Cleveland Clinic performs its first in utero surgery on fetus, repairs spina bifida before baby’s birth

The Cleveland Clinic has joined other major hospitals in North America and can now offer menopausal treatment. The hospital announced on Wednesday that more than a year after the preparations had successfully completed the first operation of North Ohio on the fetus inside the uterus to repair spina bifida.

“The operation of the fetus in the uterus, I am directing and in charge of it, and directions on where to open the uterus, the exposure of the baby,” said Dr. Darell Kas, director of fetal surgery at the Cleveland Fetal Center at the Clinic.

The baby girl was born nearly 37 weeks on June 3rd. At the moment, both the mother and the child are doing well. In the spina bifida fetus, the tube that usually protects the lowest part of the spine fails to close the spinal cord exposition, causing a myriad of problems.

“Spina bifida leads to disability in the baby, can cause paralysis of the legs, it can affect their ability to urinate,” said Kas. “Increasing pressure and fluid and that pressure can lead to brain damage.”

Fetal gynecological surgery is currently an option for parents in about 20 hospitals in North America since becoming clinically accepted in 2011. Prior to 2011, there were only four fetal surgical centers in the world. Cass was the director of one of them.

Cass in his 17 years has done more than 160 fetal operations since 2002, and after 17 years as co-director of the Children’s Fetal Center of Texas in Houston, he joined the Cleveland Clinic to start a fetal surgery program. He and his team spent more than a year preparing for their first operation.

“We started to make simulations and walks and preparations for how the activities will work, how will the family experience,” said Kas.

The team also visited other fetal surgical centers across the country to learn from top experts in the field.

While the mother does well, she is not ready for an interview. She allowed the hospital to share a video about the operation.

“We open the uterus in the smallest way directly above the place where the baby’s back is positioned,” said Tsas. The team uses ultrasound to continuously monitor the baby’s position during surgery.

Doctors repair the baby’s spine through the aperture in the womb 4.5 cm wide.

When the operation is complete, “its spinal cord is fully protected,” said Tsas. “It’s covered with muscles and skin, something called a myofascial repair, what is the current state of art.”

Cass explained that the operation is very risky for the baby; there is the potential that the mother carries his child in the immediate weeks after surgery.

But in this case, the mother carried the child almost to a mandate, 36.5 weeks, allowing the baby’s brain to be fully developed before birth by the C-section.

“The operation went perfectly, and actually repairing the back of this baby is the best I’ve seen in the last 20 years,” said Kas.

Spina bifida cannot be cured completely, but the girl will have fewer disabilities and a much better future and quality of life than if she was treated after she was born.

“It will still have to deal with some disabilities and we will work on all these things, but it will be as good as it can be,” said Kas.

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