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[To act or not to act? Developments in prenatal and postnatal care for children with spina bifida aperta]

Bart T H Lutters1,2, Jochem K H Spoor1, T H Rob de Jong1

  • 1Erasmus MC, afd. Neurochirurgie, Rotterdam.

Nederlands Tijdschrift Voor Geneeskunde
|May 30, 2019
PubMed

Insights

Advances in spina bifida aperta care have improved survival rates but created ethical dilemmas. Modern approaches include prenatal interventions and fetal surgery, balancing technological progress with quality of life considerations.

Area of Science:

  • Medical Ethics
  • Pediatric Surgery
  • Neonatal Care

Background:

  • Historically, newborns with spina bifida aperta had poor survival rates.
  • Medical advancements in the 1960s improved survival but highlighted quality of life concerns.
  • This led to an ethical deadlock regarding treatment for spina bifida patients.

Purpose of the Study:

  • To provide a historical overview of developments in prenatal and postnatal care for spina bifida aperta.
  • To examine the interplay between technological advancements and ethical dilemmas in managing spina bifida aperta.
  • To illustrate the evolution of treatment strategies and ethical considerations over time.

Main Methods:

  • Historical review of medical literature and clinical practices.
  • Analysis of ethical considerations and decision-making processes.
  • Examination of technological advancements in surgical and medical interventions.

Main Results:

  • Improved survival rates for spina bifida aperta due to advances in hydrocephalus treatment and postnatal closure.
  • Increased emphasis on selective pregnancy termination and active termination of life for severe cases.
  • Development of new strategies like fetal surgery alongside ongoing ethical debates.

Conclusions:

  • Technological developments in spina bifida aperta care continuously influence ethical dilemmas.
  • The management of spina bifida aperta involves a complex balance between survival, quality of life, and ethical considerations.
  • Ongoing research and ethical discourse are crucial for advancing patient care.

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