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Tiny Miracle: Amidst Pandemic, Connecticut's First Fetal Surgery for Spina Bifida

April 10, 2020

On March 21, Co-Directors of the Yale Fetal Care Center, David Stitelman, MD (Assistant Professor of Pediatric Surgery) and Mert Ozan Bahtiyar, MD (Associate Professor of Obstetrics, Gynecology, and Reproductive Sciences; Director,), together with Michael DiLuna, MD, FAANS (Associate Professor and Chief, Pediatric Neurosurgery), and a team of maternal fetal medicine specialists — anesthesiologists, cardiologists, and nurses — made history. The team performed the state’s first fetal surgery to correct myelomeningocele, a serious form of spina bifida that has a limited correction window in an unborn child's development.

“It is a delicate procedure to begin with, and then there’s COVID,” said Dr. Stitelman. “If any one of us had gotten sick, we would have had to cancel. It makes you value 'the team’ even more. In a multidisciplinary case like this, we have to depend on each other.”

With social-distancing a priority, the consulting, planning, and simulation for the surgery took place, primarily, via video-conference. “It’s not typical to plan for a case like this on Zoom, that’s for sure,” said Dr. Stitelman.

The mother, and child — who were referred to the Yale Fetal Care Center when an ultrasound and fetal MRI confirmed the birth defect, underwent the procedure on March 21 — the 25th week of fetal development. Ninety minutes later, the in-womb operation was completed; and after two weeks of bed rest in the hospital …

“Mom is doing really well, and the fetus is kicking like crazy, which is a great sign,” said Dr. Stitelman.

The state of Connecticut sees about 10 cases a year; however, fewer than half of those are candidates for surgery, Dr. Stitelman said. The success of the initial procedure presents new opportunity for Yale, he said, and the beginning of a dialogue around building a destination program for the region.

Submitted by Cecelia Smith on April 09, 2020