In September 2019, the Orlando Health hospital system celebrated a successful first year of performing in-utero surgery on preborn babies diagnosed with spina bifida. While Orlando Health is far from the first hospital or hospital system to start providing the revolutionary surgery to help correct spina bifida as much as possible for babies in the womb, the recent success reminds us how every life from the moment of conception is worth saving.
What Is Spina Bifida?
Spina bifida is a type of neural tube defect, resulting in an incomplete development of the brain, spinal cord, and/or meninges — the protective covering that protects the brain and spinal cord.
There are four main types of spina bifida, which can be diagnosed as early as the second trimester of fetal development:
- Myelomeningocele — While this is the most common type, it is unfortunately the most serious. This type is categorized by the spinal canal being open on part of the middle or lower back, causing the spinal cord nerves to push through the back and creating a sac externally attached to the body. This can lead to many life-threatening conditions.
- Meningocele — Similar to myelomeningocele spina bifida, this type causes a sac to be filled with fluid instead of the spinal cord. This form is less severe.
- Closed Neural Tube Defects — These are generally malformations of bone, fat, or meninges that collectively are caused by defects in the spinal cord, leading from a range of few or no noticeable symptoms to partial paralysis.
- Spina Bifida Occulta — This occurs when there is a separation between one or more vertebrae, and it is the most likely to go undetected due to signs and symptoms being difficult to detect.
Conditions which can occur as a result of spina bifida include difficulty with mobility and walking, bladder and bowel function complications, difficulty healing wounds, and accumulation of fluid in the brain (hydrocephalus). Of course, these are just a few of the very many and diverse complications which can be caused by spina bifida, and the complications can range from barely noticeable to extremely debilitating. The exact cause still remains unknown. Currently, about four in every 10,000 people are born alive with some form of spina bifida.
Treating Spina Bifida In-Utero
Spina bifida can be detected via a regular ultrasound screening of the child in the womb. Once a diagnosis has been made by a doctor, it will then be decided if the preborn child is eligible for in-utero surgery to repair the condition as much as possible. There is currently no known cure for spina bifida. Generally, the most severe cases are the only ones which require surgery, while individuals with mild cases may never need it or may be able to wait until surgery post-birth.
Preborn babies who are diagnosed with spina bifida and who are eligible for surgery will receive it between 19-26 weeks of development, as this is the earliest point in which the child could survive outside of the womb with medical attention if an emergency delivery were necessary. Children who receive this surgery before birth generally see better results than surgery after birth. According to the National Institute of Neurological Disorders and Stroke, the in-utero surgery for spina bifida prevents infection from developing on the exposed nerves as well as prevents further loss of neurological function by closing up the opening on the preborn child’s developing spinal cord.
Despite the potential risks for mothers and their preborn babies with this experimental surgery (which include premature delivery, organ immaturity, brain hemorrhage, or death for the baby along with infection, blood loss to the point of requiring a blood transfusion, and gestational diabetes for the mother), in-utero spina bifida surgery is producing more and more successful cases. This surgery has been seen to decrease the severity of some spina bifida complications and eliminated the need for further surgery in others. However, some babies may still require surgery after birth depending on their individual needs.
After the surgery, mothers will be required to stay in the hospital for a few days, followed by a few weeks of bed rest to prevent premature labor. By 37 weeks of development, a Cesarean-section birth is scheduled for the mother and the child. Regardless of whether a child receives in-utero surgery or not, most individuals diagnosed with spina bifida will receive continued lifelong physical therapy to help manage their conditions.
In this past year, the Orlando Health Winnie Palmer Hospital for Children and Babies celebrated a total of 11 successful in-utero surgeries on preborn children to treat spina bifida. It is currently the only hospital in Florida to offer this revolutionary and life-changing surgery. Additionally, Winnie Palmer Hospital is also the busiest labor and delivery unit in the state with over 14,000 children born there every year. These in-utero surgeries have given 11 children and their families unimaginable hope for a better quality of life, both reducing the need for a spinal shunt at birth as well as improving overall mobility and leg function.
One of the mothers, Jessica Trinkle, said in response to the success of her son’s in-utero spina bifida surgery,
“My son Parker is the baby I didn’t know I absolutely needed in my life. He is also behind introducing me to many other people who I didn’t know I needed in my life, including the staff of the Fetal Care Center. Their care, devotion and expertise is a large reason why Parker is so perfect today.”
In addition to the success of Fetal Care Center team at Winnie Palmer Hospital and a handful of other hospitals across the country, new developments are still being made to discover even safer and more effective in-utero surgical methods for repairing spina bifida. Earlier this year at Children’s Hospital Los Angeles, Abigail Coraline Gibson was successfully born after having been the first preborn child to receive a new experimental procedure to treat spina bifida in-utero without requiring the mother’s abdomen to be opened for surgery.
Abigail’s parents, Arnuf and Gilda, who work with disabled individuals, chose life for their preborn daughter without a second thought when they received her diagnosis of spina bifida — a joyous fate which many other preborn children diagnosed with spina bifida unfortunately do not share when parents choose abortion. Being the first to receive the new experimental procedure, and having experienced some complications pre-birth, Gilda expressed her joy at her daughter Abigail’s successful birth,
“Every birth is a great experience, but this was really, really emotional.”
Abigail’s development will continue to be monitored over the next five years to provide insight on the success of the experimental procedure.
Parker in Orlando, Abigail in Los Angeles, and dozens of other children now have a chance at a better quality of life and longer life expectancy thanks to continued medical advancements and research which continue to push the boundaries of what is possible for treating debilitating medical conditions like spina bifida. Above all, these in-utero surgeries prove one thing — all life is valuable and worth protecting from the moment of conception.
If these children were simply “products of conception” or were considered living organisms but not yet persons, then why would doctors go to such lengths to treat their conditions when they are still preborn children in the womb? The sad reality is that much of our society currently tries to tell us otherwise, that preborn children are only worth saving when they are wanted by their parents, or when their parents decide whether or not their child’s life is worth living. Every person brings unimaginable, far-reaching light to others in this world. It is absolutely heartbreaking to consider the preborn children diagnosed with spina bifida, down syndrome, or other conditions who never have the opportunity to be born and live full lives all because others thought their lives were not valuable enough.
Life is difficult. There is no getting around this fact. For those with lifelong and chronic medical conditions, life may seem even more difficult. But out of the struggles comes the opportunity to appreciate life on a deeper, more extraordinary level many others will never experience. Out of the struggles comes learning about the greatest expression of love — the love of selflessness in the service of and dependence upon others. For those who are Christians, this means learning to love Christ by loving others and learning to serve Christ by serving others, especially the most vulnerable among us, which includes those with disabilities and the preborn.
Therefore, let us celebrate the 11 lives forever improved thanks to the work of the doctors of Winnie Palmer Hospital in Orlando, Florida and all doctors everywhere working tirelessly to change and save children’s lives even before birth. Let us celebrate the parents who have chosen life and love for their children, regardless of their medical condition. Let us celebrate the reminder that all lives are valuable and worth living from the moment of conception.