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Giving Baby a Chance, Before Birth

Surgery in the Womb?
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Best Use of Resources? continued...

Normally, when babies are born with spina bifida, doctors perform surgery within 48 hours to cover an open lesion on the newborn's back. By performing it before birth, doctors cannot correct nerve damage that has already occurred but, instead, hope to prevent additional damage or paralysis.

What's more, surgeons have found that fixing the spinal defect appears to correct hindbrain herniation, which causes death associated with breathing problems in 15% of children with spina bifida. It also reduces the need for a shunt by between 33% and 50%, according to Vanderbilt's research.

"If we have the chance to lessen the extent of injury, why wouldn't we do that?" asks Joseph Bruner, MD, director of fetal diagnosis and therapy at Vanderbilt, on a fetal surgery web site started by parent Todd Gardener to get the word out about the procedure.

The operation, which costs upward of $35,000 and is covered by at least one large insurer -- Aetna U.S. Healthcare -- requires a team of medical specialists, who open the mother's uterus, repair the opening on the fetus' back with a patch made from human skin, and then close the uterus.

'I don't have to wonder, what if?'

When Kelly Hasten found her baby had spina bifida, she considered "for a split second" another option -- abortion. But when she heard about fetal surgery, she decided that was the choice for her, despite the risks.

Two weeks after her surgery on Jan. 10, those risks became real when doctors discovered that amniotic fluid had leaked out of her uterus, possibly from the surgical incision. She has since been confined to hospital bed rest to await her delivery. That means she can see her husband and 7-year-old daughter only on weekends, since they live 90 minutes away.

"I'm about to go crazy," she said from her hospital bed, where she spends a lot of time researching spina bifida on a computer.

Nonetheless, Hasten says she's glad she went through with the operation: "I don't have to wonder, 'what if?'" she says.

Kathy Bunch is a freelance writer in Philadelphia.

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