Doctors in the US have performed life-saving brain surgery on a baby while still in its mother’s womb for the first time.
Surgeons in Boston, Massachusetts were able to successfully repair a major malformation in the brain of a foetus at 34 weeks using a complex technique called embolisation.
The baby girl suffered from Vein of Galen Malformation (VGM), a rare neurological condition which can cause heart failure and stroke-like symptoms within days of birth.
VGM causes arteries in the brain to drain blood into the veins, rather than the capillaries. This floods the heart and causes brain damage.
It occurs during a baby’s early prenatal development, usually during the first trimester.
Previous studies have found that a third of VGM patients do not survive, another third suffer moderate to severe neurocognitive damage while just one third survive until adulthood without “significant” compromise.
Medics at Boston Children’s Hospital cut into the woman’s womb and were ultimately able to operate on the developing brain.
Guided by ultrasound, they located the baby’s artery and inserted a special metal coil into the abnormal connecting blood vessel. This helped to reduce the flow of blood.
The baby was born two days later with no birth defects.
Three weeks after the operation, the baby did not show evidence of any abnormal blood flow in MRI scans.
Dr Darren Orbach, of Boston Children's Hospital, the lead surgeon, said: “We were thrilled to see that the aggressive decline usually seen after birth simply did not appear.
“We are pleased to report that at six weeks, the infant is progressing remarkably well, on no medication, eating normally, gaining weight, and is back home.
“There are no signs of any negative effects on the brain.”
Dr Orbach added: “While this is only our first treated patient and it is vital that we continue the trial to assess the safety and efficacy in other patients, this approach has the potential to mark a paradigm shift in managing vein of Galen malformation where we repair the malformation prior to birth and head off the heart failure before it occurs, rather than trying to reverse it after birth.
“This may markedly reduce the risk of long-term brain damage, disability or death among these infants.”
A report on the operation has been published in the journal Stroke.
