The American College of Obstetricians and Gynecologists' Committee on Obstetric Practice has issued a new opinion recommending that patients with a fetus with spina bifida undergo counseling regarding the risks and benefits of maternal-fetal surgery.
The opinion recommends that all women who meet a specific set of criteria should now be made aware of the option of the procedure. In addition, the committee emphasizes the importance of only having the surgery performed "at facilities with the expertise, multidisciplinary teams, services, and facilities to provide the intensive care required for these patients."
"Children's Memorial Hermann is proud to be the first hospital in Texas to offer this unique service to women," said Dr. Kuojen Tsao, Co-Director of The Fetal Center at Children's Memorial Hermann Hospital and Associate Professor of Pediatric Surgery at UTHealth. "We fully support the recent ACOG opinion and are thrilled to be one of the few institutions nationwide to meet the committee's appropriate and necessary high standards of extensive experience in the field and utmost commitment to care."
"This is hugely exciting news for Children's Memorial Hermann, the entire maternal-fetal medicine community, and mothers everywhere," said Dr. Kenneth Moise, Co-Director of the Texas Fetal Center and Professor of Maternal-Fetal Medicine at UTHealth. "It means the cutting-edge procedure we've been offering here for nearly two years is not only being officially recognized, it will now be recommended for consideration by pregnant women with a fetus with spina bifida all over the country."
The committee's opinion upholds the findings of the groundbreaking MOMS Trial, reinforcing the significance of the study's promising conclusions. Sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the MOMS Trial (Management Of Myelomeningocele Study) was an eight-year study jointly conducted by the Children's Hospital of Philadelphia, the University of California at San Francisco, Vanderbilt University Medical Center in Nashville and the George Washington University in Washington, D.C. The trial studied the difference in outcomes between prenatal and postnatal closure of spina bifida - meaning surgery on the fetus while still in the mother's womb versus surgery soon after the baby is born.
The results of the trial, which were published in early 2011, found an overwhelming benefit to having the surgery performed prenatally. Specifically, babies who received prenatal treatment were half as likely to require a ventricular shunt at 12 months of age and twice as likely to walk independently by 30 months of age as the babies who received the surgery post-birth.
Myelomeningocele, the most common and the most severe form of spina bifida, is a birth defect in which the bony spine and spinal canal do not close before birth. According to the ACOG, it occurs in approximately one in 1,500 births in the United States. Symptoms may include buildup of fluid inside the skull (hydrocephalus), loss of bladder or bowel control, partial or complete lack of sensation in the lower body, abnormal positioning of the feet, partial or complete paralysis of the legs, and learning or developmental difficulties.