Thanks to surgery in the womb, newborn avoids devastating birth defect

PITTSBURGH (WTAE/Hearst/CNN) - A delicate surgery was performed in Pittsburgh for the very first time.

Allee Mullen, who takes care of critically ill boys and girls at University of Pittsburgh Medical Center Children’s Hospital, was 20 weeks pregnant when doctors diagnosed her baby with spina bifida.

The in-utero surgery to repair the baby’s spine came with serious risks, especially for the mom.

In January, the pregnant pediatric intensive care nurse was wheeled into the operating room at UPMC Magee Women’s Hospital, becoming the first patient in Pittsburgh to undergo in utero fetal surgery to repair spina bifida.

“It’s a devastating diagnosis,” said fetal medicine specialist Dr. Stephen Emery from Magee.

He and pediatric neurosurgeon Dr. Stephanie Green from Children’s Hospital teamed up for the delicate surgery.

They said many factors made Mullen the perfect first candidate, including her health and where her baby was positioned.

“But I think the main factor for Allee is that she’s, she’s a nurse in the PICU children’s hospital and she takes care of these kids. She knows what spina bifida is,” Emery said.

With spina bifida, the baby’s spinal cord and backbone don’t close, exposing it to amniotic fluid and causing severe damage.

Greene said studies show fetuses operated on in the womb do better than waiting to have the corrective surgery after birth.

“That can be the difference between not walking and walking. They had half the incidents of hydrocephalus or water on the brain that requires surgical treatment, and they had improvement in a radiographic condition that can sometimes cause death in infancy in these children,” she said.

“If we were going to do this, we might as well do it here in Pittsburgh,” Mullen said.

After considering the risks, Mullen focused on what was best for her baby.

“This was the best decision for us," she said. "We did a lot of talking and research and doctors and praying, and family was praying and researching and everything, and it just really was the best decision we could have made.”

That trust brought joy. Two months later, Mullen’s baby arrived kicking right away.

“As I looked at her toes, and she was pulling up her feet and flexing her toes, which means that there is neurologic function there, and that was a huge relief,” Emery said.

“The first thing that came out of his mouth is, ‘She’s kicking her legs,’ and we were all so excited,” Mullen said.

The baby’s back was completely healed, and the neurological exam looked promising.

“She had normal movement in her legs, except she can’t point her toes down quite all the way with one foot," Greene said. "To be fair, based on the anatomic level, she shouldn’t have had movement below her knees, so that’s fantastic.”

“It was awesome. It was, and then hearing Dr. Emery tell everyone who is in the (operating room) that day that they’re part of history, and they are,” Mullen said.

The baby girl was named Emery Greene, honoring the doctors they trusted.

“It’s a real honor. It’s a level of gratitude that they exhibit toward towards us that is just very profound," Emery said. "You know they named their daughter after us.”

“It’s really emotional. It’s, as Dr. Emery said, it’s the highest honor I could imagine somebody giving me,” Greene said.

“They’ve really made a difference in our lives and I’m excited to see how many more lives they’re going to make a difference to," Mullen said. "I’m really excited. I can’t wait to see all the things that she’s going to do and the lives that she’s going to touch.”

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