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>> Finding out that your baby is less than perfect
is hard, it really is.
Especially that this is our third child.
And we've had two healthy pregnancies,
no complications whatsoever.
It was really shocking for us to find out
that anything was wrong.
I mean, not that I would, but I didn't feel an different
being pregnant,
I didn't have any suspicion whatsoever.
Spina bifida is so different in the way
that it affects each child,
so even when you're researching,
you have so many possible outcomes.
>> It was nice that we actually had genetic counseling
at that time,
but to a certain regard, you kinda feel
like you're on an island by yourself at that point.
And we were looking for someone to really help us
become grounded and know where we were gonna be going
in the future.
>> Doctor Baschat: It's a 4D probe phase.
>> Doctor Miller: Here, at Johns Hopkins, we put together
a new, innovative approach for prenatal surgery
for spina bifida,
which is much less invasive for the mother.
>> When you do traditional open fetal spina bifida repair,
you also open the uterus with an incision,
and that happens in the most vulnerable part
of the uterine muscle.
Whereas, if you do a fetoscopic repair,
then your access to the fetus is minimally invasive
and that averts a lot of problems of open fetal surgery.
>> And gives the opportunity to have a lesser impact,
not only on the current pregnancy,
but for every future pregnancy that she may have
or consider, as well.
>> So, in cases of spina bifida,
the three most common neurological findings
are hydrocephalus, which is pressure on the brain,
Chiari malformation, and the spina bifida lesion itself.
It's important that we address those,
and through prenatal closure,
we're able to reduce the rates of both hydrocephalus
and Chiari very successfully.
Here at Hopkins, as a pediatric neurosurgeon,
I'm involved as one of the first team members
that they meet, as part of the fetal therapy team,
and I help take care of their child
throughout the course of their life.
>> They really talked about not just the pregnancy
and not just the surgery,
but then what care would look like for Harper down the line.
>> The benefits of prenatal surgery for spina bifida
are established.
When you compare the group of children
that have surgery before,
fewer children will require a shunt
for hydrocephalus after birth.
Their motor function will also be improved.
We anticipate that after the immediate
post-operative period,
for women who, their course has been uncomplicated,
they can gradually return back
towards their normal activity.
And that is a major advantage for life.
>> The idea that I also got to have a vaginal delivery
was really, really important to me.
My recovery was pretty easy after she was born
and that made a huge difference
in my ability to be there for her and for my other kids.
>> Doctor Miller: Because we have such a small core team
who's involved in the total care of these patients,
any small change, we can observe immediately.
>> We have regular followup appointments
with a lot of doctors, but that's okay.
We see neurosurgery every three months,
just to keep checking on things
and making sure things are going well.
>> Scott: From her health and the baby's health,
we couldn't have asked for anything better
from that surgery.
>> Fetal surgery is hard.
It's not an easy decision to make.
The quality of life that we expect for Harper
is the same quality of life we expect for our other kids.
>> Child: How many months are her?
>> Six months. >> Six months old.
(cheering)