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Video: UAE doctors perform rare lifesaving foetal surgery

A multi-disciplinary team of doctors successfully performed a complex in-utero procedure over three hours

Published: Tue 13 Jun 2023, 9:00 PM

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Close on the heels of the miraculous survival story of four children from Colombia’s Amazon jungle, here’s an inspirational journey of a pregnant lady from the capital city of Bogota who flew more than 13,500km to get a life-changing foetal surgery done at a hospital in Abu Dhabi.

Earlier this year, Liz Valentina Parra Rodriguez and Jason Mateo Moreno Gutierrez were devastated to learn that the ultrasound scan done during 20 weeks of pregnancy showed a rare form of spina bifida in the foetus – a defect when the spine and spinal cord don’t form properly, resulting in permanent disability. The condition can often lead to permanent loss of bowel and urinary bladder control, paralysis or weakness of both lower limb muscles.

“We were shocked after our routine scan showed that our baby’s spinal cord was not forming correctly. The options of ending pregnancy were also discussed with us but we believe in miracles and that life is a gift of God. Our doctor suggested that our best course of action was to undergo spina bifida repair before the baby was born,” the couple said.

The complex foetal surgery – an in-utero repair, is performed between 19-25 weeks of gestation to close the defect in the spine, thereby offering improved outcomes. The average worldwide incidence of spina bifida is one per 1,000 births.

Fortunately for the couple, their hospital in Colombia had a collaborative network with Abu Dhabi’s Burjeel Medical City (BMC), which also houses experienced specialists and advanced technologies at its Kypros Nicolaides Foetal Medicine and Therapy Centre.

Their doctors informed them about the availability of the crucial surgery at BMC. Additionally, Liz was sponsored by a foundation in Columbia that partners with BMC. In an impactful cross-national collaboration and cooperation, doctors from both the hospitals discussed the case and immediately, BMC management flew in the couple by using their special quota for UAE medical visas. “We travelled to Abu Dhabi with the hope of giving our baby the best life possible,” the couple noted.

A multi-disciplinary team of doctors successfully performed a complex in-utero procedure over three hours to treat meningocele – a rare type of spina bifida.

“This is one of the most complex foetal therapy procedures by our team at the centre. Foetal surgery is not a cure but a significant procedure to improve and make a positive impact on a baby's life while inside the womb,” Dr Mandeep Singh, consultant, foetal medicine and obstetrics, and CEO of Burjeel Farha – a division of women and children at Burjeel, told Khaleej Times.

It was BMC’s and Kypros Nicolaides Foetal Medicine and Therapy Centre’s first in-utero spina bifida repair procedure and a boost for medical tourism initiatives in the emirate. Apart from Dr Singh, the team included visiting physician Dr Mauricio Herrera, Dr Rajasekhar Cingapagu, specialist paediatric surgery, Dr Essam Elgamal, consultant neurosurgery, Dr Ramamurthy Baskaran, consultant anaesthesiology and transplant anaesthesia, Dr Ahmed Omran, consultant anaesthesia, and Dr Iviano Ossuetta, consultant and director of neonatology and specially trained operation theatre staff.

Complex surgery

Dr Singh explained that during the foetal repair surgery, a small incision is made on the uterus and the back of the baby is exposed to allow the neurosurgeon to close the spina bifida defect.

“We use a synthetic patch to cover the defect. The amniotic fluid is then instilled back into the cavity and the uterus is closed back up. The baby will remain in the womb for the remainder of the pregnancy and will be delivered by caesarean section at 37 weeks’ gestation,” Dr Singh noted.

Liz, the 25-year-old patient, is stable and expected to deliver her baby at BMC in August. After the birth, a specialist team of neonatologists, paediatric urologists, and a paediatric orthopaedic, and rehabilitation team will review the baby and plan its care.

Liz is now relieved after the novel surgery and excited about becoming a mother for the first time.

“To be honest, I was afraid about this surgery. A day before (the surgery) I was scared. But the medical team supported me throughout this journey. They took care of me. I know we are in safe hands. I thank the doctor, hospital and Abu Dhabi for allowing us this treatment and giving our baby a new opportunity to live,” Liz added.

According to Dr Singh, the procedure could make a big difference in the child’s life after birth.

“In-utero repair of spina bifida reduces motor function loss of limbs and improves outcomes. After the delivery, the baby needs follow up and, in some cases, may need to undergo physiotherapy and all other medical assessments to ensure their well-being,” Dr Singh said.

If untreated, depending on the severity of the condition, a baby born with spina bifida is at risk of developing a host of complications ranging from orthopaedic problems to issues with bowel and bladder control.

The Kypros Nicolaides Foetal Medicine and Therapy Centre is equipped to perform such high-risk maternity and delivery care seamlessly. It has a vast network of foetal medicine centres across Asia, Africa and South America to collaborate with and perform such procedures regularly.

“The long-term rehabilitation, neurosurgery, orthopaedics, and other complex care offerings at Burjeel Medical City are capable of providing timely support to the babies and families across the region,” Dr Singh added.

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