On March 17, baby Denver Coleman was born. She was just like every other child; neither the doctors nor her parents got anything to worry about. That was only possible because a team of doctors in Boston performed a first-of-its-kind fetal surgery two days before her birth to treat her for a rare brain condition while she was still in her mother’s womb.
About 30 weeks into Kenyatta’s pregnancy, her doctor confirmed that something was wrong with her baby. After a diagnosis, the ailment was described as the vein of Galen malformation, otherwise known as VOGM.
The condition happens when the vein of Galen, the blood vessel carrying blood from the brain to the heart, fails to develop properly. If not treated, it could lead to excessive blood that will stress the vein and the heart. The result could be a variety of severe heart and brain ailments.
Dr Darren Orbach, one of the lead doctors, told CNN that the ailment could result in “tremendous brain injuries and immediate heart failure after birth are the two big challenges.”
Kenyatta and her husband, Coleman, have two options to choose from. They could wait for surgery after their child’s birth or present their unborn child for a clinical trial.
Choosing the safest among two risky options
Soon after the diagnosis, the Colemans heard of a clinical trial by Brigham and Women’s and Boston Children’s Hospital. The team was working on providing treatment for babies before their births. They could cure the rare condition before the child is born. However, the process was not completely safe. The risks include possible preterm labour and brain haemorrhage for the fetus.
The couple opted for fetal surgery as it is safer than an after-birth treatment. On March 15, the medical experts conducted the surgery. But getting the baby to become stable for the procedure was a delicate task.
One treatment, two patients
Although the fetus was the patient, there was no way doctors could reach the baby without the mother. Hence Kenyatta was also a patient in this rare case. The first task for the team of medical experts was to ensure that the fetus was facing the mother’s abdominal wall. Secondly, they ensured that it remained in that position at least for the duration of the surgery by injecting a “medication so that it’s not moving.” The people behind the complex job were Dr Louise Wilkins-Haug, the divisional director of Maternal-Fetal Medicine and Reproductive Genetics at Brigham and Women’s Hospital and Dr Darren Orbach, a radiologist at Boston Children’s Hospital.
“It was exhilarating at the moment that we had technical success at doing the embolization,” Dr Darren Orbach told CNN.
According to the report, soon after the surgery, scan results show that the fetus showed signs of improvement, and the blood pressure became normal. Hence the surgery was certified successful.
Two days later, the baby was born, and after almost two months, baby Denver’s heart and brain are intact.
Why a surgery before birth was better
You might wonder, why carry out surgery on the fetus when the procedure can be done after the child’s birth? Dr Orbach, in an interview with CNN, said surgery after birth might be too late to save a patient.
According to him, about 60 percent of all babies will get sick immediately after birth if they have VOGM, adding that “there’s about a 40 percent mortality rate.” The babies that survive might end up having severe “neurological and cognitive issues.” On the other hand, surgery before birth will almost guarantee the baby’s survival.
Although the surgery was successful, and baby Denver looks perfectly fine, her mother and doctors feel it is too early to conclude the treatment was once-for-all-time. However, they hope that she lives a hitch-free life.
For a second I thought this had happened in Antigua..