Featured Research

from universities, journals, and other organizations

NICHD Study To Test Surgical Technique To Repair Spinal Defect Before Birth

Date:
May 5, 2003
Source:
NIH/National Institute Of Child Health And Human Development
Summary:
The National Institute of Child Health and Human Development (NICHD) will conduct a large study to determine whether a new surgery to correct spina bifida in the womb is safer and more effective than the traditional surgery to correct the disorder, which takes place a few days after birth.

The National Institute of Child Health and Human Development (NICHD) will conduct a large study to determine whether a new surgery to correct spina bifida in the womb is safer and more effective than the traditional surgery to correct the disorder, which takes place a few days after birth.

Spina bifida is a complex, often severe birth defect of the spinal cord that affects one of every 1000 pregnancies in the United States. In this condition, the spinal cord and the bones of the spinal column may fail to develop normally. With the most severe form of spina bifida, myelomeningocele, the spinal cord may be exposed through an opening in the bones of the spinal column. This may result in partial or complete paralysis of the area below the spinal opening. The paralysis may be so severe that an affected individual may be unable to walk and may experience incontinence of the urine and stool. Also, in many individuals affected by spina bifida, the brain may be positioned further down into the upper spinal column than it should be. This may result in a blockage of the cerebrospinal fluid, the fluid that bathes the brain and spinal cord. This blockage leads to a build up of fluid that could damage the brain. The blockage is treated by surgically implanting a hollow tube, or shunt in the child’s brain to drain the excess fluid into the abdominal cavity.

“This lifelong disability exacts a terrible physical, emotional and financial toll,” said Duane Alexander, M.D., Director of the NICHD. “This study will test whether a new treatment can improve on an existing technique.”

The study, called the Management of Myelomeningocele Study, or MOMS, will recruit 200 pregnant women carrying fetuses with myelomeningocele. The women will be assigned at random to one of the two treatment groups. One treatment is the traditional therapy where the children born will have the spinal column closed surgically, after birth. The other treatment will be performed between the 19th and 25th weeks of pregnancy. A surgeon taking part in the study will make an incision in the woman’s uterus, and surgically close the spinal defect of the fetus she is carrying. The women in both groups will undergo a cesarean section at the 37th week of pregnancy. For the women in the prenatal surgery group, cesarean delivery is necessary to prevent injury to the uterus, which had been opened surgically. Cesarean delivery is required for the second group as well, to prevent the stresses of the birth process from damaging the infant’s spinal column. All infants born to women in the study will be evaluated at 12 and 30 months of age and the study scientists will carefully observe the development of the two groups of children, looking specifically at whether a shunt is needed, and at bladder and motor function. The impact of the prenatal surgery on the women will also be evaluated.

To determine whether they are eligible for the study, women who wish to volunteer will undergo a preliminary evaluation by the George Washington University Biostatistics Center, which will coordinate the study. Women who are eligible for the study will be referred to one of the three participating MOMS Centers for further screening and evaluation: The Children’s Hospital of Philadelphia, Vanderbilt University Medical Center, and the University of California at San Francisco.

The three institutions participating in the study have undertaken preliminary studies of the new technique on more than 230 patients. It remains unknown, however, whether this surgical technique is more effective than the traditional therapy to close the spinal column after birth.

Since January 1998, the U.S. Food and Drug Administration has required food manufacturers to fortify certain grain products with the vitamin folic acid, to reduce the risk of spina bifida and related conditions, known collectively as neural tube defects. Also in 1998, the Institute of Medicine recommended that all women of childbearing age receive 400 micrograms of folic acid each day. The naturally occurring form of folic acid — folate — occurs in beans, leafy green vegetables, and citrus fruits.

Although consuming adequate amounts of the vitamin greatly reduces the risk that a woman will conceive a child with a neural tube defect, the vitamin does not eliminate the risk completely.

The study is currently recruiting. Further information about the study is available at 1-866-ASK-MOMS and online at www.spinabifidamoms.com.

The NICHD is part of the National Institutes of Health (NIH), the biomedical research arm of the federal government. NIH is part of the U.S. Department of Health and Human Services. The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. NICHD publications, as well as information about the Institute, are available from the NICHD Web site, http://www.nichd.nih.gov, or from the NICHD Clearinghouse, 1-800-370-2943; e-mail NICHDClearinghouse@mail.nih.gov.


Story Source:

The above story is based on materials provided by NIH/National Institute Of Child Health And Human Development. Note: Materials may be edited for content and length.


Cite This Page:

NIH/National Institute Of Child Health And Human Development. "NICHD Study To Test Surgical Technique To Repair Spinal Defect Before Birth." ScienceDaily. ScienceDaily, 5 May 2003. <www.sciencedaily.com/releases/2003/05/030505085312.htm>.
NIH/National Institute Of Child Health And Human Development. (2003, May 5). NICHD Study To Test Surgical Technique To Repair Spinal Defect Before Birth. ScienceDaily. Retrieved September 20, 2014 from www.sciencedaily.com/releases/2003/05/030505085312.htm
NIH/National Institute Of Child Health And Human Development. "NICHD Study To Test Surgical Technique To Repair Spinal Defect Before Birth." ScienceDaily. www.sciencedaily.com/releases/2003/05/030505085312.htm (accessed September 20, 2014).

Share This



More Health & Medicine News

Saturday, September 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Sierra Leone's Nationwide Ebola Curfew Underway

Sierra Leone's Nationwide Ebola Curfew Underway

Newsy (Sep. 20, 2014) Sierra Leone is locked down as aid workers and volunteers look for new cases of Ebola. Video provided by Newsy
Powered by NewsLook.com
Changes Found In Brain After One Dose Of Antidepressants

Changes Found In Brain After One Dose Of Antidepressants

Newsy (Sep. 19, 2014) A study suggest antidepressants can kick in much sooner than previously thought. Video provided by Newsy
Powered by NewsLook.com
Could Grief Affect The Immune Systems Of Senior Citizens?

Could Grief Affect The Immune Systems Of Senior Citizens?

Newsy (Sep. 19, 2014) The study found elderly people are much more likely to become susceptible to infection than younger adults going though a similar situation. Video provided by Newsy
Powered by NewsLook.com
Jury Delivers Verdict in Salmonella Trial

Jury Delivers Verdict in Salmonella Trial

AP (Sep. 19, 2014) A federal jury has convicted three people in connection with an outbreak of salmonella poisoning five years ago that sickened hundreds of people and was linked to a number of deaths. (Sept. 19) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins