The ultrasound tech was gone for a long time. I suspected something was not quite
usual about our scan. That's when he told me that it looked like she had spina bifida.
We were scared because we didn't know what that would mean for her. Spina Bifida is a term used
to describe a large number of disorders. All the disorders are disorders of development of
the central nervous system. This occurs very early as the embryo is being formed. Brittany
was a perfect candidate for fetal surgery here at Nationwide Children's Hospital We really have the
distinguished opportunity to be able to go into the uterus, into the womb to start caring for
children so that we can change the trajectory of life. It's clear that fetuses that get repaired
before birth are twice as likely to walk without support half as likely to need a shunt a tube
that connects the ventricles in the brain to the abdomen. It was just very clear, I know
what's wrong with her and I know what I could do to fix it. The potential to get her brain back
into the right position to get her spinal cord covered. We decided to move forward with surgery.
[Music]
Fetal surgery is a team sport and the cool thing is we're bringing experts from all different
specialties together. We have the mother to care for, so we have the obstetric nurses. We have
the fetal surgeons, we have the cardiologists in there with ultrasound monitoring the fetal
heart because we're doing a spina bifida repair the neurosurgeons were there. Once the maternal
fetal medicine surgeons have found the baby, found the defect, I perform the three layered closure,
closing the covering of the dura, close the skin and subcutaneous tissue. Everything was really
well put together. Having that comprehensive team is key for a successful operation.
It went really well and next thing I knew I was up in recovery. Our MRI
results showed that the surgery did exactly what it was supposed to do.
The MRI showed restoration of the brainstem to its normal location. More importantly we did not
see enlargement of the ventricles, the fluid that collects within the brain that puts them
at risk for hydrocephalus. So all the things that we really wanted to see to ensure that
we had a perfect outcome were the things that that MRI revealed. We always knew we wanted to
do this surgery but seeing the benefits even before she was born they were unbelievable.
One of the major concerns when you've had surgery in your uterus is pre-term labor. Remember,
the womb is the best intensive care for a fetus and so keeping that fetus there all the while is
key. We did this surgery at about 25 weeks and so for Brittany we wanted the pregnancy to go as far
as it could. We were hoping for 30, 32, 34, 37 and Brittany made it all the way to 37 weeks. [Music]
The C-section is something that we plan for every patient that's had open fetal
surgery. The reason for that is because of that incision on the uterus. We don't
want the uterus going into contractions. In the case of Brittany, the scar was actually
at the back of her uterus so we made a new incision in front to get the baby out. [Music]
The first time she cried it was the littlest cry and then
I started crying and then Jared started crying because we were just so happy.
Once the baby was out and it was doing fine we could then go to the back and check on that
incision. We put in dissolvable sutures some of which were still there but the incision was flat
well healed and completely closed. One of the best things about getting the surgery beforehand, the
incision had all of this time to heal. We could hold her. If we didn't have a fetal center she
would have to be immediately transferred. Here mom and baby were together. Lexi is in there looking
like a perfectly normal newborn with a scar on her back. Lexi was born term. She didn't need all the
support that the premature infant would need. So Lexi and Brittany could actually get discharged
home together. I can't imagine delivering anywhere else. Our doctors are so knowledgeable.
What we did is assemble a dream team. People that had decades of experience in fetal care
in different places and then integrating them with a team that was already present here.
So what's next for Brittany and Lexi? Well, they're part of our family now and we continue
to follow Lexi all the way into adulthood. There's a very high likelihood Lexi will walk. Just seeing
her legs move gives us a lot of hope. I think we would be in a totally different position
if we had not done the surgery beforehand. She's beyond what we could have imagined!