Abu Dhabi: Believe it or not, a South American woman flew down to Abu Dhabi all the way from Colombia during her 26th week of pregnancy so that she could avail the necessary expertise to get a spinal defect in her unborn baby corrected in utero.
Twenty six-year-old of Maria Victoria said she and her husband Gomez Sotelo were keenly awaiting the arrival of their first child when a routine scan at 23-24 weeks’ gestation revealed that their unborn baby had Spina Bifida, a birth defect affecting the spinal cord.
Subsequently, Victoria’s doctors in her home country advised her to go in for an in-utero Spina Bifida repair to give her baby the best chance at a normal life. However, the challenge of getting the procedure done as early as possible remained because of the advanced stage of her gestation.
It was at this point that an Abu Dhabi-based hospital’s expertise in in-utero repair of Spine Bifida came into focus.
“My doctors recommended The Kypros Nicolaides Fetal Medicine and Therapy Centre at Burjeel Medical City (BMC) in Abu Dhabi. After extensive research, I realised that it was important for my baby to undergo this procedure whilst inside the womb as soon as possible. This procedure would prevent damage to the brain and urinary bladder and improve my baby’s chances of being able to walk independently,” said Victoria.
There was no time to lose, but Maria’s husband Sotelo had prior work commitments which he could not miss. Faced with another challenge now, Victoria decided to air dash to the UAE with a friend.
“The weight of this new reality was overwhelming. However, I firmly placed my faith in God and embarked on an uncharted path,” she said.
BMC, which expedited Victoria’s visa and other travel arrangements, managed to get her to the centre in 14 days for the procedure. To minimise any further delays, medical teams in the UAE and her home country collaborated to conduct essential scans and tests on the patient before her travel.
Critical question
Dr. Mandeep Singh, Consultant, Fetal Maternal Medicine and Fetal Surgeon, who led the team, explained the urgency of the situation. “It is well understood that the spinal canal defect should be ideally closed before 26 weeks. In fact, it’s technically possible to perform the procedure up to 29 weeks, but the critical question is whether it would genuinely benefit the baby. This is precisely why it was imperative to act as early as possible.”
According to Dr. Singh, in-utero Spina Bifida repair in the womb has been shown to significantly reduce risk of deficiency in physical ability and hence, improve the baby’s chances for a better future. The procedure involves operating on the fetus while still in the womb to repair the spinal defect and reduce the risk of complications that can occur with open spinal surgery after birth.
He said he worked with a multidisciplinary team that included Dr. Mauricio Herrera, visiting physician and renowned fetal surgeon, Dr. Essam Elgamal, Consultant Neurosurgery, Dr. Rajasekhar Cingapagu, Specialist Pediatric Surgery, Dr. Ahmed Omran, Consultant, Anesthesia, and specially trained operation theatre staff, to conduct the procedure on Victoria’s unborn baby.
What followed was far from a smooth sail. The spinal defect, by virtue of its large size, posed a huge challenge and it took the doctors five long hours to conduct the procedure. “Smaller defects typically span two to three segments of vertebral bodies. In contrast, larger defects encompass more than four segments of vertebral bodies. Closing these larger defects can pose greater challenge for neurosurgeons due to the size and deficient skin available to close the defect,” said Dr. Singh.
Additionally, he explained how there’s invariably a time constraint when performing the closure because of the constant manipulation of the uterus, risk of preterm labour and placenta separation. “However, the procedure went well, and we managed to close the defect successfully with no complications,” he added.
Dr Singh said if untreated, Spina Bifida, depending on the severity of the condition, can lead to a range of problems, from orthopedic issues to bowel and bladder control in the child. Not just that, if the corrective surgery is done after birth, it could increase the risk of hydrocephalus, where a lot of fluid builds up in the brain and can exerceberate nerve damage.
Victoria, who has flown back to Colombia for her delivery, is extremely grateful for the support that enabled her to travel at such a short notice in the state that she was in and get the right treatment for her much-awaited baby.
