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A baby operated for spina bifida is born inside the uterus in the middle of a Covid pandemic

In the midst of the coronavirus pandemic, many babies have come into the world. One of them is a baby who had undergone surgery for spina bifida in the womb in February, during the 24th week of gestation.

The surgery was carried out at the Virgen del Rocío University Hospital in Seville, the baby was born by cesarean section at the end of April, and now both the mother and the baby have been discharged.

What is spina bifida

In week 19 of gestation, the family was informed that the baby they were expecting had spina bifida, a serious malformation of the central nervous system that affects one in 3,500 newborns. It occurs in the first month of embryonic life and occurs when the neural tube does not close completely, exposing and unprotected the contents of the spinal column. The most common form of open spina bifida is myelomeningocele , for which there is no optimal treatment after birth.

Myelomeningocele presents a high morbidity and is usually accompanied by hydrocephalus and malformations in the brain that are responsible for the great neurocognitive involvement of these children. Spina bifida can cause neurological sequelae such as paralysis, hydrocephalus, cognitive retardation, alterations of the spine), in addition to other urological and trauma (deformities, among others).

Fetal surgery inside the uterus

This malformation can be operated on inside the uterus during pregnancy, which reduces the prematurity of these babies and the subsequent sequelae of the disease. It is a very delicate operation that more and more hospitals perform

In this case, the intervention, in which more than 30 professionals took part, lasted three hours and was carried out at week 24 of gestation . Before starting the intervention, the team performs a very exhaustive preoperative assessment, which includes high-resolution ultrasound and fetal resonance where the morphology and biometry of the fetus are assessed, the placenta is located, the height, size and morphology of the fetus are determined. injury.

The mother receives general anesthesia and an incision is made in the uterus of about six to eight centimeters , using a technique developed and patented by the team for the exposure of the spinal defect. The baby, once placed in the optimal position, also receives fetal anesthesia to control pain and any possible movement.

Once the malformation has been corrected , the amniotic fluid is replaced and the uterus is closed, it is inserted into the abdomen and the abdominal wall is sutured.

Intrauterine intervention has become a real therapeutic option for babies with this birth defect. From the Virgen el Rocío they highlight that “the Andalusian public health system offers this alternative that far exceeds the results of corrective surgery after birth when it comes to avoiding, or at least minimizing the motor and neurological sequelae of the child”.

In full pandemic

If any birth during the pandemic already generates greater uncertainty in the family, in this special case, the parents have received psychological support and assistance throughout the period of admission.

We are happy that the baby has undergone such a delicate intervention and that he was discharged with his mother, despite having been born in the middle of a pandemic .

More information | Virgen del Rocío Hospital

In Babies and more | A baby with spina bifida is operated on at 27 weeks of pregnancy in the womb, through ‘keyhole’ surgery, a 24-week-old baby is operated in the womb to correct his spina bifida

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