A 700-gramme child received a defect corrected even earlier than it was born as a Dubai hospital carried out the Arab world’s first intrauterine foetal surgical procedure.
The fragile six-hour surgical procedure was carried out on a 25-week-old foetus that was recognized with myelomeningocele — a sort of Spina bifida (spinal twine defect) — at Latifa Hospital for Ladies and Kids.
Because the surgical procedure was carried out at this stage and never after the child was born — which is often nonetheless the usual medical process — the foetus’ defect was corrected, giving the child an opportunity for enhancing cognitive operate, decrease limb operate and deformities.
Spina bifida is a neural tube defect that happens through the first month of being pregnant when the spinal twine doesn’t develop or shut correctly. In its most extreme type, the defect leaves a bit of the spinal twine and nerves uncovered in a sac on the affected person’s again.
It will probably result in many bodily disabilities, together with issues with strolling and mobility, bowel and bladder operate, wounds therapeutic and fluid accumulating within the mind (hydrocephalus).
The mom and foetus have recovered within the intensive care unit (ICU) within the instant post-operative interval. They are going to be monitored till the day of the C-section. Publish-delivery, the kid shall be adopted up by a multidisciplinary crew.
The Dubai Well being Authority highlighted the medical breakthrough throughout a Press convention.
Dr Muna AbdulRazzaq Tahlak, guide in Obstetrics and Gynaecology and CEO of Latifa Ladies and Kids Hospital, stated: “The affected person was referred to us when she was 24 weeks pregnant after her situation was recognized in an ultrasound.
“Upon evaluation, the affected person underwent complete counselling to know the state of affairs at hand, the medical choices and to organize her for the surgical procedure.”
The 24-year-old Emirati affected person, F.A., has two different kids. She stated she wished to do all the things doable for her child’s wellbeing. “I would like him to be a wholesome boy and lead a wholesome and completely satisfied life.”
How the surgical procedure was carried out
Dr Tahlak stated a multidisciplinary crew was current for the surgical procedure.
“This sort of surgical procedure requires excessive precision and may be very delicate. It requires opening the uterus, however not the best way it’s completed for C-Part. On this specific case, the incision was completed from the again of the uterus. A minor incision was carried out delicately — it needed to be completed in layers with out opening the membrane that has the amniotic fluid and the foetus inside.
“We finally opened the membrane. We then used sure instruments to increase the incision because the child had a 6-cm lesion within the spinal twine that wanted to be fastened. We then gently positioned the child in a method that the lesion was dealing with the incision in order that Dr Mohammad Sultan Al Olama, the neurosurgeon, may right the spinal twine defect. All by means of this time, the child and the mom have been being monitored with common foetal coronary heart charge monitoring.”
Dr Al Olama, who’s guide neurosurgeon with paediatric and useful neurosurgery specialty at Rashid Hospital, stated he first gave the foetus anesthesia. “Then, underneath the microscope, I began to restore the defect. There was an additional sac that I eliminated after which preserved the spinal twine and the nerves. Then I coated it delicately utilizing micro devices with layers of various membranes sealed after which coated that by the pores and skin in order that amniotic fluid doesn’t contact the foetus’ spinal twine. This step is important to stop leakage of spinal fluid.”
As soon as the neurosurgeon accomplished his half, the medical doctors crammed the uterus with a particular answer of antibiotics and saline. “I crammed the fluid based on the quantity of amniotic fluid misplaced throughout this process. We then closed the uterus once more and tightly sealed it to stop any leak of amniotic fluid. This process can be essential because the uterus will broaden in measurement because the foetus grows.”