Representative image. Vishnoi M, CC BY-SA 4.0, Wikimedia Commons
Why it matters
Open spina bifida has been repaired only after birth in India's public hospitals, when some nerve damage cannot be undone. A government hospital now offers the option before birth for selected pregnancies, and this first case cost the family nothing under a central scheme.
Surgeons at the All India Institute of Medical Sciences (AIIMS) in New Delhi opened a mother’s womb at 25 weeks of pregnancy and closed a gap in her unborn baby’s spine, in what the hospital says is India’s first open fetal surgery for the most severe form of spina bifida. The AIIMS fetal surgery took six hours and was done on 12 November 2026, The Indian Express reported.
The condition treated is lumbosacral myelomeningocele: the spinal cord and its coverings bulge out through an opening in the lower back. Neurosurgeons in India usually repair it after birth. Operating before birth aims to stop months of damage to the exposed nerves inside the womb.
How the AIIMS fetal surgery was done
More than 30 doctors and nurses took part, according to the AIIMS statement carried by The News Mill with inputs from news agency Asian News International (ANI). Planning took over five weeks: detailed scans of the fetus, counselling of the parents, anaesthesia preparation and a practice run of the operation.
In the procedure, the team opens the uterus under controlled conditions, closes the baby’s spinal defect in layers to cover the exposed tissue, then closes the uterus again, The Indian Express explained. The work was done at the AIIMS Neurosciences Centre with an operating microscope and ultrasound running throughout.
Professor Deepak Gupta, who heads the Indian Society for Pediatric Neurosurgery, led the neurosurgery team. Professors Neena Malhotra and K Aparna Sharma led the maternal-fetal medicine and obstetrics side. Anaesthesia, plastic surgery, radiology and newborn care teams were also involved.
The surgery is not a cure, Dr Gupta told The Indian Express. The child may still need long-term care from neurosurgeons, urologists, orthopaedic doctors and rehabilitation staff. The mother and fetus remain under close watch through the rest of the pregnancy, birth and the newborn period, the AIIMS statement said.
What the defect does, and why repair in the womb helps
Spina bifida, a neural tube defect, starts in the first month of pregnancy, when the neural tube, which grows into the brain and spinal cord, does not close fully. Open spina bifida can cause paralysis, a build-up of fluid in the brain called hydrocephalus, and lifelong nerve problems, according to the doctors quoted by The Indian Express.
The case for operating early comes from the Management of Myelomeningocele Study (MOMS), an international trial that compared repair before birth with repair after it. Dr Gupta cited it as the evidence behind the AIIMS programme.
| MOMS trial result at 12 months | Repair before birth | Repair after birth |
|---|---|---|
| Children who needed a shunt to drain brain fluid | 40% | 82% |
On those figures, NewsPlainly’s calculation is that babies operated on in the womb needed a shunt about half as often (40 against 82 in every 100). The Indian Express also reported better early movement and fewer hindbrain problems linked to the defect after surgery before birth.
Who can get the operation before birth
Spina bifida surgery in the womb is not for every pregnancy. It carries a higher chance of premature delivery and leaves a scar on the uterus that can make later pregnancies harder, The Indian Express reported, which is why it is offered only to carefully selected cases at specialised centres. Surgeons step in between 24 and 26 weeks of pregnancy in suitable cases, the paper said.
- Timing: between 24 and 26 weeks; this case was at 25 weeks.
- Where: only designated tertiary referral centres with maternal-fetal medicine specialists, paediatric neurosurgeons, newborn intensive care and long-term rehabilitation, Dr Gupta said.
- Cost in this case: free, under the Centre’s Janani Shishu Suraksha Karyakram (JSSK) for mothers and newborns. Comparable care in the United States may cost more than ₹1 crore, the AIIMS statement said.
How many babies in India are born with the defect
Dr Gupta estimates that about 1.2 lakh babies a year in India are born with neural tube defects, which include spina bifida, of whom 20,000 to 30,000 have open defects like this one, The Indian Express reported. A 2024 review of 27 Indian studies put the pooled rate at 9.46 per 1,000 births, which works out to roughly one in every 106 births (NewsPlainly’s calculation).
The AIIMS team stressed prevention. The neural tube closes about 28 days after conception, often before a woman knows she is pregnant, so folic acid before conception and fortified food remain the main defence against neural tube defects, the team said.
A fetal surgery programme at AIIMS was first planned in 2012, after the MOMS results came out. “Fourteen years ago, we spoke of the possibility of fetal spinal surgery at AIIMS. Today, that possibility has become a reality,” Dr Gupta said in the statement. The hospital’s next aim, he said, is to make it safe and accessible to Indian families who may benefit.
For more health stories, see our Health and Science section and our report on new medical postgraduate courses at IIT Kharagpur. The full interview is in The Indian Express report.
Frequently asked questions
What is spina bifida?
A birth defect in which the neural tube does not close fully in the first month of pregnancy. In myelomeningocele, the most severe form, the spinal cord bulges out through a gap in the spine.
Is fetal surgery for spina bifida a cure?
No. Dr Deepak Gupta of AIIMS said the child may still need long-term neurosurgical, urological, orthopaedic and rehabilitation care.
How much did the AIIMS surgery cost?
It was free under the Janani Shishu Suraksha Karyakram. The AIIMS statement said comparable care in the US may exceed ₹1 crore.