RMB Solutionist Thinking
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Ermos Nicolaou: Solving problems in babies, even before they are born

RMB Solutionist Thinking is a podcast series hosted by Bruce Whitfield which focusses on great South African minds thinking differently and going against the norm. In this episode in the second series, Whitfield interviews Professor Ermos Nicolaou, Academic Head at Wits Maternal Foetal Medicine Centre.

A local doctor supported by an international team of experts recently performed Africa's first in-utero spinal surgery at Morningside Clinic. While it sounds like something from science fiction, the surgery was to treat Spina Bifida — a birth defect that affects the development of the baby's spine.

In a medical first on the continent, Specialist in Maternal and Foetal Medicine, Professor Ermos Nicolaou performed the intricate, groundbreaking spinal repair procedure — on a baby, still in its mother's womb at the gestational age of 25 week old. The procedure involved penetrating the uterine wall using tiny instruments to stop the inflammatory process that typically leads to nerve damage and other abnormalities.

This is a level up, this is now proper surgery where you actually would operate on the baby like you would do when the baby is born.

Professor Ermos Nicolaou, Academic Head – Wits Maternal Foetal Medicine Centre

Until now, parents were presented with two options: termination of the pregnancy or waiting until after delivery before performing several corrective surgeries to repair the spine and, affected organs and limbs.

Suddenly that prognosis changes dramatically because if you can fix the problem in the womb, the child has got a far better chance of having a normal life.

Professor Ermos Nicolaou, Academic Head – Wits Maternal Foetal Medicine Centre

In this case, the diagnosis was made at 21 weeks, affording the parents adequate time to make a decision ahead of the 25 week mark — which leaves the baby a chance of survival, should something go wrong during the operation.

The parents received extensive counselling to understand the condition, its consequences and the options available to the baby.

The feeling of enabling a child to actually have a reasonable life, almost normal life. That for me is priceless. That's exactly what we have been doing with our lives. And that's exactly what the aim was of this surgery.

Professor Ermos Nicolaou, Academic Head – Wits Maternal Foetal Medicine Centre

The baby, still in its mother's womb and still growing stronger and stronger, is expected to arrive in July and stands a far better chance at leading an uncomplicated life, thanks to Solutionist Thinker, Professor Ermos Nicolaou.


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