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France

French doctors perform groundbreaking fetal surgery

© AFP/Jacques Demarthon| Archival image shows the entrance to Armand Trousseau hospital in Paris.

Text by FRANCE 24

Latest update : 2014-11-19

For the first time in France, surgeons have successfully performed a prenatal operation on a 20-week-old foetus suffering from the congenital disorder spina bifida, in a procedure that is still largely unheard of in Europe.

The groundbreaking surgery was performed in July at the Armand Trousseau public hospital in Paris, hospital officials revealed this week. The baby girl in question was born at full term on November 9.

“The baby and the mother are healthy,” said doctor Jean-Marie Jouannic, who with doctor Michel Zerah led the two medical teams that completed the in-utero procedure, a first in France.

Spina bifida is diagnosed when the bones of the spine are not fully formed, leaving the nerves within the spinal cord vulnerable to damage. Harm to the baby’s neurological system can begin before birth as it moves around in the mother’s womb.

If left untreated, the disorder can lead to partial or total paralysis of the lower limbs as well as build up of cerebrospinal fluid inside the brain.

Jouannic explained that after incisions to the mother’s uterus and the fetus, the operation involved covering the spinal cord and then closing the surrounding tissue and skin to protect it.

“Ten days after the surgery, the brain anomalies [in the fetus] that were caused by the disorder had disappeared,” Jouannic told the AFP news agency. “It’s incredible to be able to protect this little girl’s brain to enable future learning.”

New in Europe

Spina bifida is the most common neurological birth defect, affecting 1,500 births each year in the United States, according to the Children’s Hospital of Philadelphia, which pioneered the prenatal surgery to repair the defect.

The disorder, which is easy to diagnose via sonogram, occurs in one out of every 1,000 pregnancies in France, AFP reported. A large majority of parents choose to terminate pregnancies after the congenital disorder is diagnosed, but around 40 children are born in France with the ailment each year.

Surgery to close the spinal column can be performed just after birth, but damage to the nerves may already be firmly established.

Doctors at Children’s Hospital of Philadelphia, which after seminal trials three years ago have now performed the operation more than 200 times, say medical evidence shows that prenatal surgery is more effective than conventional after-birth surgery in decreasing risk of future disabilities in children.

But despite the promising developments, the procedure remains largely unavailable in Europe and most of the planet.

In May, Gina Beddoe became the first British woman to have the groundbreaking procedure covered by the country’s National Health Service, but she needed to travel to Belgium for the 22-hour operation.

At the time, the Leuven Teaching Hospital – where Beddoe and her baby underwent successful surgery – was one in only four European centres to perform the revolutionary operation.

(FRANCE 24 with AFP)
 

Date created : 2014-11-19

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