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Fetal Surgery Effective Treatment For Spina Bifida LONDON, ENGLAND -- Nov. 20, 1998 -- In a research letter in this week's issue of The Lancet, Dr. N. Scott Adzick and colleagues from Philadelphia, PA., report the first successful surgical repair of a spina bifida lesion carried out on a 23-week gestation fetus in the womb. Spina bifida affects one in 2,000 livebirths and can lead to lifelong and severe physical disabilities, including paraplegia. In many cases of spina bifida (so-called open spina bifida) the nerves of the spinal cord are exposed to damage because there is a lack of protective bone and skin over the nerves. Studies in sheep have shown that if the nerves are protected-by surgery while still in the womb-before damage can occur, the function of the legs can be saved. In human beings, ultrasound examinations of babies with large spina bifida lesions early in pregnancy show that their legs move normally, whereas later in pregnancy leg movements are lost. By correcting the lesion in time, leg function can be preserved. The baby reported in the research letter this week was found to have spina bifida on an ultrasound scan done at 20 weeks of pregnancy because of an abnormal blood test from his mother. The baby's leg movements were still good, despite the extent of the spina bifida lesion and the operation was done three weeks later by access through the mother's womb under general anaesthesia. Seven weeks after the operation, the mother went into early labour and a baby boy weighing 1.3 kg was delivered by caesarean section. The baby's leg movements were good at birth and he has developed normally to his current age of six months. In-utero repair of spina bifida also prevented the hydrocephalus (fluid around the brain) that usually accompanies spina bifida in newborns. Related Links: The Lancet E-mail this page to a friend or colleague! To print, use this version