MOMS Trial

The MOMS Trial (Management of Myelomeningocele Study) is an initiative sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) that investigates the potential benefits and risks of prenatal (before birth) versus postnatal (after birth) surgical closure of myelomeningocele, commonly known as spina bifida. This collaborative study brings together some of the most esteemed medical institutions, including The Children's Hospital of Philadelphia, the University of California at San Francisco, Vanderbilt University Medical Center in Nashville, and the George Washington University in Washington, D.C.

Introduction to Spina Bifida

Spina bifida, or myelomeningocele, is a type of open neural tube defect that arises due to complications in the early developmental stages of a fetus. Factors contributing to spina bifida are believed to be a combination of genetics and environmental influences.

During the initial 28 days of pregnancy, critical formations of the brain and spinal cord transpire. Spina bifida materializes when there is a failure in the closure of the tissue at the base of the spinal cord or if the neural tube's closure is disturbed by another factor. Consequently:

Open spina bifida: A majority of babies born with this condition encounter various health challenges, such as nerve damage, motor function issues, potential paralysis of their lower body (severity varies), loss of bowel and bladder control, and brain anomalies. Closed spina bifida: Often underestimated in its frequency, closed spina bifida, or spina bifida occulta, embodies a set of milder abnormalities where the neural tube remains closed.

Historical Detection and Treatment

In earlier times, detecting spina bifida before birth was rare. Traditional methods involved maternal serum screening for raised alpha-fetoprotein levels between the 16th and 18th week of gestation, followed by an amniocentesis, which only identified a fraction of cases. Another approach involved the evaluation of Acetyl choline Esterase from amniotic fluid. Presently, thanks to advancements in medical imaging, a remarkable detection rate of 98% is achieved using an anatomical screen ultrasound at the 20-week gestation mark.

For numerous years, the conventional treatment for spina bifida was to seal the spinal defect shortly after the infant's birth, termed postnatal surgery. However, the medical community has recently introduced an experimental procedure performed while the fetus is still inside the uterus - known as prenatal surgery. The MOMS Trial explores the possibility that prenatal surgery might enhance the outcomes for infants diagnosed with spina bifida.

The Significance of The MOMS Trial

• Collaboration: The MOMS Trial exemplifies the collaborative spirit of the medical community, combining the expertise and resources of prominent institutions to address a significant health challenge.
• Innovation: By evaluating prenatal surgery's viability and potential benefits, the trial pushes the boundaries of traditional medical interventions, offering hope for better outcomes for babies with spina bifida.

See Also

• Neural tube defect
• Amniocentesis
• Prenatal surgery
• Postnatal surgery

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