2023-05-09 04:35:00
ㅣDaily Post=Reporter Kim Jeong-eunㅣA research team from Boston Children’s Hospital and Brigham and Women’s Hospital in the United States succeeded in performing cerebrovascular surgery on a ‘fetus in the womb’ for the first time in the world.
The results of this study were published in the international journal ‘Stroke’.
There have been reports of heart surgery performed on fetuses in the womb in the past, but this is the first successful brain surgery.
In 2022, Kenyatta Coleman, who lives in Louisiana, USA, is pregnant with her fourth child with her husband, Derek. Although she had already given birth and a prior genetic test also yielded a ‘low-risk’ result, she first revealed that there was a problem with her fetus during an ultrasound at 30 weeks of her pregnancy in February 2023.
Further tests confirmed that the baby’s brain had a congenital blood vessel problem called ‘Vein of Galen malformation’ (VOGM).
Galen’s venous malformation is a condition in which the veins that carry blood from the brain to the heart do not develop normally, leading to congestive heart failure, pulmonary hypertension, brain tissue damage, and hydrocephalus.
According to the American Heart Association, Galen’s vein malformation is the most common congenital cerebrovascular malformation, occurring in 1 in 60,000 births. As a treatment, there is a method of catheter treatment following birth and a method of inserting a small metal coil into the problem blood vessel to block the connection between the artery and the vein. However, heart failure may persist and severe brain damage may occur at birth.
Dr. Darren Orbach, a physician at Boston Children’s Hospital and an expert in the treatment of Galen’s vein malformation, told CNN: “50 to 60 percent of babies with this condition quickly become severe and the mortality rate is regarding 40 percent. They survive.” Even if they do, half will suffer from severe neurological and cognitive problems.”
Accordingly, the research team decided to conduct a clinical trial to perform Galen’s vein malformation surgery on fetuses in the womb. Kenyatta, who decided to participate in the clinical trial, underwent surgery on March 15, one month following the ultrasound examination.
This operation introduced heart surgery techniques previously performed on fetuses in the womb. After confirming that the fetus was in the optimal position, the doctors injected a small amount of medicine and painkillers into the fetus so that it would not move. They then inserted a catheter through the mother’s abdomen and placed a small metal coil in her blood vessel to lower her blood pressure.
After the surgery, the test results showed that the heart function improved right away and the blood pressure in important areas decreased. After her operation, the medical team confirmed that her womb was leaking amniotic fluid, and decided to give birth to her.
The Colemans and their healthy daughter, Denver, can be seen in the video below.
On the left is Derek and Kenyatta, and the baby the doctor is holding is Denver, who was born following cerebrovascular surgery in the womb.
According to the research team, although the birth was premature, Denver’s condition was stable. After weeks of observation in the neonatal care unit, Denver and his wife returned home safely.
Dr. Louise Wilkins-Haug of Brigham and Women’s Hospital said the baby was in good condition following birth and did not require coil placement or standard treatment with medications to help the heart function.
Denver is now in excellent health, regarding two months following birth, is not taking heart failure medication, and has no abnormalities on a neurological exam.
Dr. Hogg said, “I am impressed that a baby with Galen’s vein malformation does not show any of the problems seen following birth. I am pleased to report that at 6 weeks, at home, eating normally and gaining weight without taking medications. Adverse effects on the brain.” There are no signs,” he said.
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