Published Nov 15, 2026 | 11:09 AM ⚊ Updated Nov 15, 2026 | 11:09 AM
AIIMS Delhi.
Synopsis: Doctors at AIIMS, New Delhi, have performed India’s first open foetal surgery to repair a severe spinal defect in an unborn baby at 25 weeks of pregnancy. The six-hour operation involved closing the defect to protect the developing spinal cord, with more than 30 clinicians and nurses from multiple specialities participating.
Doctors at the All India Institute of Medical Sciences (AIIMS), New Delhi, have performed India’s first open foetal surgery to repair a severe spinal defect in an unborn baby, intervening before birth to prevent further damage to the developing spinal cord.
The six-hour operation, performed on 12 November at 25 weeks of pregnancy, involved repairing a lumbosacral myelomeningocele, the most severe form of spina bifida. The procedure involved closing the cerebrospinal-fluid-leaking defect while the baby was still in the womb.
Myelomeningocele is an open neural tube defect in which the spinal cord and its coverings protrude through an opening in the spine. The exposed nerves can sustain progressive damage during pregnancy. Children born with the condition can develop paralysis, bladder and bowel dysfunction, hydrocephalus and other lifelong neurological disabilities.
Traditionally, neurosurgeons repair the defect after birth. However, prenatal surgery allows doctors to close the opening and protect the exposed spinal cord while the baby is still developing.
“In rigorously selected cases, prenatal repair seeks to limit ongoing injury to exposed neural tissue, reduce the subsequent need for cerebrospinal-fluid diversion for hydrocephalus, and improve selected neurological outcomes. It is not a cure, and long-term multidisciplinary care remains essential,” said Dr Deepak Gupta, who led the neurosurgical team.
The operation followed more than five weeks of multidisciplinary preparation, including detailed foetal imaging, non-directive counselling, anaesthetic preparation and operative simulation. The surgery was performed at the AIIMS Neurosciences Centre using high-end microscopy and continuous ultrasonography assistance.
More than 30 clinicians and nurses from obstetrics and gynaecology, maternal-foetal medicine, neurosurgery, obstetric and neuroanaesthesia, plastic surgery, radiodiagnosis and neonatology participated. The maternal-foetal medicine and obstetric teams were led by Dr Neena Malhotra and Dr K Aparna Sharma.
International evidence supports prenatal repair in carefully selected pregnancies. The landmark Management of Myelomeningocele (MOMS) trial found that 40 percent of children who underwent prenatal surgery required a cerebrospinal-fluid shunt to treat hydrocephalus by 12 months, compared with 82 percent among children who underwent surgery after birth.
Prenatal repair was also associated with improved motor outcomes and reduced Chiari II hindbrain herniation.
However, operating before birth carries risks, including premature labour, preterm delivery, bleeding, infection and complications associated with the uterine scar. Therefore, the procedure requires careful patient selection and close monitoring of both the mother and foetus.
“The safety of both mother and fetus depends on detailed counselling, high-quality anaesthesia, and coordinated surveillance before and after surgery,” Dr Sharma said.
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AIIMS said the mother and foetus would continue to receive multidisciplinary monitoring through the remainder of pregnancy, delivery and the newborn period. The procedure was provided free of cost under the Centre’s Janani Shishu Suraksha Karyakram (JSSK).
The institute said it intends to develop a structured foetal-care programme to make the procedure available to eligible families.
“Fourteen years ago, we spoke of the possibility of foetal spinal surgery at AIIMS. Today, that possibility has become a reality. Our next responsibility is to make it safe and accessible to Indian families who may benefit from it,” the hospital said.
Doctors emphasised that foetal surgery is not a substitute for prevention. Neural tube closure occurs around 28 days after conception, often before a woman knows she is pregnant. Preconception folic-acid supplementation and folate fortification of staple foods remain important measures to prevent neural tube defects.
(Edited by Dese Gowda)
