By Rachel Bedford, Assistant Litigation Executive in the Medical Negligence department
It has been reported that two unborn babies had their spines repaired whilst in the womb during the summer of 2018. The procedure is thought to be the first operation of its kind to be carried out within the UK.
Both of the unborn children suffered from a condition called Spina Bifida, which is a birth defect that affects more than 200 children a year. The condition happens when the neural tube, which is an early form of a baby’s brain and spinal cord, does not form properly. This results in a gap or defect in the spinal cord membrane and bones of the spine. Most children with this birth defect survive, however they can be left with many disabilities, which can include paralysis.
The procedures were carried out at London’s University Hospital and required a team of 30 doctors to complete. During the operation, an incision is made into the womb, in a precise location to access the unborn baby’s spine. The surgeon then stitches the gap within the spine to close it.
As with any surgery, the procedure does carry risks, which include a risk of premature labour. Undergoing surgery during pregnancy in general is known to carry the associated risks of miscarriage, premature birth and low birth weight, however these risks are known to be at the lowest during the second trimester of pregnancy. During the second trimester, the risk of a miscarriage or premature labour is 1%.
Though this operation has only recently been carried out in the UK, it has been on trial in the US prior to this. During the clinical trials, it was confirmed that carrying this procedure out whilst the baby is still within the womb, improves the health and mobility of the unborn child. Normally the condition would be treated at birth however it is noted that this earlier approach found a 50% reduction on the need for a shunt to be inserted into the brain to drain fluids. A shunt procedure can carry long term complications and potentially impair the brain and motor functioning, so this pioneering procedure offers the opportunity to avoid these potential complications.
Currently, a featoscopy approach to the procedure is being developed with the hope that this will further minimise the risk of complications associated with operating on an unborn baby.
This new treatment has been made possible in the UK thanks to the hospital’s associated charities, who have made a donation of £450,000. The surgery will now be made available for suitable patients at the Centre for Prenatal Therapy at University College Hospital, London and Great Ormond Street. The vital funds have provided training for the surgical team, who travelled to Belgium to learn the procedure. The remaining money from this donation will the surgery for the first 10 patients.
This just goes to show what fantastic opportunities can arise for the NHS given suitable funding.