Cleveland Clinic performs its first in utero surgery on fetus, repairs spina bifida before birth

CLEVELAND, Ohio (FOX 35 ORLANDO) - After preparing for more than a year, the surgical team from Cleveland Clinic’s Fetal Center in Ohio has successfully performed its first surgery on a fetus inside the uterus to repair spina bifida.

It's the first surgery of its kind in northern Ohio.

According to the Cleveland Clinic's press release, the surgery was performed in February on a fetus that was nearly 23-weeks-old. The baby girl was successfully delivered by caesarean section near full term on June 3.

“By successfully repairing the defect before birth, we’re allowing this child to have the best possible outcome and significantly improve her quality of life,” said Dr. Darrell Cass. “There are different measures of quality in determining success for fetal repairs and in this particular case, all metrics for maximum quality were achieved.”

The team was led by Dr. Cass and included pediatric neurosurgeons, a fetal cardiologist and pediatric anesthesiologists. The mother and child are said to be doing well.

"Spina bifida is a birth defect that affects the lowest part of the spine and occurs when the neural tube does not fully close, causing the backbone that protects the spinal cord not to form as it should. This often results in damage to the spinal cord and nerves and can even lead to brain damage."

The condition can also affect a child's mobility, including walking and running.

To perform the surgery, an incision just 4.5 centimeters wide is made over the uterus where the baby's back is positioned, according to the clinic. The baby's spine is then repaired by doctors.

"After the uterus is closed back up, the fetus remains in the womb for the remainder of the pregnancy and is ultimately born by caesarean section," says the Cleveland Clinic.

Dr. Cass explains that the surgery is very risky for the baby: the mother has the potential of delivering the baby just weeks after the surgery.

"Although the surgery was a success, spina bifida is never cured,” said Dr. Cass. “Moving forward, the baby will require ongoing supportive care provided by a multidisciplinary team of caregivers in our Spina Bifida Clinic, which will involve neurology, urology, orthopedics, developmental pediatrics and neurosurgery, among other specialists.”

Dr. Cass, who has performed more than 160 fetal surgeries since 2002, joined Cleveland Clinic as director of Fetal Surgery in October 2017. Before that, he was the co-founder and co-director at Texas Children’s Fetal Center in Houston for 17 years.

“I am honored to work with this amazing team of clinicians and to see our efforts come to fruition after preparing for so long. Families in this region now have more options when it comes to making these types of decisions and we are thrilled to be able to provide the care needed for these complex cases.”

According to the CDC, more than 1,600 babies are born with spina bifida each year in the United States.