Spina bifida womb op baby back home in Essex
Two-week-old Elouise Simpson is home after "foetal repair" surgery following a spina bifida diagnosis.
WARNING: GRAPHIC CONTENT. Dr Wael El Banna, a surgeon in Cairo, Egypt, filmed a spinal repair operation done on a baby with spina bifida in which he removes the pregnant mother's womb.
This article will provide background to the scope of MMC, review the MOMS trial data and highlight the current clinical status of open fMMC closure.
Bethan Simpson's daughter Eloise had a "foetal repair" carried out at 24 weeks after a spina bifida diagnosis.
BACKGROUND Prenatal myelomeningocele repair by open surgery can improve the neurological prognosis of children with this condition. A shift towards a fetoscopic approach seems to reduce maternal risks and improve obstetric outcomes. OBJECTIVE The aim of this study was to report on the anaesthetic management of women undergoing prenatal open or fetoscopic surgery for neural tube defects. DESIGN A retrospective cohort study. SETTING Prenatal myelomeningocele repair research group, Vall d’Hebron University Hospital, Spain. INTERVENTION Intra-uterine foetal repairs of spina bifida between 2011 and 2016 were...
CONCLUSION: Babies exposed to fetoscopic or open in-utero MMC repair did not show significant differences in fetal or postnatal growth parameters. These results support the safety of the use of CO2 gas for fetoscopic surgery. This article is protected by copyright. All rights reserved. PMID: 30672627 [PubMed - as supplied by publisher]
CONCLUSIONS: Neurodevelopmental and neurological outcomes between prenatal versus postnatal repair are similar. As with fetal surgery, conventional postnatal surgery is associated with the reversal of hind brain herniation. Similarly, postnatal ventriculoperitoneal shunts appear to be mainly required in fetuses without evidence of significant fetal ventriculomegaly. This article is protected by copyright. All rights reserved. PMID: 30663167 [PubMed - as supplied by publisher]
Conclusions: Our data confirm that fetal surgery for OSB is associated with an increased risk of preterm delivery and premature rupture of membranes, but significantly reduces the need for postnatal treatment of hydrocephalus and improves short-term motor outcomes. Our results are similar to those published for the randomized MOMS trial. PMID: 30595963 [PubMed]
The natural wound healing events such as vascularization and epithelialization into the tissue graft are absent after in-utero repair large spina bifida defects, even up to 14 weeks after repair to delivery interval often leading to wound dehiscence and infection. However, the tissue graft site healing occurs within 2-3 weeks after delivery (Papanna et al. 2015; Figure 1). The potential source and the mechanisms for this phenomenon remain unknown. Here, we tested the effect of amniotic fluid (AF) on primary human keratinocytes (KC) and fibroblast cells (FC) line.
In this study, we tested the potential role of HUC patch to regenerate the arachnoid layer, reduce histological tethering and improve neurological function in a spina bifida sheep model.
New endoscopic prenatal spina bifida (SB) repair techniques are being proposed. These should be preclinically validated. Two-layer SB-repair has been shown feasible and effective in the fetal lamb model. Herein, we assessed the feasibility and safety of three- and single-port fetoscopic 2-layer SB repair modifications.