Surgeons in Abu Dhabi perform successful surgery on Colombian fetus with spina bifida
Dubai: The number of reported cases of spina bifida is on the rise in the Gulf region and around the world, but many doctors believe this is due to increased awareness and better diagnostic methods, rather than a spike in the condition.
Spina bifida is a birth defect that occurs when the bones that make up the spine don̵7;t develop properly, causing the spinal cord to come into contact with the amniotic fluid – the fluid that surrounds the unborn baby in the womb – and resulting in becomes a permanent disability.
No one wants to be told that their child is going to have anything less than an ideal life, but as with all things in the medical world, knowledge is power.
The rise in early diagnosis means there is a huge chance of improving a baby’s life through prenatal surgery, and that is exactly what happened in Abu Dhabi this month.
Although the process is not new, it was a first for the region.
The operation was led by Dr. Mandeep Singh, Consultant Maternal and Fetal Medicine at Burjeel Medical City Hospital.
She explained that prior to success in prenatal surgery there were other procedures to treat the condition but they were more risky.
“We had to wait for the children to be born. And then once the babies are born, the spinal cord needs to be closed within the first 24 hours, otherwise, there’s a risk of infection, and that infection can go to the brain and cause meningitis. Which is a very serious condition. They said.
A preliminary study to see whether the hysterectomy procedure was feasible was conducted in 2003.
“After 12 years of research, the results show that if you repair the defect in utero, you have twice as much strength in the lower limbs and are 1.5 times less likely to need a shunt,” Singh said.
Spina bifida can be caused by many things. Although rare, it can be genetic but most of the time there are several factors that prevent the spinal cord from closing, including a lack of folic acid (vitamin B), which is important for a healthy pregnancy.
If left untreated, the condition can have life-changing effects on the child.
“When the spinal cord is left in contact with the amniotic fluid, it causes damage. Most of the time, the centers that are controlled by the lower part of the spinal cord, or the bowel and bladder, are severely damaged.
“This means that these children may not be able to walk or run. They may be in the early part of their life, but as the upper body becomes heavier, they become unable to walk.
“And most of them are wheelchair-bound. Or can only walk with support. So it’s a very debilitating disease if it’s not treated.”
He and his team successfully performed spinal correction surgery on the unborn child of a Colombian couple.
For Jason Gutierrez and Valentina Rodriguez, being told that their baby had spina bifida was life-changing, not least because it meant they had to move halfway around the world, leaving behind everything they knew so that He could get surgery done.
“When I found out my baby had spina bifida, I was heartbroken,” Rodriguez said. “I’m a nurse and I’ve seen mothers with children with disabilities and never thought this could be a possibility for me.”
In Colombia, couples expecting a child with spina bifida have only two options: wait for the baby to be born and then have surgery, or terminate the pregnancy.
“As time went on and there was no real solution, miraculously we heard about a center in Abu Dhabi that was able to perform the surgery immediately and at no cost,” Rodriguez said.
“We decided to resign from our jobs, leave our families and home and travel here for our child.”
It wasn’t an easy decision to make, but Rodriguez said her family gave her their full support.
“My family was really sad, but on the other hand they were really happy that we were given this opportunity and there was a ray of hope for our child. In Colombia, there was no solution.
“I was diagnosed during the 20th week and it was observable from the 11th week onwards, so I suspect that if I had stayed in Colombia, no action would have been taken and the baby would have had disabilities and complications,” He said.
According to Singh, two to four children per 10,000 are diagnosed with the condition and the number is rising. While there is no clear reason for the increase, doctors think it is down to over-diagnosis, especially in the GCC region.
“Medical facilities are expanding so the figures are increasing, as more people are becoming aware of the condition and the need for diagnosis,” he said.
Singh said the prenatal surgery was not without risk, however, for the baby and the mother.
“Since this operation requires cutting through the womb, the biggest risk is scar rupture. Because this is a scar on the upper part of the womb, if she goes into labor, there is a higher chance that the scar will tear.” will disappear. If the scar ends up in pregnancy, it is not only dangerous for the mother, but the child will die or be born with severe brain damage,” he said.
But Rodriguez wasn’t thinking about the risks to herself before the surgery, which took place just two days after arriving in Abu Dhabi.
“I wanted everything to be perfect for the baby,” she said. “My preparation was more mental and spiritual. The center also helped with visa arrangements, flight tickets and surgery costs. Arrangements have been made from food to stay. Otherwise we had no way of affording it.
A team of 10 people, including four surgeons, was involved in the process. While Singh specializes in maternal-fetal medicine, the baby’s spine was repaired by a neurosurgeon.
Singh said there were several hospitals in East Asia, Africa, North America and Europe that could perform the procedure but Burjeel Medical City was a hub in the Gulf region.
“There is a vast geographical area where this process is not done. Our center now provides solutions for parents who are seeking help in this area,” he said.
“We promise to make our results available to every potential parent who comes here, because that’s the best way to assure prospective parents. And there’s nothing to hide in medicine. Don’t let people rely on you.” To be trusted, the results must be open and transparent.
Rodriguez is expected to give birth to the child in Abu Dhabi in August. She didn’t know how long she and her husband would stay in the country, but said they would stay as long as it was sure their baby was healthy and safe.