Unborn Babies with
Spina Bifida Find Hope
in Fetal Surgery

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Last Updated By Bill's Bible Basics :
February 16, 2017

By Liz Townsend

Baby Samuel Armas's tiny fingers grasped the doctor's huge hand - - not at birth, or as a result of a premature delivery but, at 21 weeks, as one of the youngest unborn babies ever to undergo surgery to relieve the effects of spina bifida and hydrocephalus, birth defects that can lead to severe disabilities.

Doctors now agree that the earlier repairs can be made on these babies, the less severe the problems will be when the child is born. This realization has stimulated a search for ways to correct anomalies while the child is in utero, rather than take the more traditional route and wait to make surgical repairs after birth.

During the operation at Vanderbilt University Medical Center in Nashville, Tennessee, to repair a lesion on Samuel's back, doctors removed Julie Armas's uterus (with baby Samuel in it) and placed the football-size uterus on top of her abdomen.

According to a report in USA Today, the amniotic fluid was then drained into a warmer, to be replaced after the operation was completed.

Both mother and baby were given anesthesia. Once the incision was made in the uterus, Dr. Joseph Bruner lifted Samuel partially out of the womb.

Pediatric neurosurgeon Dr. Noel Tulipan located the lesion on Samuel's back, closed the sac that protects the spinal cord, then closed the skin, USA Today reported. Samuel was then placed in Julie's uterus and the amniotic fluid replaced.

Amazingly, in just about an hour after the surgery began, young Samuel was back inside his mother's body, to remain for as long as possible to increase chances for a safe delivery.

Samuel Alexander Armas is due to be born any day now. He has remained in his mother's womb for over three months following his extraordinary operation in early September.

His parents, Julie and Alex, permitted pictures of their baby's operation, and a remarkable photograph of Samuel holding Dr. Bruner's hand was published in USA Today and is reprinted on this page. After their photo was discussed on the nationwide Dr. Laura radio show, Mrs. Armas wrote to Dr. Laura Schlessinger explaining why they welcomed the newspaper article and photograph.

"No matter what Samuel's outcome is, we know that God has allowed him to impact others with a photograph of his tiny, unborn hand," she wrote. "The statement that your listener included in his letter, that this photo has 'solidified his belief in the sanctity of life' was exactly what we hoped to accomplish."

Experienced Surgeons

Bruner, Tulipan, and their colleagues at Vanderbilt have performed over 70 fetal surgery procedures on babies with spina bifida. Spina bifida occurs when the spinal column fails to fuse properly, leaving a lesion (or opening) that is highly susceptible to infection. Often, hydrocephalus, a blockage in the brain that causes a build-up of spinal fluid, accompanies spina bifida.

For many unborn babies, a diagnosis of spina bifida will result in death by abortion. For those babies fortunate enough to be allowed to live, surgery is often performed soon after birth.

But unfortunately, the months spent in utero with the spina bifida untreated can result in leg paralysis, brain damage, or other problems. Hydrocephalus usually requires a shunt to drain the excess fluid and can even result in death.

The Armas baby's experience illustrates a new approach: fetal surgery. Physicians attempt to minimize the effects of spina bifida by closing the lesion in the spinal column, sparing the spinal cord from exposure to amniotic fluid and contact with the uterine wall.

The Vanderbilt doctors published the results of 39 spina bifida surgeries in the November 17 issue of the Journal of the American Medical Association. They concluded that the operation decreased the need for shunts and reduced the incidence of hindbrain herniation, but increased the likelihood of premature delivery. As the children grow, the doctors will be able to determine if the surgery prevented other effects of spina bifida, such as leg paralysis.

Sarah Marie Switzer was another Vanderbilt patient, one who had spina bifida surgery at 23 weeks' gestation. Born on August 22 at four and a half pounds, two months after her operation and nine weeks premature, she showed no sign of pressure on her brain, was kicking her legs, and seemed alert and happy, according to Life magazine. There was some indication that Sarah's head was growing faster than normal, so she may eventually need a shunt, and her feet seemed weak, indicating that she may need the help of braces to walk.

Her parents, Trish and Mike Switzer of Hollywood, Maryland, decided to have the operation after they discovered the spina bifida in a routine 18-week ultrasound, Life reported. They searched the Internet and discovered Bruner's web site at www.fetalsurgeons.com, which includes information about the work being done at Vanderbilt. They traveled to Nashville for the surgery when Sarah was 23 weeks old.

Although it will be some time before doctors can assess how the spina bifida affected Sarah, Trish Switzer told Life that she is glad they chose to have the operation. "It's impossible to say what the surgery did or what it didn't do," she said. "We didn't have a miracle, no, but at least we tried. We tried to make things different."

The power of pictures was illustrated once again when the Switzers allowed Life to photograph the surgery. This amazing series of photographs is featured in the December 1999 issue of the magazine.

Samuel's parents, Julie and Alex Armas of Georgia, took a similar route to the operation at Vanderbilt, after discovering evidence of spina bifida in an ultrasound at 14 weeks, according to USA Today. They also found Bruner's Internet site, and asked their physician help them get in touch with the Vanderbilt doctor.

The Armases never considered abortion. Mrs. Armas explained their pro-life convictions in her letter to Dr. Laura.

"We have always believed life begins at conception, and we never wavered, not even when it was actually our decision to make and not mere words that we say," she wrote. "My husband's first words after we received the news were, 'Well, we wanted a baby and this is the one God has chosen to give us.'"

Before the surgery is performed, parents are counseled by Vanderbilt staff and given all facts needed to make an informed decision. They are shown the neonatal ward that houses premature infants and told about the likelihood of early delivery after fetal surgery, which could give their baby even more obstacles to overcome.

The Armases relied on their faith in God along with their trust in the doctors when making the difficult decision to have the experimental surgery.

"We think God works through people, advances, and technology," Alex Armas told USA Today. "Why not take advantage of the surgery now instead of later?"

As they await their baby's birth, Samuel's parents are convinced that they made the right decision. "This was the first big trial we've ever been through," Mr. Armas told USA Today. "We've never had an opportunity to exercise our faith in the past. It's like the Lord said, 'Here this is. I want to see how you handle it.'"

"We get so wrapped up in the surgery and the spina bifida and all of the details," added Julie Armas. "Sometimes we just have to step back and think, 'We're finally going to have a baby.'"

Source: Information taken from National Right To Life web site

URL : https://www.nrlc.org

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