Spina Bifida Repair
At the SSM Health Cardinal Glennon St. Louis Fetal Care Institute we have one of the most experienced teams in the country ready to help families who have learned their baby will be born with spina bifida. Since we began offering the surgery in 2011, more than 100 families have been evaluated and nearly 50 mothers and babies have undergone the surgery at the Cardinal Glennon St. Louis Fetal Care Institute.
Fetal Myelomeningocele Repair Surgery History
In February 2011 the future of unborn babies diagnosed with spina bifida was changed forever when the results of the MOMS (Management of Myelomeningocele Study) Trial were released. In the NIH-sponsored trial, patients facing a spina bifida diagnosis were randomly assigned to undergo fetal surgery before 26 weeks gestation, or receive standard postnatal surgery. After examining 158 of the children in the study at one year of age, it was found that babies who have the fetal surgery often have better outcomes than those who receive the standard repair surgery after birth.
Fetal Myelomeningocele Repair Operation
The operation for open fetal surgery for myelomeningocele repair involves making a small opening in the uterus, then closing the spinal cord opening similar to the procedure that can be performed after birth. The womb is repaired and the mother is in the hospital for four to five days. The surgery is performed between 19 and 26 weeks of the pregnancy.
Mothers usually stay in the St. Louis area for about two weeks so that we can monitor the pregnancy. After this, they can return home for delivery. Because of the weakness caused by the surgery on the uterus, the baby and all future babies have to be delivered by cesarean section.
Benefits of fetal repair include:
- Protection of the spine after the fetal repair.
- The spine can no longer be damaged during the pregnancy and after.
- The leakage of cerebrospinal fluid (CSF) is stopped.
- We think that this causes the brain to rise back into the skull, allowing the fluid within the brain to circulate normally and limiting further development of hydrocephlalus. As with any prenatal surgery, there are risks to both the mother and the baby.
Our SLUCare Physician Group team at the Cardinal Glennon St. Louis Fetal Care institute will discuss all of the risks and benefits of the surgery with you and your family, so you can make the best decision for your baby.
The standard care for babies with spina bifida is to repair the defect after birth. The neurosurgeon closes the opening of the spinal cord, and restores the muscle, skin, and tissue to cover it.
Unfortunately, postnatal surgery cannot restore any of the function that has been lost during the pregnancy, and the damage from hydrocephalus, the Chiari malformation, and/or loss of movement are then permanent.
Fetal Myelomeningocele Repair Collaborative Fetal Surgery Process
Our compassionate team of specialists and nurses works with families and their referring physicians to navigate through the fetal care process, including travel arrangements and financial counseling.
- Physician refers, or patient self-refers to the Cardinal Glennon St. Louis Fetal Care Institute
- St. Louis Fetal Care Institute Team determines patient eligibility through diagnostic evaluation
- Open fetal surgery, with a 4-5 day inpatient stay
- Patient stays in St. Louis for two weeks to rule out complications
- Patient returns home for co-managed care between her prenatal care providers and the Cardinal Glennon St. Louis Fetal Care Institute
- Patient delivers via c-section at SSM Health St. Mary's Hospital - St. Louis or her home hospital
Fetal Myelomeningocele Repair Research
The Cardinal Glennon St. Louis Fetal Care Institute is currently conducting a number of research trials for myelomeningocele. For more information about fetal myelomenigocele repair or our research studies contact us anytime at 314-268-4037 or toll free at (877) SSM-FETL (877-776-3385).