Prenatal Surgery: Benefits Worth the Risk?

When googling spina bifida, there are many articles regarding prenatal surgery that pop up.  I read several from credible medical establishments and there was only one conclusion I could draw:  this procedure is still very new (meaning, there is not enough research about this procedure to make a completely informed decision) and it is highly controversial.

Ultimately, between the 19th & 25th week, a surgeon opens the mother’s uterus, exposes the fetus, and performs a surgery that repairs some of the damaged nerves.  In most cases, the risk of premature labor & delivery after the surgery is high.  There is a high risk of death and a high risk to the health of the mother.

According to the Mayo Clinic

Proponents of fetal surgery believe that nerve function in babies with spina bifida seems to worsen rapidly after birth, so it may be better to repair spina bifida defects while you’re still pregnant and the baby is still in your uterus (in utero). So far, children who received the fetal surgery seem to need fewer shunts, but their walking ability and bowel and bladder functioning don’t seem to be improved.

And the operation poses risks to the mother and greatly increases the risk of premature delivery.

To get a better idea if there is enough of a benefit to justify the risks, the National Institute of Child Health and Human Development is conducting a large, long-term clinical trial called the Management of Myelomeningocele Study. The study hasn’t yet been completed, so for now, it’s unclear whether this risky technique is more effective than is traditional surgery to close the spinal column after birth.

Like everything in medicine, the more research and technological improvements that are made, the better the procedures will be.  However, it seems that at this time, there just is not enough information or conclusive studies to determine if the benefits of this particular procedure is worth the risk to both the mother and child.

-lk herndon

3 Responses to “Prenatal Surgery: Benefits Worth the Risk?”

  1. Gretchen says:

    I saw this, and was ver interested in reading some deep thoughts on the subject, but am very disappointed with the limited scope here.

    My son had the surgery over 10 years ago (new??) and I believe that the “medical” scope of it all hides the personal scope of it.

    There are dangers and risks in ALL procedures …. I firmly believe that with proper care and preperation the fetal surgery has great benefits.

    I would love to see some facts to back up you “dreary outlook”, otherwise this is no better than the dooms day predictions that the doctors give us when they diagnosis our children.

    Fetal surgery is a valid option that has had great out come for many families. It depends on the people invovled. I hope that those in that dark place of having just recieved a diagnosis find the hope that this procdure can bring the right people :)

  2. heather says:

    Thank you to Cassie for adding your little girl and your website. I just wanted to add to this posting from the perpective of a mom that had the fetal surgery. I thought that it was scary and unknown but that I was doing the best Iknew for my baby to be. We had a very successful Surgery in January and she was born at 36 and a half weeks in April. She did need the shunt a month later. I still believe that the surgery was a huge benefit to our little Charlotte. But you are right about everything you said above. It is a huge risk to both mom and baby and a hard study to be apart of if you have other kids and work requirements.

    I”m so glad we did it but to anyone else. I would surely advise lots of prayer for the right guidence in your life.

  3. Stacy says:

    I just had fetal surgery at the Childrens Hospital of Philadelphia on 12/3/2010. I was 23 wks and 5 days pregnant. My son has a lesion starting at L2-S4. I had one complication during surgery which was a bloodclot in my uterus and I required a blood transfusion. After the surgery my amniotic fluid stayed around 8cc which is low but as long as it’s above 5cc they are not extremly concerned. I also had a swperation of membranes but it actually corrected itself. The Chiari II malformation is now corrected and Max can move his toes, ankles, knees, and legs which I was told by every dr I met that more than likely he would have little to no movement from the waist down. With the surgery I believe it kept what movement he had and I believe the prenatal surgery is the best option, but that’s my personal opinion it’s not for everyone. It is extremly painful and you remain in pain I cannot sleep for hurting every night but I know this is temporary and if Max has benefited from one thing from the surgery I would do it all over for him.

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