MediGence: Enabling Better Health Decisions

Spina bifida is a birth-defect involving the nervous system. In this condition, there is improper development of the spinal cord and spinal column. In spina bifida, the neural tube of the fetus does not close properly. There are various types of spina bifida. These include spina bifida occulta and Spina bifida Aperta. Spina bifida Aperta is also known as Myelomeningocele. It is a severe form of spina bifida. As the severe form is progressive, it requires immediate repair to prevent further damage. In such a case, your doctor may advise fetal surgery.

You may expect the following before the fetal surgery for spina bifida:

A multidisciplinary team will determine the possibility of fetal surgery by evaluating your health. The team comprises a neonatologist, a fetal surgeon, a pediatric surgeon, a maternal-fetal health specialist, and a fetal cardiologist.
Your doctor will provide complete details about the fatal surgery including the procedure, the complications, and a possible outcome.
Clear all your concerns regarding the surgery as well as the alternative treatment. Take complete knowledge about the benefits and risks of the surgery to you and the fetus.
Before the surgery, your doctor may evaluate fetal health through various imaging techniques such as MRI and ultrasound. The evaluation helps the doctor to understand more clearly the abnormality of the baby.
The doctor performs the surgery before 26 weeks of gestation.
The doctor advises fetal surgery only in case of singleton pregnancy (only one fetus).
The doctor may not recommend the surgery if there is a risk of preterm delivery, maternal obesity, a chromosomal abnormality in the fetus, and the case of a low-lying placenta.
The doctor, before performing the surgery, seeks your permission. You may have to sign a consent form.
In case the fetal surgery is not possible due to any reason, the doctor performs the surgery after birth.

The doctors perform the surgery on the fetus in prenatal surgery for spina bifida. The surgeons generally execute the procedure by exposing the uterus. However, in some cases, the patients may also undergo minimally invasive surgery. You may undergo the following steps during the surgery:

The doctor advises you to visit the hospital on the morning of surgery with overnight fasting.
The staff guides you to the changing room and provides you a gown for changing.
our surgeon and the anesthesia expert may meet you to evaluate your health.
Once everything is fine, the staff will take you into the operation theatre.
The surgeon inserts an epidural catheter to provide relief from pain after the surgery.
The anesthesiologist will give you general anesthesia that will make you sleep throughout the surgery.
The surgeon then exposes the uterus by making an incision on the abdomen. The incision is probably wider as compared to that done during the caesarian surgery.
The surgeon opens the uterus to get excess to the fetus.
The surgeon examines the abnormality in the spine and closes the spine.
The surgeon then closes the uterus and the abdomen and places a bandage on the wound.
The staff then sifts you to the ICU to monitor your vital parameters.

You may feel some pain once you wake up. However, it is manageable through medications and epidural catheters. Once your vital parameters are stable, the staff shifts you to the general ward. You need to stay at the hospital for around one week. After discharge, you need to take good care of your health and visit the hospital for follow-up evaluation