A medical team in Texas has completed a pioneering fetal surgery that corrected a severe congenital malformation in a baby while he was still inside his mother's womb. The baby, Theo, is now five months old and developing normally.
His mother, Maisie Savage, traveled from the United Kingdom to the United States for the procedure when she was 26 weeks pregnant. She later gave birth to Theo in February by vaginal delivery in Texas.
What malformation did the baby have
Theo was diagnosed with complex gastroschisis, a congenital condition that prevents the navel from developing properly and causes the intestines to grow outside the abdomen. In the most severe cases, the condition can require months in intensive care, multiple surgeries, and even an intestinal transplant.
Josh French, Theo's father, said discovering that Theo had gastroschisis had been a shock and something incredibly frightening.
Given the complexity of the case, specialists at Great Ormond Street Hospital in London decided to refer the family to Texas Children's Hospital to evaluate an alternative treatment that was only beginning to be studied.
How the in-utero surgery was performed
Before the main operation, Savage traveled to Belgium to receive a Botox injection targeted at the fetus's abdominal wall, intended to relax the muscles and make the repair easier.
She was then transferred to Texas, where a team of fetal surgeons carried out the procedure when the pregnancy had reached 26 weeks. During the operation, doctors partially exposed the uterus, temporarily replaced the amniotic fluid with carbon dioxide to expand the working space, and used minimally invasive surgery to carefully reposition the baby's intestines into the abdomen before closing the opening with sutures.
The outcome of the pioneering procedure
The surgery went smoothly and allowed the pregnancy to continue to full term. Five months after birth, Theo shows healthy development that has exceeded the specialists' initial expectations.
Why the surgery could change prenatal medicine
Theo became the first British baby operated on inside the womb to correct complex gastroschisis and the third patient in the world to benefit from this clinical trial.
Dr. Michael Belfort, who leads the trial at Texas Children's Hospital, said the inside of the uterus has become a new surgical space for innovation. He explained that the technique could in the future be extended to treat other fetal conditions, including some heart defects and lung diseases.
