Doctors at the All India Institute of Medical Sciences (AIIMS) in New Delhi have performed India's first open fetal repair of a lumbosacral myelomeningocele, the most severe form of spina bifida, repairing the defect in a baby at 25 weeks of gestation while still in the womb, ANI reported on November 14.

Source: ANI

The six-hour operation, carried out on November 12, repaired the cerebrospinal-fluid-leaking defect in the developing baby's lower spine. It followed more than five weeks of multidisciplinary planning, including detailed fetal imaging, counselling of the family, anaesthetic planning and surgical simulation, according to the reports.

More than 30 doctors and healthcare staff took part. The neurosurgical component was led by Professor Deepak Gupta, president of the Indian Society for Pediatric Neurosurgery, while the maternal-fetal medicine and obstetric component was led by Professor Neena Malhotra and Professor K. Aparna Sharma, with plastic surgery, anaesthesia and neonatology teams also involved.

Why operating before birth matters

In conventional treatment, the spinal defect is repaired only after the baby is born, by which time some neurological damage may already have occurred. Prenatal repair seeks to limit ongoing injury to the exposed spinal tissue, reduce the later need for cerebrospinal-fluid diversion for hydrocephalus, and improve selected neurological outcomes, the AIIMS team said.

The doctors stressed that fetal surgery is not a cure. It carries risks, including premature delivery and complications linked to the uterine incision, and is offered only in rigorously selected cases at specialised centres. The mother and the baby will remain under close multidisciplinary surveillance through the rest of the pregnancy, delivery and the newborn period.

The procedure was provided free of cost to the family under the Government of India's Janani Shishu Suraksha Karyakram (JSSK). AIIMS said the achievement shows the institute now has the integrated expertise needed to assess and offer fetal myelomeningocele repair to appropriately selected Indian families.

Source: Sahara Samay