Friday, February 18, 2011

Sometimes you just have to gloat about your place of business

The Neonatal Intensive Care Unit at Monroe Carell Jr. Children’s Hospital at Vanderbilt is one of the best in the nation. I was blessed to begin my nursing career here, and everything that we do continues to amaze me.

Vanderbilt was recently in the news for a ground breaking seven year study that we participated in. Our hospital along with the University of California San Francisco and Children's Hospital of Philadelphia offered a National Institutes of Health-funded trial, Management of Myelomeningocele Study (MOMS). In the trial, babies underwent fetal surgery to treat spina bifida, the most common birth defect in the central nervous system.

Fetal Surgery… before they are born.

Those individuals that are born with spinal bifida (myelomeningocele) are expected to encounter multiple hardships. From the time they are admitted, we expect to see them fall on a spectrum, experiencing fluid buildup on the brain (hydrocephalus) with brain herniation, possible lower extremity paralysis, inability to void, no control over bowels… the list goes on. 

This landmark trial allowed surgeons to correct the defect before the infant was born – allowing the child to continue to grow and heal while still in utero. The enrollment was actually halted because researchers at the study's three trial sites found the procedure demonstrated a SIGNFICANT  benefit over the current standard of care, surgical repair after birth and the surgeries needed to be moved out of that “trial” stage and offered as an option to families. (Trials have so much red tape!) 

 (21 week old Baby Samuel after his repair surgery at Vanderbilt. He was born 15 weeks later. His parents said that it appears his brain herniation resolved before birth and at birth he was independently moving his legs and hips. It was said he caught the surgeon by surprise when he reached his hand through his mother's uterus and grabbed a hold of his finger.)

The findings from the sites were amazing. 90 percent of infants that were surgically repaired after birth are stricken with hydrocephalus and need surgical placement of a shunt to remove fluid buildup. (If the shunts fail or infection, it becomes a life – threatening situation. This is what brings the children back for multiple visits the hospital.) The MOMS trial found fetal surgery reduced the need for a shunt by almost 30 percent and significantly improved the child's chances of being able to walk. There was no increased risk of death for the baby or the mother when the fetal surgery group was compared with a group that received surgery after birth.


With the conclusion of the study, Vanderbilt is now immediately offering this procedure to patients with consultations already scheduled.

So proud. 

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Have a happy Friday everyone!!!

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