Fetal surgery performed at St. Louis Fetal Care Institute

5:12 PM, Apr 29, 2013   |    comments
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By Alex Fees

ST. LOUIS (KSDK) - Twenty weeks into their second pregnancy, Justin and Patty Stepien, of Green Bay, Wis., learned from an ultra sound test that their daughter had spina bifida.

A doctor's referral brought them to the St. Louis Fetal Care Institute, a partnership between SSM Cardinal Glennon and SSM St. Mary's health centers.

"My next question is, 'How can we fix it?'" said Justin. "We found out we're having a little girl. All I wanted to know is how do we make it better."

Doctors performed surgery on the fetus April 22 at St. Mary's Health Center.

"Basically I know they went in through my uterus and repaired the baby," said Patty. "They obviously took the baby out to repair the spina bifida, and basically put everything back together, which is mind-boggling to me, that they can even do that."

Baby Stepien has a Myelomengocele, a form of spina bifida characterized by the back bones not closing over the spinal cord. It can cause brain damage and paralysis before the baby is even born.

"The baby is rolled so the spina bifida is exposed in the opening of the uterus," said Dr. Mike Vlastos, director of the St. Louis Fetal Care Institute.

He said the surgery is based upon the results of the MOMS Trial. MOMS stands for Management of Myelomeningocele. Vlastos said the study at Children's Hospital of Philadelphia, Vanderbilt, and University of California at San Francisco performed a very thorough test of spina bifida repair before and after birth.

While the procedure is cutting-edge medicine, it's not the first one at SSM. In fact, doctors here have done 22 procedures.

Dr. Vlastos said, "They found two distinct advantages to repair before birth. In those cases of course the spina bifida was closed. In those cases kids were less likely to need a shunt to divert the extra fluid from the brain to the abdomen. The need for a shunt decreased that risk by 50 percent. To avoid a shunt is considered a fantastic advancement for these little people. Secondly the babies also have better overall development and motor function, particularly in lower extremities, legs, and their torso. A lot of these children they found could hold their urine and bowels, and be able to walk."

The Stepiens could not be more pleased.

"Basically it's a miracle that they can do that, and all the ultrasounds after, seeing the baby move," said Patty.

Justin added, "Waving fingers and toes... and moving! Granted she could do that before, but they worked on a spinal cord, so... I'm impressed."

The Stepiens will soon be going home to Green Bay, to progress through the remainder of Patty's pregnancy. After this surgery, doctors generally take the baby by C-section at about week 37. They don't want to the mother to go into labor due to the incision in the uterus.


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