Her parents signed up for a clinical trial of an in-utero surgical treatment to see if doctors could intervene before any of these outcomes materialized. It seems to have worked. The team behind the operation now plans to treat more fetuses in the same way. Other, similar brain conditions might benefit from the same approach. For conditions like these, fetal brain surgery could be the future.
The baby's condition, known as vein of Galen malformation, was first noticed during a routine ultrasound scan at 30 weeks of pregnancy. The condition occurs when a vein connects with an artery in the brain. These two types of vessels have different functions and should be kept separate—arteries ferry high-pressure flows of oxygenated blood from the heart, while thin-walled veins carry low-pressure blood back the other way.
When the two combine, the high-pressure blood flow from an artery can stretch the thin walls of the vein. "Over time the vein essentially blows up like a balloon," says Darren Orbach, a radiologist at Boston Children's Hospital in Massachusetts, who treats babies born with the condition.
The resulting balloon of blood can cause serious problems for a baby. "It's stealing blood from the rest of the circulation," says Mario Ganau, a consultant neurosurgeon at Oxford University Hospitals in the UK, who was not involved in this particular case. Other parts of the brain can end up being starved of oxygenated blood, causing brain damage, and there's a risk of bleeding in the brain. The extra pressure put on the heart to pump blood can lead to heart failure. And other organs can suffer too—especially the lungs and kidneys, says Ganau.
Fetuses with the condition are thought to be protected by the placenta to some degree. But that changes from the moment the umbilical cord is clamped at birth. "All of a sudden there's this enormous burden placed right on the newborn heart," says Orbach. "Most babies with this condition will become very sick, very quickly."
Journal Reference:
Darren B. Orbach, Louise E. Wilkins-Haug, Carol B. Benson, et al., Transuterine Ultrasound-Guided Fetal Embolization of Vein of Galen Malformation, Eliminating Postnatal Pathophysiology [open], Stroke, 2023. DOI: https://www.ahajournals.org/doi/10.1161/STROKEAHA.123.043421
(Score: -1, Troll) by Anonymous Coward on Friday May 05, @01:44PM (8 children)
That's a lot of work for something that is no more significant that a toenail clipping. It's almost like they're treating the fetus as though it's an actual human being.
(Score: 4, Informative) by sjames on Friday May 05, @04:45PM (7 children)
Nice try troll, but this is a condition that was detected at 30 weeks and had to wait a bit for the operation to be do-able. That's well beyond the limits for abortion even before Roe V. Wade was overturned by the cuckoo stacked Supreme Court.
(Score: -1, Troll) by Anonymous Coward on Friday May 05, @05:45PM (6 children)
A number of States allow abortion up to the moment of birth (and unofficially, allow a baby that survives an abortion attempt to be left to die), so you're obviously full of shit.
Additionally, the Supreme Court simply restored abortion to the States, where it belongs, since there is absolutely nothing in the Constitution about it. So, again, you're full of shit.
(Score: 1, Troll) by DadaDoofy on Friday May 05, @07:33PM (2 children)
Not true. States like NY allow abortion until the moment of birth. In fact, if an abortion is botched and the baby comes out alive, their law says medical treatment can be withheld from the baby until it dies. BTW, the NY legislature stood up and cheered when this law passed.
(Score: 2) by DadaDoofy on Friday May 05, @07:35PM
Sorry, I meant to reply to the parent of your comment.
(Score: 4, Informative) by gnuman on Saturday May 06, @11:50AM
That's not how it works.
