Fetal Surgery for Spina Bifida

Spina bifida is a neurological condition that can cause a portion of the spinal cord to develop outside the body. A complex form, myelomeningocele (MMC), affects around 1,500 babies in the U.S every year. MMC can cause a buildup of spinal fluid in the brain, mobility problems and other lifelong issues.

At one time, surgeons had to wait to repair the defect until after a baby was born. Recent studies have proven, however, that babies who receive surgery prenatally are twice as likely to walk independently at two years of age and half as likely to need shunt placement at time of delivery to relieve pressure from the neonate’s brain. Though not every pregnancy is a candidate for surgery it is now standard of care for patients to meet and discuss with a high risk pregnancy doctor the option of prenatal surgery in cases of spina bifida.

In 2013, Ochsner was proud to perform the first in-utero surgery for spina bifida in the Gulf South. Our fetal surgery team, composed of over 20 members, operated successfully on a 23-week-old fetus with MMC with excellent results. This is a groundbreaking procedure that fewer than 15 hospitals in the United States are able to perform. Today, Ochsner is the only hospital in Louisiana, Mississippi or Alabama to offer this cutting edge option to our expecting families.

Ochsner is an award-winning, full-service, multi-specialty hospital – one of only 36 hospitals in the country to be nationally ranked in nine or more medical specialties, according to U.S. News & World Report’s 2014-2015 Best Hospitals rankings. We were named one of America’s 100 Best Hospitals for Critical Care™ for 2 Years in a Row (2012-2013), one of the Nation’s 100 Best for Cardiac Care & Critical Care, and received the Healthgrades Neurosciences Excellence Award™ in 2012. If something goes wrong, the right doctor with the specific knowledge and experience is never far away at Ochsner.

Ochsner also houses the only 24/7 Maternal Fetal Specialist Team and Fetal Therapy Team in the region. In addition, we are home to a highly acclaimed Intensive Care Unit as well as a Level III Neonatal Intensive Care Unit (NICU) – the highest level designation awarded by the State of Louisiana. Mother and baby couldn’t be in better hands.

But at Ochsner, we recognize that more than our patients need care. A diagnosis of spina bifida can leave dads, grandparents and siblings frightened and confused. You’ll find our team always has time to answer questions, provide resources and lend a compassionate ear.

The fetal surgery team at Ochsner is comprised of over 20 members who are specialized in areas such as Pediatric Neurosurgery, Obstetric Anesthesiology, Pediatrics, Pediatric Cardiology, Neonatal Intensive Care Unit (NICU) and ICU. Unlike most teams, we also have a plastic surgeon onboard at this stage. You’ll have peace of mind knowing mother and baby are being cared for by the best team in the region.

After a thorough evaluation including an ultrasound, MRI and fetal echocardiogram, you will meet with members our team to review your test results, confirm the diagnosis, explain treatment options and potential outcomes and answer all of your questions. Our team will work with your family to help you fully understand the benefits and risks involved ­­­so you can make the best decisions for your unique situation.

If you are a candidate, then between 22 and 26 weeks pregnant, we’ll perform the surgery on you and your fetus, which will be very much like a cesarean section. A surgeon will make an incision into your abdomen and uterus, large enough for access to the spinal defect, allowing the pediatric neurosurgeon to repair the defect. After the surgery is complete, your incision will be closed, and you’ll be given medications for pain and to keep you from laboring. You will be observed closely after your surgery in the hospital for about 5-7 days ensuring no evidence of preterm labor and that your baby is doing well. You’ll get to go home after recovery but your daily activity will be strictly limited. Our team will keep a close eye on your baby with weekly follow-up appointments and ultrasounds. Then, at 37 weeks, you’ll deliver your baby by C-section. This will protect the scar you have on your uterus from the fetal intervention.

Having a child with a medical condition can be tough emotionally as well as financially. Brent House Hotel, connected to Ochsner Medical Center on Jefferson Highway, can help reduce the financial burden. Families with children at Ochsner Baptist will soon be able to stay at Alder Hotel, opening in 2016.

Genetic testing for spina bifida is available at Ochsner.

Find out more

To refer a patient to Ochsner Maternal Fetal Medicine specialists or for additional inquiries about fetal surgery, call 504-842-6290.

Read more on the fetal surgery for spina bifida performed at Ochsner Medical Center.

Read more and view the video on nola.com about the surgery and the story of Kolby.