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Successful birth of baby after in-womb spina bifida surgery

16 April 2019

A baby who had surgery on her spine while still in her mother's womb is home with her family. The surgery was performed by a team from UCL, University College London Hospitals (UCLH) and Great Ormond Street Hospital (GOSH) in a medical first for the UK.

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The team repaired the defect in the spine of Bethan Simpson’s baby, who was shown to have spina bifida during her 20-week scan, in a four-hour operation in October 2018. On 1 April this year, baby Elouise was born at UCLH and at two weeks old is doing well and shows no sign of the condition.

The operation brought together researchers from UCL working with NHS clinicians from UCLH and GOSH in partnership with University Hospitals Leuven in Belgium to carry out the operations in the UK for the first time.

Until now, mothers could choose to have the fetal surgery abroad or have surgery after the baby is born, which is the current practice in the UK. The UCLH surgeries are being funded by GOSH Children’s Charity and UCLH Charities. NHS England has now confirmed that spinal surgery for unborn babies with spina bifida will soon be routinely available for NHS patients.

The specialist fetal surgery will give Elouise a significantly better chance in life, as compared to postnatal surgery, as babies with spina bifida are very often incapable of walking, and may require a series of operations to drain fluid from the brain (shunt placement) later in life.

Bethan Simpson told the BBC that Elouise is a “very hungry” baby, who “came out literally kicking and screaming”, a good sign for her health. Her kidney, bladder and hips are all performing normally and she has sensation “right down to her toes.”

“Our team from UCLH, GOSH and UCL at the Centre for Prenatal Therapy have now operated on 15 patients, five at UCLH,” says Professor Anna David, consultant in obstetrics and maternal fetal medicine and Director of the Institute for Women’s Health.

“A further ten women travelled to have surgery at Leuven, Belgium through our links with Professor Jan Deprest who trained our team and who is UCLH fetal surgical lead. The mother and baby outcomes are comparable to results from other international fetal surgery centres. Patient satisfaction with our service is high.”

UCL and GOSH researchers are working with engineers at Wellcome / EPSRC Centre for Interventional and Surgical Sciences (WEISS), King’s College London and KU Leuven to develop new fetoscopic tools and imaging techniques to support prenatal therapy.

The project called GIFT-Surg will optimise a less invasive fetoscopic repair technique and is funded by the Wellcome Trust and the Engineering and Physical Sciences Research Council (EPSRC).

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