Unborn baby has pioneering surgery inside the womb.
asserted
baby → have → womb
Now his doctor is waiting to see if it was a success
The operation was to treat unborn baby whose intestines were growing outside of his body
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intestines → wait → body
For some babies diagnosed with gastroschisis in the womb, treatment can mean surgery followed by months of medical appointments afterward.
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treatment → diagnose → appointments
In more complex cases, the birth defect — in which a baby's intestines develop outside the body — can be fatal.
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intestines → develop → body
Theo was diagnosed with gastroschisis, a rare condition affecting about one in 2,200 pregnancies, after Savage's 20-week scan.
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Theo → diagnose → scan
Today, doctors in the U.S. say Theo is a healthy five-month-old, thanks to a pioneering surgery performed while he was still in the womb.
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he → say → womb
According to the BBC, the complex operation was part of a groundbreaking clinical trial at Texas Children's Hospital in Houston.
uncertain
operation → accord → Houston
Dr. Sundeep Keswani, the pediatric and fetal surgeon who performed the operation in November, spoke to As It Happens guest host Rebecca Zandbergen about how the procedure works, its risks and benefits and what makes it so revolutionary.
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it → perform → Zandbergen
Here's part of that conversation:
How is Theo doing right now?
Theo is doing great....
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Theo → do → conversation
Theo is now five months old and, as far as we can tell, is acting like a normal baby.
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we → tell → baby
And so, what was it like to see him behave in this way five months in?
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him → see → way
I got to know this family around 22 weeks of gestation, and we operated on Maisie at 26 weeks of gestation.
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we → get → gestation
And then she amazingly delivered at term, around 39 weeks.
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she → deliver → weeks
And when this baby came out … the normal sized at term, and just like every other normal baby, started feeding right away, and within two days was on full feeds, and on day three was out of the hospital.
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normal → come → hospital
So I think that's the amazing part that this kid with this kind of complex disease just looks like every other baby.
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kid → think → baby
It was your colleagues at Great Ormond Street Hospital in London who made the initial diagnosis, and then you had to work out if it was a simple or complex case.
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it → make → diagnosis
The bowel itself was probably — one loop of it was half of the size of the whole abdomen … and so, you know, that's going to be a very complicated type.
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that → know → abdomen
It told us with almost certainty that this young boy was going to have a very complicated start to life — likely from historical averages, three to six months in the NICU, go on with some feeding disorders after that, and then even a small percentage of these patients go on to intestinal transplant.
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percentage → tell → transplant
How does the surgery work then?
You and I, we all have this issue where our intestines are outside of our body at around 10 to 12 weeks, and then most of us rotate back in and they're in the abdomen.
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they → work → abdomen
And that doesn't happen in patients with gastroschisis, like Theo.
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that → happen → Theo
Surgeons can fix that.
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Surgeons → fix → that
It's the fact that these intestines don't work.
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intestines → work → ?
It's likely because it's caused from the amniotic fluid floating in that, or maybe tightening at the ring.
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it → cause → ring
And so, the idea is to go back in around 26 weeks and gently get access into the uterus, take out the amniotic fluid, and then gently put air in, and then slowly put the bowel back in loop by loop.
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idea → go → loop
Then, with the defect that's left right by the umbilical stalk, close that skin so that way the anatomy is what it should be at that gestational age….
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it → leave → age
Maisie was almost 13 or 14 weeks until she delivered.
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she → deliver → ?
And so, the bowel was recuperating inside, wasn't exposed to the amniotic fluid, had good blood supply.
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bowel → recuperate → supply
You do this surgery, and then she continues to have the baby inside, has a vaginal birth, and everything's okay?
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everything → do → birth
And it's the vaginal birth part that's nice because, when you don't make it a large incision on the uterus and you use this minimally invasive technique, these moms can have a vaginal delivery, if indicated.
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moms → make → delivery
It sounds — I mean, the surgery itself sounds extremely risky.
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surgery → sound → ?
We've only done a handful of these.
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We → do → these
This is the only place in the world that's doing under this trial environment.
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that → do → environment
But we do tell [moms] — to make them feel better — is that we've done 220 of these types of operations for something called spina bifida.
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we → tell → something
So we've kind of ameliorated a lot of the problems with open fetal surgery with this minimally invasive technique.
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we → ameliorate → technique
Yet it hasn't been done a whole lot with gastroschisis, I understand.
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I → do → gastroschisis
So how do you tell the mom, "Let's give this a go?"
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's → tell → go
I mean, was she on board right away?
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she → mean → board
One thing I've appreciated over this career is that moms will do whatever they need to do for the safety of their child.
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they → appreciate → child
And what we need to do, as the physicians, is make sure that we're looking out for them and the baby.
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looking → need → them
So that starts with a very upfront, honest conversation about the risks and benefits, especially when we're talking about something that is not proven.
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that → start → something
…and 62 more, not listed.
The Aporia
