A patch made of stem cells from donor placentas has been used to treat fetuses in the womb with a severe form of spina bifida as part of a world-first trial. The novel approach seems to have reversed a brain complication associated with the congenital condition at least as effectively as the go-to treatment, but is expected to enable more children to walk over the long term.

The mother of one of the babies, who is now 4 years old, says she expected that her son Toby would require a wheelchair when he was diagnosed with the condition in the womb. “But Toby is healthy [and] has hit all of his milestones – he’s walking, running and jumping – and has no problems with bladder control, which is rare for people with the condition,” she says.

Spina bifida – which affects about 1 in every 2,800 births in the US every year – occurs when a baby’s spine and spinal cord do not fully develop in the womb. In the most severe form of the condition, called myelomeningocele, the spinal cord and its surrounding tissue protrude out of a gap in the vertebrae, which often impairs mobility and bowel and bladder control. The cause of spina bifida is unknown, but folic acid deficiency during pregnancy raises the risk.

One of the standard treatments involves surgery in the womb that tucks the spinal cord and the surrounding tissue back into the vertebrae, before sewing up the skin to form a tight seal. “But many children still end up unable to walk and there’s [usually] no improvement in bowel or bladder control,” says Diana Farmer at the University of California, Davis.

This led Farmer and her colleagues to wonder if the addition of stem cells could help by promoting the growth and repair of spinal tissue. To find out, they recruited six pregnant women carrying fetuses with myelomeningocele.

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