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Birth of a Breakthrough: Spina Bifida Video - CHOP

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Newborn Care at CHOP After Spina Bifida Surgery

Evaluation and workup of the newborn after spina bifida surgery is the same whether prenatal or postnatal surgery was chosen. Newborn care at CHOP is comprehensive, as specialists from all disciplines evaluate the newborn to ensure any spina bifida complications are identified and addressed. CHOP’s expert newborn care staff is well versed in the special circumstances of babies who have undergone fetal or postnatal surgery, and in the issues of prematurity. In general, babies who are delivered early will remain at CHOP until about their original due date – or what would have been their 40th week of gestation. Discharge planning begins early in the baby’s NIICU stay to educate families about their newborn’s care, care related to spina bifida, and arrange for the family to be connected to a spina bifida clinic close to their home.

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The Birth of a Breakthrough Video explores spina bifida diagnosis, treatment options, delivery and follow-up care at The Children’s Hospital of Philadelphia. Experts at CHOP’s Center for Fetal Diagnosis and Treatment have the world’s greatest collective experience in prenatal repair for spina bifida.
 

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Transcript: Newborn Care at CHOP After Spina Bifida Surgery


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Martha G. Hudson, MSW: In the postnatal course, regardless of whether or not you have had fetal surgery or postnatal surgery, our aim is get the mom down to the NICU as soon as possible to be with her baby. The babies all have the exact same workup regardless of which treatment they have had.

Lori J. Howell, RN: They are descended upon by a team of experts from urology, orthopedics, the spina bifida clinic, and a variety of folks from those areas to get the baseline tests that they might need.

Leslie N. Sutton, MD: We look at the head to see is there any sign that the water is building up with the hydrocephalus. We look at the legs and the feet to see if they're moving. And then we order certain radiographic studies, the MRIs, to look at those things from the inside.

Natalie E. Rintoul, MD: The near-term babies, 35 weeks and above, are often quite mature. I mean, they need a little bit of help feeding and maybe a little respiratory support, but we feel pretty good once they get to that gestation. And then kids between 26 to 32 weeks, they're young. We have to, you know, follow them very closely for all the regular, routine issues of prematurity.

N. Scott Adzick, MD: One of the important things in terms of neonatal care, particularly for premature babies, is a level of expertise that's unparalleled.

Natalie E. Rintoul, MD: The newborn infant ICU at the Children's Hospital of Philadelphia is one of the leading units in the country, if not the world. The unit has a lot of experience taking care of babies, preterm infants up to 6 months, up to a year. But what's very important for these families is that there are physicians and nurses, respiratory therapists, a whole team that know how to take care of a baby that's had fetal surgery.

N. Scott Adzick, MD: That is just not a baby who's born at 29 weeks gestation. That is a baby who's had open fetal surgery several weeks previously, born very premature at 29 weeks gestation. So you want expertise in that NICU that can care for any consequence for that baby, whether it's 2:00 in the morning or 2:00 in the afternoon, and that's the sort of expertise and depth of care that we have.

Michael Mulligan, father: It's tough to watch this happening to your loved ones, and you just feel much better knowing that there's this support staff. That they have an understanding of what consequences can come, of what outcomes could be. And they're ready for those outcomes.

Lori J. Howell, RN: I always tell parents that if your due date was April 1st and you're going to deliver at 37 weeks, that you'll probably go home around April 1st.

Natalie E. Rintoul, MD: So expect to be with us until your due date. Some kids graduate a little earlier, and some kids that may have had some complications may be with us a little longer. But that's a pretty good rule of thumb.

Martha G. Hudson, MSW: When a child is ready to go home from the NICU, we make sure they are completely hooked up in a spina bifida clinic in their area. If they are local, we will have them hooked up in our spina bifida clinic, and we will make sure that all the services they need in their community are set up prior to discharge.

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