Texas Children's Fetal Center Performs Successful Fetal Surgery to Treat Spina Bifida

HOUSTON, Feb. 23, 2012 /PRNewswire-USNewswire/ -- As one of the country's leading medical centers diagnosing and treating fetal anomalies, Texas Children's Fetal Center is proud to announce the birth of Baby Charlotte, the team's first patient to undergo in-utero surgery for the treatment of spina bifida. Baby Charlotte's mother went into labor nearly 11 weeks after fetal closure was performed, and delivered on Saturday evening by cesarean section.  Mother and baby are doing well. 

(Photo: http://photos.prnewswire.com/prnh/20120223/DC58641)

"Texas Children's Fetal Center is now one of the very few centers in the country providing all aspects of fetal surgery, and the addition of this capability increases the options of our Texas and regional patients tremendously," said Dr. Michael Belfort, MD, Ph.D., obstetrician and gynecologist-in-chief at Texas Children's Hospital and professor and chairman of the Department of Obstetrics at Baylor College of Medicine. "We have a magnificent team of specialists from a number of departments working together in the best interests of our fetal and neonatal patients. I am incredibly proud to be a member of this outstanding team and to be able to play a role in this mission."  

Myelomeningocele, also known as spina bifida or open neural tube defect (NTD), occurs in 3.4 out of every 10,000 live births in the U.S. and is the most common permanently disabling birth defect for which there is no known cure. Myelomeningocele is a developmental defect in which the spine is improperly formed and the spinal cord is open to and fused with the skin; it is usually associated with hydrocephalus, or the buildup of cerebrospinal fluid in the brain, which requires surgical treatment to drain the fluid via an implanted device called a shunt.  The standard of care is neurosurgical closure of the defect in the first days of life. 

"A prenatal diagnosis of spina bifida can be daunting for families because it is often associated with a constellation of neurologic disabilities as well as hydrocephalus," said Dr. Robert Bollo, pediatric neurosurgeon at Texas Children's Hospital and assistant professor of neurosurgery at Baylor College of Medicine. "Closure of the spinal defect before birth reduces the risk of hydrocephalus and may improve motor function in select patients.  Fetal surgery is an exciting new tool in our multidisciplinary commitment to life-long care of patients with spina bifida."

The spina bifida program at Texas Children's Hospital includes a dedicated multidisciplinary team of physicians including pediatric specialists in neurosurgery, orthopedics, urology, physical medicine and rehabilitation, as well as physical therapists, social workers, and child-life experts, under the leadership of Dr. Kathryn Ostermaier, developmental pediatrician at Texas Children's Hospital and assistant professor of pediatrics at Baylor College of Medicine.  

Recently, a NICHD-funded study entitled the Management of Myelomeningocele Study (MOMS) published in the New England Journal of Medicine demonstrated a significant decrease in the risk of hydrocephalus for select patients undergoing fetal closure of the spine, as well as possible improvement in lower extremity function, compared to patients who underwent standard closure after birth. 

"The confirmation that fetal surgery may decrease the physical challenges some of these babies face is not only a ray of hope for families, it is also a significant achievement for fetal medicine," said Dr. Darrell Cass, co-director of Texas Children's Fetal Center and associate professor, departments of surgery, pediatrics and obstetrics and gynecology at Baylor College of Medicine. "Breakthrough studies like the MOMS trial are exciting and reaffirm our commitment to advancing fetal medicine and giving babies with complications and anomalies the healthiest possible start to life."

The MOMS trial is the second fetal intervention that has proved beneficial through a multi-center randomized clinical trial. The first was the Euro FETUS trial for laser ablation in the treatment of twin-to-twin transfusion syndrome (TTTS).  Texas Children's Fetal Center has performed almost 400 cases of laser ablation for TTTS. Very recently, a third in-utero intervention has been shown in a randomized clinical trial in Brazil to be of benefit in babies with congenital diaphragmatic hernia. This seminal study was published in February this year by Dr. Rodrigo Ruano, MD, Ph.D., who is now a member of the Texas Children's Fetal Center team.

"We are excited to be able to offer these types of life-changing procedures to our patients through our one-of-a-kind Fetal Center," said Cris Daskevich, senior vice president at the new Texas Children's Pavilion for Women. "Our mission is about caring for women through every stage of their pregnancy and I am grateful we have a program that can provide hope for these mothers in such a scary time in their pregnancy." 

The Fetal Center at Texas Children's Hospital has developed extensive screening and diagnostic algorithms for pregnancies with fetal spina bifida. It takes a large multi-disciplinary team to successfully complete these types of fetal surgeries.  The team includes physicians from maternal fetal medicine, pediatric surgery and neurosurgery, anesthesiology, neonatology, pediatric radiology, cardiology and a highly-dedicated group of specialized nurses, ultrasound technologists and genetic counselors. 

Texas Children's Fetal Center recently moved and is now open on the fourth floor of the landmark new facility, Texas Children's Pavilion for Women. Texas Children's Pavilion for Women ushers in a new era as the pediatric hospital expands into obstetrical and gynecological services, establishing one of the nation's premier facilities for women's, fetal and newborn health.

For more information, please visit http://women.texaschildrens.org/.

About Texas Children's Hospital
Texas Children's Hospital, a not-for-profit organization, is committed to creating a community of healthy children through excellence in patient care, education and research. Consistently ranked among the top children's hospitals in the nation, Texas Children's has recognized Centers of Excellence in multiple pediatric subspecialties including the Cancer and Heart Centers, and operates the largest primary pediatric care network in the country. Texas Children's is completing a $1.5 billion expansion, which includes the Jan and Dan Duncan Neurological Research Institute; Texas Children's Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; and Texas Children's Hospital West Campus, a community hospital in suburban West Houston.  For more information on Texas Children's, go to www.texaschildrens.org. Get the latest news from Texas Children's by visiting the online newsroom and on Twitter at twitter.com/texaschildrens.

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Darrell Cass
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Contact: Christy Brunton
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SOURCE Texas Children's Hospital