A better treatment for spina bifida?: New in utero surgery is a marvel

Another study in the current issue of the New England Journal of Medicine reports on a surgical marvel. A controlled study of fetuses diagnosed via sonogram in utero with spina bifida — a neural tube defect — showed that their outcomes could be dramatically improved through surgery performed prenatally. Spina bifida is a condition in which the spinal column is incompletely fused and the spinal cord is exposed, and it can lead to muscle weakness, bladder dysfunction or even death.

Researchers divided a population of 160 fetuses with spina bifida into two cohorts of 80 each. The prenatal experimental group, which was on average more severely affected by the condition, was operated on in the womb between the nineteenth and twenty-sixth week of gestation. The control group was operated on after birth. Researchers found that the cohort treated in the womb was half as likely to require a shunt to drain excess brain and spinal fluid, and eight times more likely to have a normally positioned brainstem. While the first group was typically born three weeks earlier and mothers in this group had to undergo C-sections which might affect the ease of subsequent births, there was no evident difference in these infants’ cognitive development with that of babies in the control group. There were only two deaths in each group.