Aster doctors give new lease of life to new-born with meningomyelocele

Bengaluru: Doctors at Aster CMI Hospital have given a lease of life to an infant born with a birth defect. Suffering from a rare condition, called Meningomyelocele, a birth defect in which the spinal canal and the backbone don't close before the baby is born, Shweta's (name changed) chances of survival were bleak as the complication had forced the parents to think of terminating the child.

However, extensive counselling from the doctors at Aster CMI Hospital ensured that the baby got an opportunity to breathe a new life and her parents a chance to experience parenthood. In a surgery that lasted four hours, a team of neurosurgeons under the leadership of Dr. Ravi Gopal Varma, Dr. Nirmala S and Dr. Madhusudan G performed a meningomyelocele repair and closed the gap in her backbone to ensure the child's survival.

Hailing from Bengaluru, Satish and Sushma (names changed) were overjoyed when, after 4 years of marriage, they were about to become parents for the first time. As new parents, they were eagerly waiting for their child's arrival into the world. However, while undergoing a routine check-up during the 5 months of Sushma's pregnancy, the would-be parents were shocked to learn that their child in the womb had a birth defect called meningomyelocele.

As the parents were recovering from the shocking news and were looking for a solution, their hopes were further shattered as counselling from several doctors suggested that they had better terminate the pregnancy or visit a neurosurgeon.

With their last ray of hope, the couple visited Dr. Ravi Gopal Varma at Aster CMI Hospital for consultation. The doctor gave them confidence about the birth defect being treatable and assured them that they need not worry about the child's wellbeing.

Meningomyelocele, is a type of Spina Bifida, a birth defect in which the spinal canal and the backbone don't close before the baby is born. Among the neural tube defects, Spina Bifida is the second-highest birth complication in the country and impacts 1.9 per 1000 births annually.

The condition is usually diagnosed during the pregnancy through some tests and the treatment requires surgery in which neurosurgeons operate to close the opening on the back. If left untreated, this condition could lead to several serious complications such as an increased chance of bacterial infection that could potentially affect even the brain, impaired control of bowel and bladder movements, and loss of power in the limbs.

Sharing his views on the condition, Dr Ravi Gopal Varma, Head of Neurosurgery, Aster CMI, Bangalore, said: "Every year we come across several newborns who suffer from neural tube defects like meningomyelocele. These defects are generally diagnosed before the 5th month of pregnancy and are completely treatable without affecting the child's quality of life.

However, since many parents are unaware of the possible treatments regarding the condition they often choose to terminate the child. This lack of awareness not only has a psychological impact on the family and the parents but also impacts the population as a whole as it leads to an increase in child mortality. The only challenge while treating this condition is to ensure that the meningocele does not rupture during the delivery as it is like a thin inflated balloon."

Sharing her views, Dr. Nirmala S, Consultant, Neurosurgery, Aster CMI Hospital, said: "It was a critical surgery as we had to perform it on a newborn child. If the spinal cord is injured during surgery then the child would have a lifelong neurologic defect.

Therefore, to increase the margin of safety while precisely removing the swelling, we performed the Neuromonitoring technique on the child and removed the swelling without causing any damage to the spinal cord of the new-born baby.

Through the multi-specialty team of neuro and plastic surgeons, we were able to close the gap in her backbone after pushing her spine in and with the team efforts of paediatricians after a few days of postoperative stay in the hospital, the child was finally discharged. We feel elated that we can give the parents the joy of experiencing parenthood."

Speaking about the challenges Dr. Madhusudan G, Lead and Senior Consultant, Plastic Surgery, said "After the completion of the neurosurgical procedure, there was a midline wound which needed closed watertight. The muscles which lie close to the midline normally are splayed away in spina bifida and often the overlying skin is abnormal. Hence we mobilized the adjacent skin as a flap and provided water-tight closure."