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Patch may allow spina bifida repair before birth, study says

Using a patch made from donated umbilical cord allowed the condition to naturally heal itself within weeks of birth.

By Stephen Feller
Patch may allow spina bifida repair before birth, study says
A patch made from donated human umbilical cord facilitated the natural healing of spina bifida in fetuses, a condition characterized by the incomplete development of the protective covering of the spinal cord, according to researchers at the University of Texas. Photo by Lightspring/Shutterstock

HOUSTON, July 12 (UPI) -- A series of experimental surgeries suggests applying a patch to fetuses with spina bifida could prevent them from being born with the condition and allow for normal development.

Researchers at the University of Texas found a donated patch from cryopreserved human umbilical cord could treat spina bifida and allow children to avoid the developmental problems it causes.

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Spina bifida is a neural tube defect caused by the spine not forming properly, preventing it from protecting the spinal cord and nerves, which can cause physical and intellectual disabilities.

Previous studies have shown that if babies receive surgery before birth to correct the opening, the condition could be reduced or eliminated. Patches used in a clinical trial by the National Institutes of Health in 2011 were somewhat effective, though some babies developed scar tissue that, if it adhered to the spinal cord during healing, could lead to a loss of neurologic function.

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In a new study, researchers found using a patch taken from donated human umbilical cord prevented the formation of scar tissue while motivating the opening to heal properly.

Part of this, researchers say, is because the umbilical cord contains heavy chain hyaluronic acid and pentraxin3, which has regenerative properties. This is beneficial over other repair methods because it motivates local tissue to grow, decreasing scar formation and reducing the potential need for surgeries to remove scar tissue after birth.

"This patch acts as a scaffold, which is watertight and allows native tissue to regenerate in an organized manner, and has anti-scarring, anti-inflammatory properties," Dr. Lovepreet Mann, an instructer of obstetrics, gynecology and reproductive sciences at the University of Texas, said in a press release. "Preventing the scarring could prevent tethering, which can prevent further damage to the cord."

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After testing the method successfully on 16 sheep fetuses with spina bifida, the researchers have now performed the surgery on three humans.

In the first two, which have been documented in a study published in the journal Obstetrics and Gynecology, the researchers performed surgery on two fetuses at 24 weeks and 25 weeks of gestation to repair spina bifida lesions.

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In both cases, the babies were delivered at 37 weeks of gestation. In the first baby, the patch appeared semi-translucent at birth with incomplete growth of skin over it, though within two weeks it had healed over the patch the child had normal movement and bladder control.

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In the second baby, skin also had not grown over the patch, though by 30 days after birth the lesion was completely healed and the child had normal movement and urinary function.

Future research will focus on methods of motivating the skin to heal before birth, as well as methods of applying the patch with less invasive surgical procedures.

"The use of this patch for fetal repair heralds a new era for fetal spina bifida repair," said Dr. Kenneth Moise, a professor, as well as director of the Fetal Intervention Fellowship Program, at McGovern Medical School at the University of Texas. "For the first time, a bioscaffold has been successfully employed to allow the fetus to heal itself. The implications for the future of a minimally invasive approach to fetal spina bifida repair and even neonatal spina bifida repair are enormous."

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