Thursday, February 10, 2011

In utero operation for Spina Bifida better for baby but more dangerous for mother


It's not unusual for a baby who has spina bifida to require a permanent shunt to drain fluid from her brain. Because the neural tube defect affects nerves in the lower back and pelvis, many such children are incontinent and never learn to walk. Then there's Anna Williamson, a basketball-playing, bike-riding, piano-playing 10-year-old.

Anna was operated on while still in the womb in an experimental fetal surgery that became the subject of an eight-year clinical trial designed to evaluate whether babies who receive corrective surgery prenatally have better outcomes than those who undergo the operation after birth.

The trial, led by researchers at the University of California, San Francisco (UCSF), was stopped early because of clear evidence that operating in utero resulted in healthier children. Specifically, it led to a decreased need for permanent shunts to direct fluid away from the brain, improved mental development and motor function and a greater likelihood that some children with spina bifida will learn to walk. Results were published online Wednesday in the New England Journal of Medicine.[...]

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