In July 2014, a little girl underwent surgery on her spinal cord. Achievement of a spina bifida(a malformation of the central nervous system), she was operated on in utero by the team of the fetal medicine department of the Armand Trousseau-AP-HP hospital, and the neurosurgery team of the Necker-Enfants Malades-AP-hospital. HP.
“In the 10 days following this intervention, a normalization of the pre-existing brain abnormalities caused by the malformation was observed. The pregnancy then continued under normal conditions and the mother gave birth by caesarean section at 8 months on November 09, 2014. The baby and the mother are in perfect health, ”welcomes the Assistance publique-Hôpitaux de Paris (AP- HP) in a press release.
This malformation of the central nervous system is quite common and affects on average 1 pregnancy out of 1000, or 800 cases each year. In more than 90% of cases, this anomaly is diagnosed before birth by ultrasound. This disease causes motor problems in the legs that can compromise the acquisition of walking and an abnormality in sphincter control. It also generates cerebral repercussions that can compromise the development of children’s acquisitions.
Improve children’s brain development
Numerous studies have shown that prenatal repair of this malformation carried out around 5 months of pregnancy made it possible to reduce the handicap of these children by protecting the marrow, which improves motor control of the legs.
“This intervention has been carried out for many years in the United States. It consists of covering the exteriorized spinal cord by repairing the envelope which normally covers it with a suture, then suturing the baby’s skin. Compared to care after birth, the benefits for the baby are greater ”explains Professor Jean-Marie Jouannic from the Armand Trousseau-AP-HP Hospital.
“This procedure will not cure the child. But this repair makes it possible to stop the leakage of cerebrospinal fluid. The brain being thus protected, the intellectual development of the children is improved. However, this fetal intervention exposes the risk of premature birth. It also imposes the birth of children by cesarean », Recalls Professor Jean-Marie Jouannic.
“This premiere at AP-HP is a big step for children with spina bifida and their mothers. It opens the way to better care and subsequently improves the motor and intellectual development of these children ”concludes Professor Jean-Marie Jouannic.
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