In a first of its kind operation that was carried out inside the womb of an expecting mother, doctors were able to save a child’s life after discovering a “bubble” on an ultrasound that turned out to be a rare kind of tumor.
After a scan at 17 weeks, mother Tammy Gonzalez said she “could see a bubble” coming out of her baby’s mouth.
Doctors said it was a very rare tumour called an oral teratoma and there was little chance her daughter would survive.
After the pioneering operation, baby Leyna was born five months later.
Doctors at the Jackson Memorial Hospital in Florida, said this type of tumour was so rare it had been seen only once in 20 years at the hospital.
The details of this highly technical operation, which involved the use of finely attuned lasers, have just been revealed in the American Journal of Obstetrics & Gynecology.
The mother was given a drug that acted as a fetal analgesia, and then a separate general anesthetic herself. Surgeons, through a small incision, were then able to navigate through the woman’s body into the amniotic cavity where they were able to use an endoscope to gauge the status of the 17-week-old fetus. To their relief, they found that the tumor had not caused a cleft lip or cleft palate.
Confirming that the tumor was rooted to the hard palate, surgeons used a laser to carefully cut away the mass. A minimal amount of bleeding from the base of the tumor was then stemmed and the tumor, having fallen into the amniotic cavity, was left to degrade on its own having been assessed that, once severed, it was no threat to mother or child. There were no maternal or fetal complications as a result of this procedure.
Due to the lack of post-operative complications, this first of its kind procedure has given scientists new impetus to explore in utero treatment:
To our knowledge, this is the first successful treatment of a fetal oral teratoma in utero. The experience in this case suggests that fetoscopy can be of use in the detailed assessment of the lesion as well as potentially allowing resection of the mass in utero in selected cases. In utero resection is aimed at avoiding the development of polyhydramnios, preterm labor/delivery, or potential fetal demise that could occur with expectant management. Furthermore, in utero resection allows for vaginal delivery and eliminates the need to perform an EXIT or OOPS procedure, with its attendant logistic and medical disadvantages. In utero treatment could potentially be associated with improved healing as well.
And what of the child? Baby Leyna was born a few months later without incident. Doctors were also cheered to find that there were no overt signs of the tumor’s existence and minimal tissue scarring within the child’s oral cavity.
Leyna is now a very healthy, and if the BBC’s video report is anything to go by, very active 20-month-old.
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