An unborn seven weeks old girl got a dangerous condition that called for a surgery. High risk for a brain damage, heart problems, and trouble breathing after she was born.
Vein of Galen malformation
Her parents joined a clinical trial of a surgery done while the baby was still in the womb to see if doctors could stop any of these things from happening. It looks like it worked, and the team behind the operation is now planning to use the same method on more unborns.
The problem with the unborn, called vein of Galen malformation, was first seen at 30 weeks of pregnancy during a routine ultrasound scan. The resulting balloon of blood can cause a baby serious problems, like brain damage, heart failure, and damage to other organs.
Conditions like these might be treated in the future with foetal brain surgery. Orbach and his colleagues at Boston Children’s Hospital and Brigham and Women’s Hospital signed up for a clinical trial in 2020 to see if foetal brain surgery could help.
The operation
On March 15, when the girl’s mother was 34 weeks pregnant, she had an experimental surgery that took two hours and involved a number of doctors. A spinal anaesthetic was used to make sure the mother didn’t feel anything in her lower half. In the second step, the foetus had to be moved physically inside the uterus so that the brain could be reached from the front.
Before the surgery began, an injection was given to the foetus to stop it from feeling pain or moving. The doctors then used an ultrasound to help them guide a needle through the mother’s abdomen, the wall of the uterus, the fetus’s skull, and into the brain malformation. Members of the team fed a tiny catheter through the needle to put a series of tiny platinum coils into the blood-filled pocket. Once each was let go, it grew bigger and helped block the place where the artery and vein met. Once they saw that it was back to normal, they stopped giving it to the coils and carefully took out the needle.
Life
A few days later, the baby girl was born healthy. She was watched for a few weeks in the hospital and is now home and doing well. This is a very exciting new development that gives kids a chance who would not have survived otherwise.
The procedure has risks and might only be worth it if the problem is very bad and there is a good chance of getting better. Other conditions, like problems with blood vessels or brain tumours, might also benefit from operations like this one.
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