Doctors in Boston successfully perform first-of-its-kind surgery on baby still in womb
Derek and Kenyatta Coleman with newborn Denver after a successful in utero surgery
A newborn baby has proved herself "a fighter" after doctors successfully performed a first-of-its-kind brain surgery while she was still in the womb.
In March, a team of doctors in Boston performed a novel fetal surgery to treat a rare brain condition known as vein of Galen malformation on Denver Coleman, who had not yet been born.
It occurs when the blood vessel that carries blood from the brain to the heart, also known as the vein of Galen, doesn’t develop correctly.
The malformation, known as VOGM, results in an overwhelming amount of blood stressing the vein and heart and can lead to a cascade of health problems.
The baby's mother, Kenyatta Coleman, said nothing seemed particularly notable about her fourth pregnancy until a doctor sat her down at 30 weeks.
“She shared with me that something wasn’t right in terms of the baby’s brain and also her heart was enlarged,” Ms Coleman said she remembers.
After the diagnosis, Ms Coleman and her husband, Derek, learned about a clinical trial run by Brigham and Women’s and Boston Children’s hospitals that could provide treatment before their baby was born.
She said she was informed about the possible risks, including preterm labour or brain hemorrhage for the fetus but they felt there was no other option - they wanted to join the trial.
Utero surgery – performed before a baby is born – has been used for other conditions, but this ultrasound-guided procedure was among the first for this condition.
Despite advancements in care, “50 to 60 percent of all babies with this condition will get very sick immediately. And for those, it looks like there’s about a 40 percent mortality,” Dr Darren Orbach, a radiologist at Boston Children’s Hospital and expert in treating VOGM, told CNN.
About half of infants that survive, experience severe neurological and cognitive issues, he said.
Ms Coleman went through surgery on March 15.
Dr Louise Wilkins-Haug, division director of Maternal Fetal Medicine and Reproductive Genetics at Brigham and Women’s Hospital, partnered with Orbach to make sure the fetus was not only in the right position for the procedure, but stayed there.
Once the fetus is in the optimal position, it “gets a small injection of medication so that it’s not moving and it is also getting a small injection of medication for pain relief,” Dr Wilkins-Haug said.
From there, the doctors inserted a needle through the abdominal wall, carefully threading a catheter through the needle, so that the tiny metal coils can fill up the vein, slow the blood flow and reduce the pressure.
The baby showed signs of improvement immediately, with scans showing decreased blood pressure in key areas.
“It was exhilarating at the moment that we had technical success at doing the embolisation,” said Dr Orbach.After the procedure, Ms Coleman was leaking amniotic fluid and two days later, she went into labour at 34 weeks.
Denver Coleman was born on on March 17 and was "very stable".
“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,” her mother said.
"She’s shown us from the very beginning that she was a fighter."
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