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A team of Boston doctors has successfully completed a never-before-attempted procedure that saved the life of a baby in the womb. The novel brain surgery was conducted in utero in order to address often lethal complications due to a rare condition known as vein of Galen malformation (VOGM). Now, after two months, the child is thriving, but more clinical studies are needed.
CBS reports that Derek and Kenyatta Coleman had no idea that their pregnancy was headed for complications when they went in for their 30-week ultrasound examination. It was then that the VOGM was discovered. The condition affects an estimated 1 in 60,000 births and can cause congestive heart failure, high blood pressure, damage or loss of brain tissue, or an enlarged head.
VOGM is a rare blood vessel deformation within the brain that causes capillaries to not connect to veins and arteries as they should. When the blood flow bypasses the capillaries, it travels through the veins at the base of the head too fast, which can cause life threatening problems. It is estimated that more than half of babies born with VOGM become sick immediately after birth, and this group has about a 40% mortality rate.
According to CNN, the two-patient procedure, involving both mother and child, was performed by a joint team from Brigham and Women's Hospital and Boston Children's Hospital. First they needed to ensure that the baby was facing the right direction. The unborn infant was then injected with medication to prevent her from moving during the operation, as well as another for pain relief.
The doctors then needed to breach through the mother’s abdomen and uterine wall, before entering the infant’s skull to operate on her brain. They did this by inserting a needle and threading a catheter through it. Once the malformed vein was located, they inserted tiny metal coils that help restrict the blood flow and reduce pressure.
The doctors said the baby showed signs of improvement almost immediately. Still, because the procedure poked through the uterine lining – which essentially caused the mother’s water to break – they had to induce labor two days later. Denver was born at just over 4 lbs, which is light for a newborn, and she was monitored in the hospital for several weeks. Now, two months after the never-before-attempted operation, Denver is reportedly flourishing.
In an interview with CBS, her parents called their daughter’s recovery a “miracle”:
"Derek and I are deeply rooted in our faith and we prayed hard for this," Kenyatta Coleman said. "You know, there was no doubt in our minds that God would perform a miracle and he did, on a public platform using a little girl before she was even born. She made her mark on the world."
Lead study author Darren B. Orbach, M.D., Ph.D. commented in a news release:
“In our ongoing clinical trial, we are using ultrasound-guided transuterine embolization to address the vein of Galen malformation before birth, and in our first treated case, 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 medications, eating normally, gaining weight and is back home. There are no signs of any negative effects on the brain.”
Orbach gives a more in depth explanation of VOGM in the video below.
