The National Institute for Health and Care Excellence (NICE) has ruled that babies at risk of spina bifida can be operated on while still in the womb using a new innovative operation.
The Institute’s interventional procedures advisory committee considered two operations for babies with open neural tube defect – an intra-womb operation on the fetus inside (open repair) and internal keyhole surgery. Both procedures aim to prevent further damage to a baby’s brain, spinal cord and nerves.
According to the Committee, evidence on the open repair shows “serious but well recognised safety concerns for the mother and baby” but the procedure “works well enough for it to be used in the NHS as long as it is done in specialised centres, by clinicians and teams with specific training and experience and there are special arrangements for clinical governance, consent, and audit in place”.
Consequently, NHS England has announced plans to fund open fetal surgery for spina bifida for those who are eligible for the procedure, with the service expected to be operational in the coming weeks
The Committee felt more evidence was required for the internal keyhole repair procedure and, as such, it should currently only be used in the context of research.
There is no cure for spina bifida. Usual current practice involves operating on babies within 48 hours of their birth. These new options could be carried out before 26 weeks of pregnancy have passed.
Every week four women give birth to an affected child.
