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A fetus that had an aneurysmal malformation was operated on while still in its mother’s womb, and is doing very well today.

It is not the first time that a fetus has been operated on while still in its mother’s womb. But this is the first time that a malformation in the brain has been treated in this way. In a press release, the APHP tells how a baby with an aneurysmal malformation was taken care of during pregnancy at the Necker hospital in Paris.

The fetus had a “congenital vascular malformation located in the central part of the brain which consists of an abnormal communication between arteries and the vein of Galen”, which could have led to death at birth, or had serious consequences for the development of the baby’s brain. In this case, the child had a “90% risk of failure and/or death at birth“, notes the APHP.

An intero intervention at 5 weeks from birth

Until now, when this type of malformation was detected (on ultrasound in the second or third trimester), parents were offered medical termination of pregnancy, treatment by neuroradiology by embolization at birth, or limiting care after birth if the lesions were too severe.

After having carried out an MRI of the fetus, the doctors this time estimated that it was possible to carry out an intervention in utero, at 31 + 4 weeks. The APHP details the intervention: “Under ultrasound guidance, a microcatheter was positioned in Galen’s vein, through the mother’s skin and uterus, then through the fetal skullallowing the deployment of 5 meters of platinum wire until obtaining a clear slowing down of the malformation.” The operation lasted only 30 minutes.

When he was born 5 weeks later, he had no brain damage. Two other embolizations (via the femoral artery) were performed on the 5th and 67th day of life, for complete recovery. Born in September 2022, the baby is now 8 months old and developing normally.

Source: APHP

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