Ten-week-old Flora Song doesn't know it yet, but a surgery before she was born helped give her a better chance at life. The fetal surgery - the 100th operation of its kind at Cincinnati Children's Hospital Medical Center - may be just the start of a wide range of neurological issues that could be corrected this way.
Operating on a fetus involves making an incision in the mom's belly, then opening up the womb, draining some amniotic fluid and gently inflating the uterus with warmed and humidified carbon dioxide.
Pediatric neurosurgeon Charles Stevenson has been involved with every one of the 100 fetal spina bifida surgeries at Children's. He and his team strive to make the procedure continually safer.
"The procedure is a little unique if you think about it," he says. "For most surgeries, there's only one patient. But for this surgery there are two patients. But from an ethical standpoint, only one of them can derive direct benefit, right? We're putting two individuals at risk but only one will gain, and so there's always an onus on us to make the procedure as safe as possible for the mom herself."
Here's a simulation of how the surgery was done.
https://www.youtube.com/watch?v=0Gf6o2ZEQkc&t=8s
Kelsey and her husband Henry Song were nervous before the December surgery, but after the Columbus couple learned Cincinnati Children's had been correcting spina bifida in the womb for the last decade, "We just turned very hopeful and had little doubt at that point that that was the right decision to make," Henry says.
Correcting spina bifida before birth is the only neurological fetal surgery Cincinnati Children's does. Eventually they may be able to operate on babies with hydrocephalus, or the build up of fluids deep inside the brain.
"There are several centers across the globe now that are looking specifically at intervening during early gestation for hydrocephalus to protect the brain throughout the remainder of the pregnancy," Stevenson says.
Other technological advancements center on improving the spina bifida fetal surgery. In Orlando, Florida, doctors are making 3-D models to help better plan the surgery.
Despite all the difficulties, Flora's mom Kelsey is looking forward to the future. "I'm very excited that she's here. She's doing well and I'm looking forward to see her grow healthy and happy."
