Baby born at 37 weeks following in-utero surgery for spina bifida

Baby born at 37 weeks following in-utero surgery for spina bifida

The second Kiwi to undergo in-utero surgery for spina bifida in Australia has given birth to a healthy baby girl at 37 weeks at Mater Mothers' Hospital, a long way from home.

Baby Moana Rose arrived at exactly 37 weeks, a healthy 3270 g, with good leg and feet movement and a tidy scar on her lower back.

Pregnant mum Rebecca (Becs) Dryland had been in Mater Mothers' Hospital on restricted activities for 10 weeks, following the complex operation performed at the hospital on 17 April. 

Prior to surgery, Becs was given permission to return to New Zealand once she had recovered and have the baby closer to home, however her waters broke on 7 May at 27 weeks gestation. This meant Becs had to stay in Brisbane, close to medical support to monitor her unborn baby until delivery.

Spina bifida is a condition where the lower part of a baby’s spine is open and it affects 1 in 2000 pregnancies in Australia. Currently families often discover the diagnosis of spina bifida at their 20 week ultrasound scan and until July 2016, Australian parents had to wait until the baby was born to perform surgery on the baby’s spine.

Becs’s rollercoaster journey began in March 2018 when she received the distressing news her baby had spina bifida at her 21 week morphology scan.

“I had just started relaxing about the pregnancy, thinking I was over the danger period for miscarriage or issues,” Becs said.

“This was a big shock–a huge change in expectations and of the picture I had built in my mind of my baby and our future.

“I knew hardly anything about spina bifida so I started trying to learn as much as I could,” Becs said.

“While trying to discover what spina bifida is, I read a story about surgery at Mater Mothers in Brisbane and saw the US MOMS study results and wondered if the surgery was possible for me,” she said.

The seven year MOMS trial in the US demonstrated that in-utero surgery, in comparison to surgery post-birth, halved the need for a child to have a brain shunt and doubled a child’s chance of walking without the need for assistance.

“I spoke to the doctors at Christchurch’s Maternal Fetal Medicine centre and asked them if they could tell me more and I also called the Spina Bifida Association New Zealand who put me in touch with New Zealand mum Catherine who had surgery at Mater Mothers’ in Brisbane,” she said.

“I was also given the contact details for Mater Mothers’ Hospitals Maternal Fetal Medicine team who called me on a Saturday and got the ball rolling incredibly fast,” Becs said.

The pregnancy needed to be assessed quickly as there is only a small window of opportunity for in-utero surgery between 23 and 25 weeks gestation.

For Becs, it was approximately three to four weeks from diagnosis to surgery.

“It was a whirlwind and I couldn’t have done it without the Mater team’s support,” she said.

Becs is an outdoor education tutor and yet for someone whose life is normally busy and spent outside, she didn’t feel trapped being on restricted activities following the surgery.

“The process could have been stressful but really it wasn’t because I was in the place I needed to be,” Becs said.

“I felt so well supported and everyone was lovely–the staff were fantastic and there were many family and friends helping out here and back home,” she said.

Despite the regular scans, Becs managed to not find out the baby’s gender.

“Sometimes they referred to the baby as ‘he’, other times ‘she’, I did think it may become impractical to not find out, but we did pretty well!” she jokes.

At 34 weeks gestation, the scans show great promise for her baby. Pre-surgery, the baby’s head was shaped liked a lemon but now it’s normal.

As the pregnancy progressed, doctors set a delivery date at 37 weeks and Becs was feeling a range of emotions.

“Until this point I hadn’t thought much about actually having the baby! I’d been so focussed on getting through surgery and the possible complications following my waters breaking,” Becs said.

Becs hopes that through sharing her story, she can create greater awareness of in-utero surgery options for families who face a similar diagnosis.

“I feel really fortunate to have had the opportunity of surgery,” she said.

“I’m grateful to all those that have helped make it possible including the teams at Christchurch Hospital and Mater Mothers’ Hospitals, the mums that paved the way before me and to the New Zealand Ministry of Health who helped make it possible for me to be here,” Becs said.

During the delicate surgery, Director of Maternal Fetal Medicine Dr Glenn Gardener marked out a site to open Becs's abdomen and uterus to safely expose the baby’s back. Neurosurgeon Dr Martin Wood then stepped in to close the spina bifida defect on the spine, before the amniotic fluid was replaced and the womb was carefully closed.

Both the mother and baby were asleep during the procedure through the use of anaesthetic agents that also cross the placenta.

While Becs is the second New Zealand mum to have in-utero surgery, she is the sixth open fetal surgery since the Australian first in July 2016.

We’re thrilled for Becs for hanging in as long as she did and wish her and baby Moana Rose the best on their journey.

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