New operation could help unborn babies with spina bifida

Babies who are at risk of developing spina bifida could undergo a new innovative procedure that takes place while they are still in the womb, The National Institute for Health and Care Excellence (NICE), has said today.

Two different operations have been looked into by NICE to help babies with an open neural tube defect, which can lead to spina bifida.

The first consisted of opening the womb through surgery and operating on the foetus, and the other involved using keyhole surgery to access the unborn baby.

In the case of the open repair procedure, safety concerns were raised by the committee for mother and baby. However, they were familiar with the risks and found that it worked effectively enough to justify using it in the NHS in specialised centres by clinicians with specific training and experience.

This follows an NHS England announcement to fund open foetal surgery for spina bifida on eligible cases, as soon as in the next few weeks.

The second, keyhole method was said to require further evidence and is currently being used for research purposes only, the committee said.

Spina bifida comes from a tube defect that happens while the baby is still in the womb, is occurs when part of the spinal column does not close properly, producing a gap exposing the spinal cord and nerves to the outside of the body.

There is no cure for spina bifida and every week four women give birth to an affected child potentially causing lifelong disabilities. The procedures put forward today aim to prevent further damage to the baby’s brain, spinal cord and nerves.

By tackling the defect at foetal stage, the chances of it developing into Spina Bifida are reduced.

Before this development, the standard practice was to operate on babies within 28 hours of their birth. The new options could be implemented before 26 weeks into the pregnancy.

Professor Kevin Harris, clinical advisor for the Interventional Procedures Programme at NICE, said:

 “These innovative procedures have the potential to reduce the symptoms that would otherwise result from spina bifida, improving the quality of life for those with the condition.”

“However, these are technically challenging procedures and should only be done in specialised centres, by clinicians and teams with specific training and experience in foetal surgery and who analyse the outcomes to both the foetus and mother.”

Professor Stephen Powis, NHS medical director, said:

“The NHS leads the world on innovation, with thousands of people set to benefit from world-leading, cutting-edge care as part of our NHS Long Term Plan, which not only means the best possible treatment for patients, but better value for taxpayers, as more money is ploughed in to life-saving, life-changing medicines and procedures like these.”

"The NHS will be offering open spinal surgery for spina bifida for unborn babies to eligible women in just a few weeks.”


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