Spina bifida surgery offered on NHS during 23 to 26 weeks pregnancy

Dozens of babies with spina bifida have been spared paralysis and other life-limiting conditions after undergoing surgery in the womb in a cutting-edge procedure made available on the NHS.

Spina bifida prevents the spine and spinal cord developing properly and can lead to paralysis, bowel, bladder and kidney problems.

Operating on babies between 23 and 26 weeks of pregnancy, instead of after birth, results in a much better outcome for the baby.

The procedure involves a team of up to 30 in the operating theatre, including fetal surgeons, neurosurgeons, anaesthesiologists (one for the mother one for the baby), obstetricians, neuro-paediatric surgeons, radiologists, the scrub team, and neonatologists in case the baby needs to be delivered.

Professor Stephen Powis, Medical Director for NHS England, said: “Spina bifida fetal surgery - where neurosurgeons carry out complex spinal surgery on an unborn baby - is routinely available on the NHS, and is just one example of the NHS leading innovative treatments across the world.

“As well as fighting a global pandemic the NHS continues to develop and offer these trailblazing services and continue to be there for patients.”

So far 32 babies have benefited from the procedure since NHS England announced it would be available on the health service.

The programme is commissioned by NHS England through a partnership between University College London Hospitals NHS Foundation Trust (UCLH), Great Ormond Street Hospital for Children NHS Foundation Trust (GOSH) and the University Hospitals Leuven in Belgium.

The centres in London and Belgium work collaboratively through the NHS, with the long-established centre of excellence in Belgium sharing its expertise and help to develop a world-class service in London.

Professor Anna David , Fetal Medicine Consultant at UCLH, and Service Lead, said: “The service is streamlined to make it easy for patients and referring hospitals. Our coordinator based at UCLH manages referrals from the whole of the UK and devolved nations. Patients are then offered surgery either at London or Leuven, based on their geographical location. We are really pleased to offer this joined up service to smooth the patient journey as much as possible.”

Professor Jan Deprest, Consultant Foetal surgeon at UCLH and University Hospitals Leuven, said: “Throughout the pandemic the spina bifida fetal surgery NHS service was available to women 24/7, crossing borders and Covid lockdown restrictions to provide the best possible care for women and their unborn babies.

“With our teams in London and Belgium working collaboratively as one NHS centre, mothers can access the best world-class care and get the best chance for their baby’s future. “

Dominic Thompson, Lead Neurosurgeon at Great Ormond Street Hospital for Children NHS Foundation Trust (GOSH) said: “It’s been an incredible multi-institutional and multidisciplinary team effort to continue this collaboration between the London and Belgium centres, even despite the challenges of the pandemic.

“At GOSH we continue to see many of the children who’ve benefitted from fetal surgery in our specialist spina bifida clinic for their after-care, and what we’ve noted is a reduced need for shunts and further invasive surgery, as well as improved mobility. This makes all the difference to the quality of their lives.”

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