Prenatal Surgery and Spina Bifida: No longer considered “experimental”

By Dave Andrusko

“I remember when I did my first one when this was just being pioneered. I was just awestruck with it – and I was doing it! And I still get a kind of a shiver almost when I do one of these.”
           — Dr. Lee Sutton, pediatric neurosurgeon at Children’s Hospital of Philadelphia.

The report on the huge advances in prenatal surgery, which aired on two days ago on National Public Radio, only came to my attention today. I am going to be very brief because you really should listen to the NPR story at  www.npr.org/2011/07/11/137712436/a-prenatal-surgery-for-spina-bifida-comes-of-age.

The fetus's back "looks a little bit like the laces of a miniature football" after surgery, says Dr. Scott Adzick, chief of surgery at Children's Hospital of Philadelphia.

I could spend what few minutes of your time I had belaboring the schizophrenia on display. The introduction by Michele Norris to the lengthy report by Richard Knox talks (as if awed by the thought) about “operating on a child who is not yet born.” Knox himself alternates back and forth between (most commonly)  “fetus” and “baby.” The parents, of course, talk only about their “baby.

I’m guessing that the inspiration for this story is a recent review Knox refers to in a sidebar that you can read online but which is not part of the audio.  We read, “Today, about 2 in every 100 pregnancies involve birth defects that could be repaired prenatally, according to a recent review by the Agency for Healthcare Quality and Research.” That and that fact (as Knox mentions at the very end) in utero surgery for spina bifida is no longer considered experimental, “so soon more children will have the chance.”

What was really news to me was how many “other types of fetal treatments” there are “in various stages of development.”  In other words, fetal malformations for which surgery may become an option.

A great story, an important story, for as Knox says not so long ago  the only two “options” were surgery after birth or “termination.”

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