Children in whom the spinal canal does not close correctly have lifelong limitations such as incontinence, wheelchair use and hydrocephalus, depending on the severity of the so-called spina bifida. However, prenatal surgery to close the open spine promises a much better quality of life than if the surgery is performed after birth.
In this study, unborn babies will be examined with ultrasound and magnetic resonance imaging before and after planned fetal surgery. The aim is to determine whether preoperative changes in the middle cerebral artery (MCA) are associated with more severe forms of entrapment (herniation) of the brain stem. Furthermore, it will be investigated whether an intraoperative MCA improvement is a reliable marker for an adequate release of the adherent spinal cord and a concomitant regression of the brainstem entrapment, so that these children do not need a shunt, respectively an artificially created connecting canal, after birth and at the age of 1 year.
The study is led by Prof. Nicole Ochsenbein-Kölble, M.D., Head of the Department of Obstetrics at the University Hospital Zurich.