Patient Counseling Regarding Groundbreaking Maternal-Fetal Surgery for Spina Bifida Now Recommended by the American College of Obstetricians and Gynecologists (ACOG)

The American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice has issued a new opinion recommending that patients with a fetus with spina bifida undergo counseling regarding the risks and benefits of maternal-fetal surgery.

The opinion recommends that all women who meet a specific set of criteria should now be made aware of the option of the procedure. In addition, the committee emphasizes the importance of only having the surgery performed “at facilities with the expertise, multidisciplinary teams, services, and facilities to provide the intensive care required for these patients.”

“Children’s Memorial Hermann is proud to be the first hospital in Texas to offer this unique service to women,” said Dr. Kuojen Tsao, Co-Director of the Texas Fetal Center at Children’s Memorial Hermann and Associate Professor of Pediatric Surgery at UTHealth. “We fully support the recent ACOG opinion and are thrilled to be one of the few institutions nationwide to meet the committee’s appropriate and necessary high standards of extensive experience in the field and utmost commitment to care.”

“This is hugely exciting news for Children’s Memorial Hermann, the entire maternal-fetal medicine community, and mothers everywhere,” said Dr. Kenneth Moise, Co-Director of the Texas Fetal Center and Professor of Maternal-Fetal Medicine at UTHealth. “It means the cutting-edge procedure we’ve been offering here for nearly two years is not only being officially recognized, it will now be recommended for consideration by pregnant women with a fetus with spina bifida all over the country.”

The committee’s opinion upholds the findings of the groundbreaking MOMS Trial, reinforcing the significance of the study’s promising conclusions. Sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the MOMS Trial (Management Of Myelomeningocele Study) was an eight-year study jointly conducted by the Children’s Hospital of Philadelphia, the University of California at San Francisco, Vanderbilt University Medical Center in Nashville and the George Washington University in Washington, D.C. The trial studied the difference in outcomes between prenatal and postnatal closure of spina bifida – meaning surgery on the fetus while still in the mother’s womb versus surgery soon after the baby is born.

The results of the trial, which were published in early 2011, found an overwhelming benefit to having the surgery performed prenatally. Specifically, babies who received prenatal treatment were half as likely to require a ventricular shunt at 12 months of age and twice as likely to walk independently by 30 months of age as the babies who received the surgery post-birth.

Myelomeningocele, the most common and the most severe form of spina bifida, is a birth defect in which the bony spine and spinal canal do not close before birth. According to the ACOG, it occurs in approximately one in 1,500 births in the United States. Symptoms may include buildup of fluid inside the skull (hydrocephalus), loss of bladder or bowel control, partial or complete lack of sensation in the lower body, abnormal positioning of the feet, partial or complete paralysis of the legs, and learning or developmental difficulties.

About the Texas Fetal Center

The Texas Fetal Center is a leader in providing diagnosis, treatment and complete care for mothers with high-risk pregnancies and babies with congenital anomalies or genetic conditions. The multidisciplinary team is the most experienced at providing comprehensive fetal diagnosis and intervention in the Southwest, and its members are world leaders in laser ablation in Twin-Twin Transfusion Syndrome (TTTS) — performing over 300 laser ablation cases — and performed the first fetal spina bifida repair in the region. The team is the first Extracorporeal Membrane Oxygenation (ECMO) center in Texas, and also the first in Texas to perform the Ex-utero Intrapartum Treatment (EXIT) procedure.  The center is a national leader in research studies, being one of only eight centers nationally to be included in the NICHD Network. The center, located in the Texas Medical Center, is a collaboration between Children’s Memorial Hermann Hospital and The University of Texas Health Science Center at Houston. Learn more about the Texas Fetal Center as well as the maternal-fetal surgery for spina bifida.

About Children’s Memorial Hermann

Children’s Memorial Hermann is a 240-bed hospital dedicated to pediatric and neonatal care with an additional 68 beds dedicated to women’s services.  The hospital’s special compassion and healing expertise has distinguished it as one of the finest children’s hospitals in the nation. In partnership with the University of Texas Medical School, Children’s Memorial Hermann specialists provide care for more than 120,000 patient visits annually, including the tiniest premature infants, children and adolescents. Memorial Hermann takes a holistic approach to healthcare, offering programs and services that address the physical, social, psychological and spiritual aspects of well-being. An integrated health system, Memorial Hermann is known for world-class clinical expertise, patient-centered care, leading-edge technology and innovation.  The system, with its exceptional medical staff and 19,000 employees, serves southeast Texas and the greater Houston community. Learn more about Children’s Memorial Hermann.