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Cleveland Clinic has successfully performed its first in utero fetal surgery to repair a spina bifida birth defect in a nearly 23-week-old fetus.
A multispecialty team of clinicians performed the surgery in February, and the baby, a girl, was later delivered by caesarean section near full term June 3, making it northern Ohio’s first surgery of its kind. Mother and daughter are doing well.
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During the fetal repair surgery, a caesarean section-like incision is made and the mother’s uterus is exposed. An ultrasound is then used to locate the placenta and fetus. The uterus is opened 4.5 cm and the back of the fetus is exposed, showing the spina bifida lesion. The surgeons then carefully suture several individual layers of tissue (myofascia, dura and skin) in order to cover the defect. 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.
“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. 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.”
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Prior to fetal repair surgery, the back of the brain herniates down the spinal column – known as an Arnold-Chiari malformation – causing cerebrospinal fluid to back up and build pressure that can cause brain damage. Typically babies with spina bifida need shunts to decompress the built-up fluid after they are born. When a successful fetal surgery repair is completed and the brain is examined one month later, the malformation is reversed and the back of the brain returns to a normal appearance, which was observed in this case.
Pretty soon The Cleveland Clinic will demolish the last building that is not the Cleveland Clinic and the city will change its name to The Cleveland Clinic.
But it's just a clump of cells. It's not alive at all. /sarcasm/
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