Uterine surgery, another alternative to spina bifida surgery

People with spina bifida have been exposed and seen spinal nerves with invisible eyes. This condition is caused by a failure of the neural tube closure. Spina Bifida makes her victims vulnerable to a high risk of infection and nerve damage. Generally, people with spina bifida die within 6 to 12 months of birth. For those who are able to survive, they will experience serious disabilities throughout their lives. Although spina bifida cannot be cured, its effects can be minimized by surgery.

Spina bifida can be detected by ultrasound while the baby is still in the womb. Spina Bifida closure surgery is usually done after the baby is born. Therefore, as long as the baby is in the womb, no action can be taken to treat this condition. In fact, nerve damage continues to occur and increases the risk of severe disability in the future. But now there are other solutions in the treatment of spina bifida, uterine fetal surgery.

Spina bifida surgery in the uterus

In 2018, two British babies with spina bifida were operated on in the womb. This operation is a very complex operation which can only be carried out by a team of competent experts. The surgery is done by opening the mother's uterus, without giving birth to the baby, closing the baby's spinal abnormalities, and then sewing the mother's uterus so that the pregnancy can last for months.

This operation does not cure spina bifida, but by accelerating the closure of spina bifida. Nerve damage that occurs must be much lighter than waiting a few months until the baby is born. Babies must also have the opportunity to enjoy a better quality of life through this operation.

Studies show that fetal surgery in the womb gives better results than surgery after the birth of a baby (postnatal). In postnatal surgery, children with spina bifida often need to be placed in a shunt, which allows them to drain fluid from the brain. Branch installation is associated with more severe disability.

Thanks to surgery in the uterus, the need for shunt placement is far more important. In addition, this operation can increase mobility and offer children the opportunity to walk on their own without assistance.

The MOMS study compared 77 children with spina bifida who had been operated on in the womb and 80 babies who were operated on after birth. The results of this study indicate that people operated on in the womb have the following advantages:

Less hernia of the hind brain (Chiari II malformation)
Less likely to need a shunt at the age of 1 year
Lower limb function is better at 30 months
Urinary control works better, although postoperative assessment studies are still needed

Criteria and risks of spina bifida surgery in the uterus

All cases of spina bifida cannot be operated. Some criteria for spina bifida surgery in the uterus, namely:

Location of the disease, where myelomeningocele occurs from the T1-S1 spinal cord
Posterior brain hernias (Chiari II malformations) are found on MRI
There are no genetic abnormalities (as evidenced by amniocentesis)
Gestational age between 19 and 26 weeks

Spina bifida surgery in the womb is not free of certain risks. The risk of this surgery is the increased risk of premature birth, premature rupture of membranes and reduction in amniotic fluid volume. Premature birth is very dangerous because it can cause infant death. Therefore it must be determined whether uterine surgery is the best solution.

With the development of technology and science, people with spina bifida who previously did not have much hope now have a better hope to survive for a long time and have better quality.