
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: TUESDAY, May 1, 1990                   TAG: 9005010413
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A/4   EDITION: EVENING 
SOURCE: Associated Press
DATELINE: NASHVILLE, TENN.                                LENGTH: Medium

SURGERY IN WOMB SOME DAY MAY REPAIR FETAL SPINE DAMAGE

Spina bifida, a common and severe birth defect, may one day be prevented by surgery to patch the fetal spine inside the womb, a new study indicates.

The study conducted by Johns Hopkins University in Baltimore suggests spina bifida may result in part from exposure of the spinal cord to the womb's amniotic fluid, according to Dr. Dan Heffez.

Heffez, assistant professor of neurosurgery at Johns Hopkins, presented the study's findings Monday to the American Association of Neurological Surgeons.

Spina bifida is caused by the failure of the spine and skin to form over the spinal cord, and the most serious form occurs in an estimated one of 1,000 births.

The study showed baby rats were paralyzed if the protective spinal cord covering was surgically removed while they were still in the womb. But if skin was sewn over the wound within 24 hours, the rats were "entirely normal," Heffez said.

Heffez said spina bifida damage may not occur until the 20th week of pregnancy, when amniotic fluid surrounding the fetus changes in a way that may jeopardize an unprotected spinal cord.

But a hole in the spine can be diagnosed through blood tests and ultrasounds by the 18th week of pregnancy, and fetal surgery has been attempted before 20 weeks to correct other problems, Heffez said.

Years of research remain before such a procedure could be attempted on a human fetus, Heffez said. He said Johns Hopkins researchers are conducting studies to discover whether the damage is progressive in humans.

"We need first to establish beyond a doubt that in man this is a progressive problem," he said. "We have to follow [fetal] leg movements with ultrasound - something we are trying to do right now."

The damage would be considered progressive if leg movements diminished over time in fetuses diagnosed with spina bifida, Heffez said.

Spina bifida can cause paralysis of the legs, loss of bladder and bowel functions and a malformed spinal cord. The afflicted can live into adulthood, but are more susceptible to infections because of the open wound and hole in their spine. And they require lifetime care.

"The long-term cost is enormous," Heffez said. "I don't think you can put a number on that cost or on the wasted potential."

by CNB