Pioneering fetal surgery corrects severe birth defect before baby is born

Doctors have successfully performed a groundbreaking operation on an unborn baby to treat a severe congenital defect while he was still in the womb, BBC reported.

The procedure was carried out on London resident Maisie Savage when she was 26 weeks pregnant. Her son, Theo, had been diagnosed with complex gastroschisis, a rare birth defect in which the abdominal wall fails to develop properly, leaving the intestines outside the body.

Theo became the first British baby to undergo this experimental prenatal procedure as part of an international clinical trial led by specialists at Texas Children's Hospital in Houston. He was the third baby worldwide to receive the treatment.

Before the operation, Maisie traveled to Belgium, where doctors injected Botox into the baby's abdominal wall to relax the muscles and make the repair easier. She then flew to Texas, where surgeons partially exposed her uterus, temporarily replaced the amniotic fluid with carbon dioxide to create space, and used minimally invasive keyhole surgery to gently return Theo's intestines to his abdomen before closing the opening.

Despite the extensive procedure, there were no complications for either mother or baby. Maisie continued her pregnancy for another 14 weeks and gave birth to Theo naturally in February. He is now five months old and developing normally.

Complex gastroschisis affects about one in every 3,000 babies in the UK. In severe cases, newborns often require months of intensive care, multiple operations, prolonged intravenous nutrition and, in some cases, intestinal transplantation. Even with advanced treatment, around 10% of affected babies do not survive.

The clinical trial is being led by fetal surgeon Dr. Michael Belfort, who previously pioneered prenatal surgery for spina bifida. Specialists say the successful outcome suggests fetal surgery could dramatically improve outcomes for babies with complex gastroschisis.

Professor Paolo de Coppi of Great Ormond Street Hospital said that, if the trial continues to demonstrate positive results, the procedure could soon become available in the UK. Researchers also believe similar prenatal techniques may eventually be used to treat certain heart and lung conditions before birth.

Theo's parents say the surgery completely changed their son's future and are grateful to the medical teams in both the UK and the US for giving him the chance to begin life without the severe complications normally associated with the condition.

https://bbc.com/news/videos/crrvjy8ez4qo

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