Few stories are more intriguing, more fascinating than accounts of breakthrough in fetal surgery—treating the unborn as a patient.
A press release issued from Boston Children’s Hospital touted how doctors had performed the first ever successful brain surgery on a baby in the womb.
“Vein of Galen malformation” (VOGM) is “a rare blood vessel abnormality inside the brain in which misshapen arteries in the brain connect directly with veins instead of capillaries, which slows blood flow, and high-pressure blood can rush into the brain, “the New York Post reported.
In layman’s terms, doctors repaired this potentially deadly developmental condition by treating an aggressive vascular malformation, in the baby’s brain before birth. The surgery was performed at 34 weeks and 2 days gestational age.
It is estimated that VOGM occurs in as many as one in every 60,000 births. It is the most common congenital vascular brain malformation.
“We are pleased to report that at six weeks, the infant is progressing remarkably well, on no medications, eating normally, gaining weight and is back home. There are no signs of any negative effects on the brain,” lead study author Darren B. Orbach, MD, PhD, co-director of the Cerebrovascular Surgery & Interventions Center at Boston Children’s Hospital and an associate professor of radiology at Harvard Medical School, said in a news release.
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The proud parents of the baby girl are Derek and Kenyatta Coleman.
Brooke Steinberg of the Post reported that the couple was excited that Kenyatta was pregnant again. “Baby was doing well. The anatomy scan came back unremarkable. All of her biophysical profiles were all unremarkable,” Kenyatta, 36, told CNN.
However when she went in for her 30–week ultrasound, Steinberg reported, “the doctor told her that ‘something wasn’t right in terms of the baby’s brain and also her heart was enlarged.’ The baby was diagnosed with a vein of Galen malformation at 30 weeks.”
The misconnection slows blood flow, and high-pressure blood can rush into the brain.
Because of the extra pressure, the potential for a whole range of life-threatening diseases was very high. Congestive heart failure in some infants “and rising blood pressure leading to pulmonary hypertension,” according to Steinberg.
“It can also prevent the baby’s brain from draining accurately which can lead to brain injury and sometimes causing loss of brain tissue, and sometimes developing hydrocephalus — an enlarged head.”
Their best option, the Colemans decided, “was to join the clinical trial for treatment, regardless of the possible risks, such as preterm labor or brain hemorrhage for the baby.”
A team from Boston Children’s Hospital and Massachusetts General Hospital carried out the surgery on the baby and the mom. They cut into the womb, “then the baby’s skull and ultimately operating on the developing brain,” Steinberg explained. “After they cut into the pregnant woman’s abdomen, they used an ultrasound to locate the baby’s artery and help navigate the procedure.”
Denver Coleman “was born two days post-op with no birth defects and limited complications at 4.2 pounds, which is light for a newborn,” Steinberg wrote.
“I heard her cry for the first time and that just, I – I can’t even put into words how I felt at that moment,” Kenyatta told CNN. “It was just, you know, the most beautiful moment being able to hold her, gaze up on her and then hear her cry.”
“I gave her a kiss and she was just making little baby noises and stuff,” Derek said. “That was all I needed right there.”
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