When Tiersa Cross was only 24 weeks pregnant, she underwent a surgery that positively impacted her baby’s life.
Cross was referred to the Children’s Hospital of Philadelphia’s Center for Fetal Diagnosis and Treatment, when a prenatal screening test determined that her baby girl had spina bifida — a common birth defect that affects about 1,500 babies a year in the United States.
Spina bifida is a defect in which the backbone and spinal canal do not close before birth. The birth defect could cause partial or complete paralysis of the newborn’s legs, loss of bladder or bowel control, weakness of the hips and legs or feet and build up of fluid in the brain.
On October 19, Cross and her baby Madisyn Cruickshank underwent surgery at CHOP.
“They said that if I didn’t get the surgery, her chances of being able to walk would be slim to none. Closing that hole in her back was really important at that time, for her to be able to walk and also to keep fluid from retaining in her brain,” says the resident of Norristown.
“I just wanted to let her have the best life possible. I was just really looking out for her.”
While she was aware of the risk that her baby could possibly be born prematurely, Cross was more concerned about the potential outcome of the surgery.
Madisyn was born January 18 in CHOP’s Garbose Family Special Delivery Unit. Since her birth, she’s returned to the hospital every week for follow-up visits with her doctors.
“She’s doing really well. Her legs are moving. She has full bladder and bowel control,” Cross says of the baby.
Cross also noted that Madisyn doesn’t need a shunt — a surgically implanted tube that drains fluid from the brain.
“We’re optimistic that the operation [she had] before birth will help that baby, but obviously we need to do the long-term follow up. I think that it will end up being a good result,” Dr. Scott Adzick, CHOP’s surgeon-in-chief and director of the Center for Fetal Diagnosis and Treatment says of Madisyn’s surgery.
The surgical highlight comes on the one-year anniversary of a CHOP-led groundbreaking national study published in the New England Journal of Medicine, which found that performing delicate surgery in the womb could substantially improve outcomes for children with spina bifida. The Management of Myelomeningocele Study (MOMS) trial showed that surgery reduced the need to divert fluid from the brain, improved mobility and the chances that the child will be able to walk independently. CHOP worked with Vanderbilt University and the University of California San Francisco to conduct the National Institutes of Health-funded trial.
Adzick says the concept of fetal surgery arose approximately 30 years ago out of frustration by doctors who realized that they couldn’t treat the damage done to babies’ organs before birth.
After undergoing the surgical procedure, the baby’s mother is monitored very closely.
“With fetal surgery as we do it now, there is a substantial risk of pre-term birth,” said Adzick, noting that a study showed that babies who undergo the procedure were born approximately three weeks early.
Adzick said mothers who undergo this operation need to understand that the procedure leaves a scar on the uterus that can rupture during subsequent pregnancies. With that in mind, mothers who undergo this surgery must deliver their babies by Cesarean section.
According to Adzick, this year the Center for Fetal Diagnosis and Treatment will evaluate approximately 1,200 mothers from around the world who are carrying babies with birth defects.