US A team of doctors in Boston has successfully performed surgery in utero to treat a rare brain disease in a baby girl.
Baby Denver Coleman has a vein of Galen malformation, which occurs when the blood vessels carrying blood from the brain to the heart develop abnormally. This condition causes too much blood to be pumped, putting strain on the veins and heart, leading to a host of health problems. To treat it, doctors had to perform surgery while the baby was still in the womb.
This is the first time doctors have successfully operated from the uterus to treat a vein of Galen malformation. Details of the surgery were published in the journal Stroke on May 4.
The baby girl's parents are Derek Coleman, 39, and Kenyatta Coleman, 36, according to reports. When they found out they were pregnant for the fourth time, they were both surprised and happy. Kenyatta's pregnancy was uneventful. Ultrasound scans showed good results. The couple even did genetic testing to ensure the pregnancy was "low risk."
However, a 30-week ultrasound revealed abnormalities in the fetus’s brain and heart. Doctors diagnosed her baby with a vein of Galen malformation. To treat the condition, Kenyatta decided to participate in a clinical trial run by Brigham and Women’s Hospital in Boston, where doctors would operate on her daughter before she was born.
Risks after surgery include premature birth and fetal brain hemorrhage. However, this is also the only way to save the life of the unborn child.
Baby girl Denver Coleman turns one month old. Photo: Coleman
On March 15, exactly one month after the ultrasound revealed the abnormality, Kenyatta went into surgery. "There are two patients in this surgery: Kenyatta and her baby," doctors at Boston's Brigham and Women's Hospital confirmed.
The surgical team had to ensure the fetus was positioned correctly, with its head facing the mother’s abdominal wall. Doctors had to use techniques borrowed from previous in-utero heart surgeries, said Dr. Louise Wilkins-Haug, director of the Department of Maternal Fetal Medicine and Reproductive Genetics.
Once in the ideal position, the fetus is injected with a small amount of anesthetic and pain medication to keep it from moving. From there, the doctor inserts a needle through the mother’s abdominal wall, carefully threads a catheter through the needle, and coils tiny metal wires that can fill the vein, slowing the blood flow and reducing the pressure.
The fetus showed immediate signs of improvement. X-rays showed a drop in blood pressure in vital areas.
“We were very excited because we had a technical success,” said Darren Orbach, a radiologist at Boston Children’s Hospital. “But there were issues that followed. Could the baby’s health continue to improve? Would she go into immediate heart failure?”
Typically, 50-60% of newborns with vein of Galen malformation will become seriously ill immediately, with a mortality rate of about 40%. About half of those who survive will have serious neurological or cognitive problems.
After the surgery, Kenyatta’s water broke. Two days later, at 34 weeks, she went into labor. On March 17, Denver Coleman was born, weighing 4 pounds, 1 ounce.
"The first time I heard my baby cry, I couldn't even put my feelings into words. The best moment was when I held my baby in my arms," Kenyatta recalled.
Doctors said that baby Denver was very stable during the newborn period and did not need any immediate treatment. Now, nearly two months after her birth, she continues to develop healthily, eating and sleeping normally. Denver does not need to take any heart failure medication, and neurological examination results are also positive.
“From the very beginning, she proved herself to be a fighter who wanted to be in this world,” Kenyatta said.
Thuc Linh (According to CNN )
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