Spina Bifida Surgery in Utero | The Chicago Institute for Fetal Health at Lurie Children’s

The Chicago Institute for Fetal Health at Ann & Robert H. Lurie Children’s Hospital of Chicago is one of the only fetal centers in the country that offers a minimally invasive approach for spina bifida repair in utero. Open spina bifida (also known as myelomeningocele) is a birth defect that occurs when the bones in a baby’s spinal column do not properly close. The baby’s spinal cord extends through the bones and is attached to the skin, which may cause spinal cord damage.

Babies who have the defect closed surgically before being born have been shown to have better long-term prognoses. The fetoscopic repair technique may reduce risks for the mother and the baby while preserving the option for a vaginal delivery. In this video, Dr. Robin Bowman, co-director of fetal neurosurgery for The Chicago Institute, explains what happens during the procedure, which happens before 26 weeks gestation.

Using intraoperative ultrasound to identify the position of the baby and placenta in the mother, the surgical team enters the uterus safely, inserting an initial port. The uterine cavity is expanded and a camera and two additional ports are inserted into the uterus. Instruments are then inserted through the ports to begin the fetal surgery. The spinal cord is released from surrounding tissues, and that allows the team to close the open defect of the spinal cord with a few fine stitches. The dura, or tough membrane covering the brain and spinal cord which holds the spina fluid, is closed in a water tight fashion and the fetal skin is also closed. Once ports are removed and incisions to the uterus are closed, the fetus continues to develop and heal for the duration of pregnancy.

Ideally, the pregnancy continues to full term, at which point the baby is delivered vaginally and cared for by The Chicago Institute of Fetal Health’s expert team of specialists.

Open spina bifida is among the many fetal complications The Chicago Institute’s experts can help your family with.

For more information about The Chicago Institute, or to make an appointment, call 1.866.FETAL24 or visit http://LurieChildrens.org/FetalHealth.