You do realize that early medical termination of pregnancy is called "abortion", by definition? You do realize that there are thousands and thousands of cases each year (in US alone) of non-viable fetuses? And in virtually all of these cases, the parents want the baby but there is very little hope?
https://www.nbcnews.com/news/us-news/louisiana-woman-carrying-fetus-skull-seek-abortion-another-state-rcna45005 [nbcnews.com]
https://www.theguardian.com/global-development/2022/jan/26/poland-death-of-woman-refused-abortion [theguardian.com]
https://www.cdc.gov/ncbddd/birthdefects/anencephaly.html [cdc.gov]
In sane countries, like Canada, there is no "limit" imposed by politicians about gestational age and abortion. But there are virtually no abortions, aside from reasons like above, done after 16 weeks or so. None. Why?? You make it sound like medical establishment is without morals, like the oath they take to "do no harm" is pointless and that only your righteous convictions can stop evil from happening. Well, my ignorant friend, road to hell is paved with good intentions -- that's not a euphemism, that's reality. There well over 100 million births per year in the world. While 98% will be just fine at birth, that leaves about 2,000,000 that will be sick, need surgery to correct birth defects and many will be non-viable.
So keep your paranoia and moral panic to yourself. There is a lot of suffering that is brought into this world unnecessarily (to the parents, never mind the child) because people like yourself can't imagine scenarios that happen every minute of our lives. "but but I obviously don't mean baby with no head..." ... or chromosomal abnormalities where baby is dead before first birthday..
And here, the facts for abortion by gestational age.
https://en.wikipedia.org/wiki/Abortion#/media/File:US_abortion_by_gestational_age_2016_histogram.svg [wikipedia.org]
As you can see, very few abortions past 1st trimester and basically none past 20 weeks... but I guess let's not let the facts stop your prejudice.
(Score: 2) by Tork on Friday May 05, @10:22PM
I triple-dog dare you to pick a few respected female members of your family and say this verbatim to them.
Slashdolt Logic: "25 year old jokes about sharks and lasers are +5, Funny." 💩
(Score: 3, Informative) by sjames on Saturday May 06, @12:42AM
None of those states allow elective abortion up to birth. They all cut that off somewhere around the end of the second trimester before a live birth would survive.
They allow medically indicated abortions at any time, meaning if the mother is seriously endangered by continuing the pregnancy or the baby is not expected to live.
(Score: 2) by Mykl on Sunday May 07, @11:54PM
I know I'm not supposed to feed the troll, but am wondering:
Exactly how many people do you think are out there that want an elective abortion, but wait for 40 weeks to get it done?
(Score: 4, Interesting) by OrugTor on Friday May 05, @04:36PM (1 child)
What surprised me was picking up the condition on ultrasound. My generation expected very little information from an ultrasound, basically a limb count and biological gender. The image looked like it had gone through a blurrer. Now they are detecting anomalies on the scale of a vein? Impressive progress.
(Score: 3, Informative) by gnuman on Saturday May 06, @11:19AM
Ultrasound has been used as screening test for Down's Syndrome for 2 decades?
https://en.wikipedia.org/wiki/Down_syndrome#Ultrasound [wikipedia.org]
Currently the resolution of ultrasound is sub-1mm and reaching below 0.5mm. And sure, the image looks 'grainy' but that's a 2D live view. The image has far more information. CT resolution is similar and that's what? A bunch of x-rays. It's all about image processing these days and not just "eyeballing it".
Normally you don't do brain imaging with ultrasound because the skull blocks sound. But for unborn, you can see inside since their skull is still mostly transparent.
(Score: 0, Flamebait) by DadaDoofy on Friday May 05, @07:17PM (3 children)
How is that possible? I was told a fetus is just "a clump of tissue". I guess that is a lie.
(Score: 3, Insightful) by Tork on Friday May 05, @07:49PM
Slashdolt Logic: "25 year old jokes about sharks and lasers are +5, Funny." 💩
(Score: 3, Informative) by gnuman on Friday May 05, @10:05PM
30 weeks is not 3 weeks. Google what a 30 weeks fetus looks like. When it's out, it can survive with a little help.
(Score: 2) by Magic Oddball on Saturday May 06, @11:09PM
Did you flunk high school biology? Pretty sure that it covers how the sperm & egg unite to form a zygote, that then develops into an embryo, which then develops into a fetus and spends several months developing the organs necessary for sentience & survival outside the woman's body. At 30 weeks, it has it; at 3 weeks, it doesn't. Not that hard to grasp, really.