Doctors in U.K. Spinal Repair Cords in the Womb :: WRAL.com



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LONDON – A team of surgeons has successfully repaired the spinal cords of two babies while they were still in their mothers' wombs, the first surgery of its kind in Britain.

The operations were carried out at University College Hospital in London by 30 surgeons to treat spina bifida, a condition in which the spinal column and spinal cord do not develop properly in the womb, causing a gap in the spine.

"Dominic Thompson, a neurosurgeon at the Great Ormond Street Hospital in London", said Thursday in a statement.

The surgery is usually performed after birth, but it is more likely that the condition is treated, the greater the chances of healthy mobility. Those born with spina bifida are often unable to walk through a series of operations to drain fluid from their brain.

The prenatal surgery involved opening the uterus, exposing the spina bifida and closing the defect without delivering the baby. Previously, mothers-to-be in Britain had to travel to the United States, Belgium or Switzerland to receive the prenatal surgery or to wait for the baby to born.

The babies who had the surgery this summer, and their mothers, were doing well, according to a spokeswoman for University College London Hospitals.

Professor Anna David, a fetal medicine consultant at the Institute for Women's Health at University College London, said that it took three years to bring the procedure to Britain, where more than 200 children are born with spina bifida each year.

"Our solution to this article is based on a large, multicenter, randomized control trial in the US, which compared prenatal closure to postnatal closure, and the observation that fetal surgery could be safely reproduced in Europe by proper training," David said in an email.

The U.S. trial has been shown to take place in the absence of a surgical device – a device that relies on fluid accumulation – in newborns. The procedure can have long-term risks and complications. The prenatal procedure also showed a significant improvement in the motor function at 30 months of age.

"Long-term follow-up of children who have undergone prenatal closure in the womb suggests that brain function, mobility and total independence were increased in size," Professor Paolo De Coppi of the UCL Great Ormond Street Institute of Child Health, said in the study.

The surgery will be made available for patients at the Center for Prenatal Therapy at University College London Hospitals and Great Ormond Street. It takes about 90 minutes and carries a risk of premature labor.

The British government is preparing a consultation on whether or not to add folic acid to flour to help reduce birth defects like spina bifida. Research from the Scientific Advisory Committee on Nutrition suggests that folic acid significantly reduces the risk of fetal abnormalities.

The public health minister, Steve Brine, announced on Tuesday that the government would consider the benefits of folic acid fortification, as well as practicality and safety.

Women who are trying to get pregnant is a supplement of 400 micrograms of folic acid before they are pregnant.

Plans for fortify with folic acid are aimed at those with the lowest intake, including younger women from deprived backgrounds.

"All women should be able to access the nutrients they need for a healthy pregnancy," Brine said in a statement. "And in turn, reduce the risk of devastating complications."

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