On March 21, as Connecticut Governor Ned Lamont asked doctors and patients to postpone all elective procedures due to COVID-19, a life-saving breakthrough surgery took place at Yale New Haven Hospital (YNHH). A team of medical professionals there performed surgery on a preborn baby to correct spina bifida.
“There are a lot of people who are having surgeries canceled because of COVID-19 … but this was a procedure that had to happen that day, or it wouldn’t have been able to happen at all,” said Dr. David Stitelman, surgical director of the Yale Fetal Care Center.
The baby had been diagnosed with myelomeningocele, the most severe and most common form of spina bifida, a condition in which the nerves in a baby’s spinal cord are exposed to amniotic fluid, leading to nerve damage. That nerve damage can cause bowel and bladder dysfunction, infections, brain herniation, inability to walk, and in some cases death. While not a cure, performing surgery before birth as opposed to after has shown improved outcomes for children with spina bifida. Research from the Mayo Clinic found that prenatal surgery for spina bifida can restore normal brain function. Surgery is typically completed between 19 and 25 weeks gestation.
“We discovered the main benefit of this procedure is not only to close the spine, but the most important thing is to improve the brain structure and the brain anatomy,” said Dr. Rodrigo Ruano, M.D., Ph.D., chair of Mayo Clinic’s Division of Maternal and Fetal Medicine. “Our study shows we can regenerate the brain structure so that it comes back to better development.”
The surgery performed at YNHH took about three hours and had the support of the hospital and the medical school, said Dr. Mert Ozan Bahtiyar, director of the Yale Fetal Care Center. “This [surgery] was for the benefit of the patient,” he explained, “and I am proud that we had this support because I know other centers did not.” The patient and mother are said to be doing well.
According to Stitelman, about half of all babies diagnosed with spina bifida before birth are aborted. He said there are about 10 cases of the condition in Connecticut each year and half of those are candidates for prenatal surgery.
The parents of another baby with spina bifida, Elouise, were initially told to abort her. But after seeking a second opinion, Elouise underwent prenatal surgery and she celebrated her first birthday in April. Her mother Bethan Simpson told Live Action News that she is “doing amazingly well.” She has yet to need interventions and she has started taking steps. “Meeting all her little milestones that they once said would be unlikely,” she explained.
As more hospitals begin to perform this surgery, the demand will increase and YNHH is expecting to see more surgeries of this kind performed throughout New England.
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