by cesarean section for future babies.

And risks for babies, who were more likely to be born premature than those who had surgery after birth, and to have breathing problems. Moreover, most babies still needed shunts and were unable to walk unaided as toddlers.

Still, as lead researcher Dr Diana farmer notes:

"I know from having talked to pregnant women that if you said cutting off their right arm would save their baby, every one of them would do it," Farmer said. "So it's a very difficult and delicate counseling process that we undertake before we consider patients for fetal surgery."

If only doctors would take that much care when offering abortions.