Remarkable advances in medicine have been developed that help in improving maternal and prenatal care. Advances in genetic screening and testing allow doctors to diagnose and treat diseases among infants even before they are born. Just recently, a pioneer surgery procedure was performed on a fetus while still in the womb to repair a malformed blood vessel that formed in its brain.
First-of-Its-Kind Prenatal Treatment
One of the rare conditions affecting children is the vein of Galen malformation or VOGM. It is an abnormality affecting the blood vessels which deliver oxygenated blood from the heart to the brain. According to the American Heart Association, VOGM occurs once in every 60,000 births.
A new clinical trial was launched by a group of doctors from the Cerebrovascular Surgery and Interventions Center of Boston Children's Hospital along with experts from Boston Children's Maternal Fetal Care Center and the Brigham and Women's Hospital Maternal-Fetal Medicine Group. The procedure involves using an in vitro surgery that can reduce the aggressive blood flow through the VOGM.
Out of the 20 babies included in the trial, the first to undergo the procedure named Denver Coleman was successfully treated. The transuterine procedure was performed to Denver and his mother Kenyatta at 34 weeks and two days of pregnancy. When Kenyatta's water began to break, the baby was delivered two days later by inducting vaginal birth.
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Effect of VOGM
VOGM is a kind of rare blood vessel abnormality that develops inside the brain when the malformed arteries directly connect with veins instead of connecting with capillaries. As a result, the flow of blood is slowed down and a high-pressure blood rushes into the veins.
A number of problems arise from the extra pressure in the veins. The rush of blood forces the heart to work overtime leading to congestive heart failure. Some infants can also suffer from pulmonary hypertension or hydrocephalus.
While VOGM develops during the first trimester or early prenatal development, it is usually detected on a prenatal ultrasound in the late stage of pregnancy, while some cases are noticed after birth.
Symptoms of a VOGM are usually detected right after birth or during the early stage of childhood. These include unusually prominent veins on the scalp, delays in the child's development, persistent headache, and heart failure. Experts still cannot identify the exact cause of this condition, but they believe that it is likely genetic.
In treating VOGM, the doctors aim to eliminate or reduce the amount of blood flowing through the malformed blood vessel while maximizing the supply of blood to the brain. Conventional treatment includes a minimally invasive procedure such as endovascular embolization. In this procedure, a catheter is inserted into the artery through the infant's groin. A special material is then injected into the blood vessels in order to close the flow of blood through the VOGM.
Until now, VOGM is usually treated right after birth where the connection of artery and vein within the malformation is blocked. However, it comes with an onset of a heart failure which cannot be reversed, and performing this procedure right after birth might be too late in avoiding life-threatening damage in the brain.
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