1. Research in Prenatal
Surgery to Treat Open
Spina Bifida is Promising,
but Carries Risks
Dr. Ravish Patwardhan

2. Dr. Ravish Patwardhan: Research in Prenatal Surgery to
Treat Open Spina Bifida is Promising, but Carries Risks
Dr. Ravish Patwardhan, who has performed brain and spinal surgery
and currently maintains www.ravishonhealth.com, a website devoted
to medical issues, discusses spina bifida and highlights recent
research on prenatal surgery in open spina bifida cases.

3. Dr. Ravish Patwardhan: Research in Prenatal Surgery to
Treat Open Spina Bifida is Promising, but Carries Risks
Some estimate that approximately 1,500 children are born with spina
bifida in the United States each year. Spina bifida is a condition in
which the neural tube, the tissue that will eventually develop into a
child’s spinal cord and brain, does not close as it should. The
condition can lead to a number of complications, ranging from
hydrocephalus (water on the brain) to impaired mobility.

4. Dr. Ravish Patwardhan: Research in Prenatal Surgery to
Treat Open Spina Bifida is Promising, but Carries Risks
A recent study by the National Institutes of Health, however, offers
promise for babies with open spina bifida, in which the spinal cord
itself is exposed. According to the study, published in the New
England Journal of Medicine in 2011, prenatal surgery on the fetus to
close the spinal opening can reduce the need to shunt fluid away
from the baby’s brain after birth, and seems to reduce subsequent
mobility limitations when compared with performing the surgery after
the baby was born. Another problem, called Chiari malformation
(where part of the brain sags down towards the spinal canal), is
reduced in occurrence when the operation is done before birth.
However, there are risks -- infants who underwent the prenatal
surgery were more likely to be born prematurely. Thus, while the
study appears to show positive results, the risks associated with pre-
term delivery must be considered as well.