Doctors and nurses pose for a photo after surgery in Abu Dhabi.Wan
Doctors at a hospital in Abu Dhabi recently performed a potentially life-changing intrauterine operation on a pregnant woman from South America.
A patient from Colombia underwent a rare open spina bifida surgery at the Kypros Nicolaides Fetal Medicine and Treatment Center in Burjeel Medical City in hopes of preventing short- and long-term complications for her baby. Spina bifida is a birth defect that occurs when the bones of the spine don’t form, which can lead to permanent disability by exposing the spinal cord to the amniotic fluid.
This condition usually results in permanent loss of bowel and bladder control, paralysis, or muscle weakness in both lower extremities. In utero repair is performed between 19-25 weeks of gestation to repair spinal defects and thus provide better results. The average incidence of spina bifida worldwide is one in a thousand.
Dr Mandeep Singh (right) and Dr Mauricio Herrera scan before surgery.Wan
A team of doctors from Burjeel Medical City performed the operation last week. The multidisciplinary team was led by Dr Mandeep Singh, Consultant Fetal Medicine and Obstetrics at Burjeel Medical City and CEO and Visiting Physician of Burjeel Farha (Women and Children Division), Dr Mauricio Herrera, and also included Dr Rajasekhar Cingapagu, Pediatric Surgery Specialist, Neurology Dr. Essam Elgamal, Consultant Surgery, Dr. Ramamurthy Baskaran, Consultant Anesthesiology and Transplantation Anesthesia, Dr. Ahmed Omran, Consultant Anesthesia, and Dr. Iviano Ossuetta, Consultant and Director of Neonatology and specially trained operating theater staff.
According to Dr. Singh, who has been trained and worked in the UK for 22 years, during fetal repair surgery, a small incision will be made on the uterus to expose the baby’s back and allow neurosurgeons to close the spina bifida defect.
“We use a synthetic patch to cover the defect. Amniotic fluid is then returned into the cavity and the uterus is closed. The baby will remain in the uterus for the remainder of the pregnancy and will be delivered by C-section at 37 weeks’ gestation,” the doctor said.
The mother is in stable condition and is expected to deliver in August at Burjeel Medical City. After birth, an expert team of neonatologists, pediatric urologists, pediatric orthopedics, and a rehabilitation team will examine the baby and create a plan of care.
“We were devastated after our routine scan at 20 weeks revealed that our baby’s spinal cord was not forming properly. We also discussed the option of terminating the pregnancy with us, but we believe in miracles and that life is a gift from God. Our doctor advised The best thing we can do is to have spina bifida repair before the baby is born,” said Liz Valentina Parra Rodriguez and Jason Mateo Moreno Gutierrez, a Colombian couple who traveled to Abu Dhabi for the surgery to give their baby the best possible treatment Chance.
Advanced Fetal Care
According to Dr. Singh, surgery is not a cure, but it can have a significant impact on a child’s life after birth. “In utero repair of spina bifida reduces loss of limb motor function and improves outcomes. After delivery, babies need follow up and, in some cases, may need physical therapy and all other medical evaluations to ensure their health, ’ said Dr Singh.
If left untreated, babies born with spina bifida are at risk for a range of complications, from orthopedic problems to problems with bladder and bowel control, depending on the severity of the condition.
Despite the risks, early intervention through fetal surgery is said to improve outcomes for babies. Fetal surgery for spina bifida reduces the need for a ventriculoperitoneal (VP) shunt — a procedure in which a tube is placed from the brain to the abdomen to Drains all fluid and prevents damage to the brain – once the baby is born. If corrective surgery is done after birth, it may increase the risk of hydrocephalus, which can exacerbate nerve damage due to changes in the amniotic fluid during pregnancy.
Kypros Nicolaides Fetal Medicine and Treatment Center in Burjeel Medical City is well-equipped to perform such high-risk maternity and delivery care seamlessly. Laser separation of the placenta for twin transfusion syndrome, fetal endotracheal obstruction for congenital diaphragmatic hernia, fetal transfusions, shunts, and management of fetal tumors are some of the other procedures that can be performed in a fetal therapy center. The hospital’s Integrated Care Unit supports the Center by providing other medical services to help patients recover after birth.
It is important that fetal surgeons and centers performing complex intrauterine procedures receive appropriate training and continue to perform such procedures on a regular basis to ensure good results. Kypros Nicolaides Fetal Medicine and Therapy Center has a large network of fetal medicine centers in Asia, Africa and South America that regularly collaborate and perform such procedures.
“Burjeel Medical City’s long-term rehabilitation, neurosurgery, orthopedic and other complex care services provide timely support to infants and families in the region,” said Dr. Singh