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Minimally invasive, in-utero surgery could be future of spina bifida treatment

Research has shown operating in utero gives babies with spina bifida a better chance of walking one day.

HOUSTON — When Millie Kershaw wiggles her toes, it’s a big deal. The 5-month-old has spina bifida, which means her spine didn’t form properly. She underwent back surgery at Children’s Memorial Hermann Hospital while she was still in the womb.

“We were 25 weeks and one day, so she was just a little teeny, tiny baby. We were terrified,” Megan Kershaw said.

Kershaw, who lives in Oklahoma with her family, traveled to Houston for the surgery. She delivered Millie through a scheduled C-section at 37 weeks. For years, the treatment has meant two C-sections for moms - one for the baby’s surgery and again at delivery.

Research has shown operating in utero gives babies with spina bifida a better chance of walking one day. It also reduces the need for shunts to relieve a buildup of fluid in the brain.

“Open fetal surgery is a major undertaking for these families. It’s amazing what they go through. I think we’d all like to see a minimally invasive approach become the standard,” said Eric Bergh, MD, maternal-fetal medicine doctor with McGovern Medical School at UTHealth/UT Physicians.

Doctors all over the world are researching whether the same spinal repairs can be made through tiny incisions. Surgeons with UT Physicians just completed the first minimally invasive in utero procedure on a child with spina bifida at Children’s Memorial Hermann Hospital.

“She’s 36 weeks and things are going well. We anticipate she is going to deliver in the next month,” said Ramesha Papanna, MD, MPH, maternal-fetal medicine doctors with McGovern Medical School at UTHealth/UT Physicians. He is also an attending physician at Children’s Memorial Hermann Hospital. “The good thing is there is a lot of interest all over the world (there are ) many centers focusing on it. This is a good time for research in spina bifida.”

Papanna said this research is important because even with surgery, only half of the children with the condition can walk when they’re 2 1/2 years old.

The goal is to improve spinal cord function for children and also achieve a better outcome for mothers.

“I feel this surgery has given her that hope. I really do think this surgery was the best option for our family,” Kershaw said.

So far, she says Millie is hitting every milestone.

“They get this scary diagnosis, and it’s not the end-all. They have a wonderful life. I’ve met so many wonderful families in this whole ordeal that seems so scary in the beginning, but in the end, they’re just like normal little babies and they have purpose and worth,” she said.

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