Few accounts are more intriguing or fascinating than those of breakthroughs in fetal surgery, which treat the unborn as a patient.
A press release from Boston Children’s Hospital announced the successful completion of the first ever brain surgery on a fetus in utero.
The New York Post reported that a “Vein of Galen malformation” (VOGM) is a rare blood vessel abnormality inside the brain in which misshapen arteries in the brain connect directly with veins instead of capillaries. This results in slowed blood flow and the potential for high-pressure blood to rush into the brain.
In plain language, the doctors repaired this potentially lethal developmental condition by treating an aggressive vascular malformation in the baby’s brain before birth. The surgical procedure was conducted at 34 weeks and 2 days gestational age.
It is estimated that VOGM occurs in as many as one in every 60,000 births. It is the most prevalent congenital vascular brain malformation.
It is our pleasure to report that at six weeks, the infant is making remarkable progress, without the use of medications, is eating normally, is gaining weight, and has been returned to their home. “There are no indications of any adverse effects on the brain,” stated lead study author Darren B. Orbach, MD, PhD, co-director of the Cerebrovascular Surgery & Interventions Center at Boston Children’s Hospital and an associate professor of radiology at Harvard Medical School, in a news release.
The infant’s parents, Derek and Kenyatta Coleman, are understandably proud of their daughter’s progress.
In a report by Brooke Steinberg of the Post, the couple expressed their excitement at the prospect of Kenyatta becoming pregnant again. The infant was progressing well. The results of the ultrasound examination were unremarkable. All of her biophysical profiles were unremarkable, according to Kenyatta, 36.
However, when she underwent a 30-week ultrasound examination, Steinberg reported that the obstetrician informed her that there were concerns regarding the baby’s brain and that the heart was enlarged. At 30 weeks, the infant was diagnosed with a vein of Galen malformation.
The misconnection impedes blood flow, allowing high-pressure blood to rush into the brain.
The elevated pressure posed a significant risk of developing a range of life-threatening conditions. Some infants have been diagnosed with congestive heart failure, and there have been reports of rising blood pressure leading to pulmonary hypertension, according to Steinberg.
Additionally, it can impede the drainage of the infant’s brain, which may result in brain injury and, in some cases, the loss of brain tissue. In severe cases, this can also lead to the development of hydrocephalus, or an enlarged head.
The Colemans, recognizing the potential benefits of the clinical trial, elected to proceed with the treatment, despite the acknowledged risks, including preterm labor and brain hemorrhage for the infant.
A team from Boston Children’s Hospital and Massachusetts General Hospital was responsible for carrying out the surgical procedure on the infant and the mother. The procedure involved incising the uterus, subsequently the skull of the infant, and finally the cerebral cortex, as Steinberg elucidated. Once the incision had been made in the pregnant woman’s abdomen, an ultrasound was employed to identify the location of the baby’s artery, thereby assisting the surgical team in navigating the procedure.
Denver Coleman was born two days post-op with no birth defects and minimal complications at 4.2 pounds, which is below the average weight for a newborn.
“I heard her cry for the first time, and that moment was so profound that I am unable to convey its full impact in words,” Kenyatta told CNN. “It was a profoundly moving experience, being able to hold her, gaze up at her, and then hear her cry.”
“I proceeded to kiss her, and she emitted a series of infantile vocalizations,” Derek stated. “That was all I required at that moment.”
Chelsea Garcia is a political writer with a special interest in international relations and social issues. Events surrounding the war in Ukraine and the war in Israel are a major focus for political journalists. But as a former local reporter, she is also interested in national politics.
Chelsea Garcia studied media, communication and political science in Texas, USA, and learned the journalistic trade during an internship at a daily newspaper. In addition to her political writing, she is pursuing a master's degree in multimedia and writing at Texas.
