Vita gazette – Doctors in Boston performed a procedure first of its kind last month when they successfully performed brain surgery on a baby who utero.

The baby had a rare condition with a 40% mortality rate. On September 14, Kenya Coleman and her husband had their first ultrasound. This was Coleman and her husband Derek Coleman’s fourth baby, a girl named Denver, and they were excited. However, during their routine 30-week ultrasound, a nightmare began.

The doctor shared with them that something wasn’t right in terms of the baby’s brain. And also her heart was enlarged… “Ironically, despite all of this blood going to the brain, it’s not supplying brain tissue; it’s just going through the malformation like a short circuit right back to the heart,” said Dr Darren Orbach, a radiologist at Boston Children’s Hospital. So they understand that a vein in Denver’s brain was getting too much blood too quickly.

Orbach typically treats these rare malformations right after a baby is born, but that often can be too late because fifty to 60% of all babies with this condition get very sick immediately. So for those, there’s about a 40% mortality.” So Orbach and his team offered the Colemans something new, a chance to treat Denver in a clinical trial in utero before she was born. Doctors thought fixing the problem before the baby was born might save her.

In-utero surgery meant they had to take two patients to the operating room instead of one. And they had to carefully thread a catheter into the middle of that gigantic blood vessel inside a tiny baby brain.

Orbach was concerned about the fear of injury to the brain. So they thought to access the head through the skull and the dura and back into the big collecting vein.  Coleman was taken to the operating room and given an epidural to accomplish this. And then Denver was rotated into the correct position and then given anaesthesia to keep her from moving. When the baby is in utero, the baby is flipped so that the back of the head is towards the abdominal wall. The needle would then go through the mother’s abdominal wall and the baby’s occipital bone. And at that point,  they introduced the microcatheter through the needle and went up through the sinus to get to the big vein. Through that needle, tiny little coils were used to fill up the vein.

The actual procedure itself took about 20 minutes. And just two days later, Denver was born. The baby and her family are now happy and healthy. From Boston Children’s Hospital, Dr Darren Orbach spoke to the US press about the complex surgery he performed. “The best moment was when the baby was born. Seeing him doing well in the neonatal intensive care unit was amazing. We all looked at each other as a team and pinched ourselves joyfully,” Orbach said.

“We weren’t sure when it would be appropriate to celebrate post-surgery because you can’t be sure about this with babies,” said Orbach.