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Doctors optimistic about results of spinal-defect surgery on fetus

Noah, 5 months old, underwent fetal surgery for spina bifida

CNN's Rhonda Rowland on a new advances in Spina Bifida
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They hope child's spina bifida will be less severe

In this story:

November 20, 1998
Web posted at: 6:07 p.m. EST (2307 GMT)

From Medical Correspondent Rhonda Rowland

PHILADEPHIA (CNN) -- Doctors are reporting the first successful surgical attempt to repair spina bifida while a fetus is in the womb.

The surgery, detailed in this week's medical journal, The Lancet, was carried out when Mellissa Kipfmiller was just five months pregnant.

Through a routine ultrasound test, Kipfmiller and her husband, Kevin, learned the baby boy she was carrying had a severe case of spina bifida, one of the most common and devastating birth defects. The neural tube defect affects about one of every 1,000 newborns in the United States.

It results when the spinal column doesn't completely close during the first month of pregnancy.

Doctors said the baby, Noah, now 5 months old, would be paralyzed from the waist down.

"[They] said he would definitely have problems with bowel and bladder control and problems walking," Kevin Kipfmiller said.

Surgeons at Children's Hospital of Philadelphia hope fetal surgery may lessen the severity of spina bifida  

Surgery not touted as cure

Surgeons at Children's Hospital of Philadelphia said they could operate on the baby before it was born, attempting to repair the spinal defect while the baby was still in the womb.

"You're trying to use the surrounding tissues there on the back and then basically sew things up so the developing spinal cord has some element of protection," said Dr. Scott Adzick.

The fetal surgery wasn't meant to cure Noah's spinal bifida, but make it less severe.

The field of fetal surgery is still in its infancy. There are only two centers worldwide that offer this kind of treatment. Until recently, all of Adzick's patients were carrying fetuses with life-threatening conditions.

Operation has its critics

Although spina bifida can be crippling, it's not life-threatening, and some experts feel the procedure may be too risky.

"It's right on the edge, I suspect, of being an area where is it ethical to do the surgery with the risk that you may cause an abortion, spontaneous abortion, cause harm to the mom," said Dr. Arthur Caplan of the Center for Bioethics at the University of Pennsylvania.

Noah's doctors said they don't know yet how well the surgery corrected his spina bifida, but they are hopeful he will be able to walk.

"We feel optimistic about the outcome, but he is a little pioneer basically and we're going to have to wait and see what he is going to teach us," Adzick said.

Even though they don't yet know the results, the Kipfmillers said they don't regret taking the risk.

"I felt we had to give him the chance to walk and run and play," Mellissa Kipfmiller said.

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