World’s first surgery in womb in case of premature rupture of foetal membrane

November 14th, 2007 - 3:01 am ICT by admin  
The girl-child named Miriam is now one year old, and full of beans.

The doctors have revealed that she had a very slim chance of surviving birth when the bag of waters burst in the 20th week of pregnancy. They say that her lungs had stopped growing, due to which she could have most probably suffocated after birth.

However, the surgery in the womb stimulated lung growth, and saved Miriam’s life.

Writing about their case in the scientific journal Fetal Diagnosis and Therapy, the doctors have revealed that a rupture before the 22nd week of pregnancy results in the child being constricted due to the lack of its protective liquid cushion and the organs pressing on the lung.

Miriam’s parents, however, did not give up on their daughter, and assented to a prenatal operation offered by Professor Thomas Kohl, Head of the German Centre of Foetal Surgery and Minimally Invasive Therapy at Bonn University Clinic.

“My husband and me prayed and put our faith in God. We were prepared to do anything for our child. Miracles do happen,” says her mother Lori.

Professor Kohl says that the kind of foetal surgical procedure is currently an experiment whose outcome is uncertain.

“But here we were dealing with a healthy child and it was a question of significantly increasing its chances of survival,” he adds.

During the operation, the foetal surgeons inserted the operating device, which is the size of a ballpoint pen, into the foetal membranes via a small opening in the mother’s stomach. They carefully moved this foetoscope, assisted by a camera and ultrasonic apparatus, via the mouth and into the trachea of the unborn baby.

There a miniature balloon was inflated, blocking the respiratory channel so that the fluid which was continuously produced by the prenatal lung did not drain away. The fluid pressure built up this way stimulated lung growth.

Professor Kohl used the protein serum albumin, which increases the amount of water collected in the lung and amplifies the effect of the latex balloon, in Miriam’s case.

“Our little patient’s lungs rose like yeast cake. The balloon stayed in the lungs for five days and during this period the volume of the lungs almost doubled,” he says.

During the whole process, gynaecologists and midwives provided intensive care for the mother and child.

The baby was born in the 33rd week of pregnancy, and then the premature baby specialists of the Neonatological Intensive Care Department took over the postnatal care.

“The prenatal operation only takes one or two hours. Competent follow-up care of the children after birth is at least as important for their healthy survival,” says Professor Kohl.

For the team in Bonn, now the focus is on testing the life-saving potential of the new method of treatment on further patients with premature rupture of the foetal membrane. (ANI)

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