The short version
- Doctors performed keyhole surgery on a fetus at 26 weeks gestation to correct complex gastroschisis, returning externalized intestines to the abdomen.
- The procedure avoided the typical six-month neonatal intensive care stay and multiple post-birth surgeries associated with severe cases of this birth defect.
- This case marks the third participant in a global trial led by Texas Children's Hospital, with plans to expand access through partnerships with UK specialists.
A clinical trial involving fetal surgery has demonstrated successful outcomes for treating complex gastroschisis before birth. In a procedure conducted at Texas Children’s Hospital in Houston, surgeons corrected the condition in an unborn baby while he remained inside his mother’s womb. The infant, now five months old, is reported to be thriving without the extensive postnatal interventions typically required for such severe cases.
Gastroschisis is a birth defect affecting approximately one in 3,000 babies in the UK annually, characterized by the failure of the abdominal wall to close properly. This allows intestines to develop outside the body. While milder cases may require weeks of intensive care and tube feeding, complex instances often involve up to six months in neonatal units, multiple corrective surgeries, long-term intravenous nutrition, and potential intestinal transplants. Mortality rates for these severe cases can reach ten percent even with advanced medical support.
The surgical intervention took place when the mother was 26 weeks pregnant. The procedure involved partially exposing the uterus and replacing amniotic fluid with carbon dioxide gas to create operating space. Using keyhole techniques, surgeons gently pushed the fetus’s organs back into the abdomen and stitched the area closed. Prior to the main surgery, the mother received a Botox injection in Belgium to relax the abdominal muscles, facilitating the repair process.
This patient was the third individual worldwide to participate in this specific trial, led by Dr. Michael Belfort. The operation proceeded without complications, and the baby was carried to term and born via vaginal delivery. Medical experts from Great Ormond Street Hospital in London are collaborating with the Texas team, with hopes of offering similar procedures to patients in the UK in the near future. The success of this trial suggests a significant shift in how complex fetal defects might be managed.
The mother underwent a recovery period that included managing pain from the surgical site while continuing her pregnancy for an additional 14 weeks. Despite the physical challenges, the outcome avoided the prolonged hospitalization and invasive treatments usually associated with severe gastroschisis. The collaborative effort between US and UK medical institutions aims to scale this approach, potentially reducing the burden on neonatal intensive care units and improving long-term health outcomes for affected infants.
Sources behind this briefing
Go to the original reporting
- BBC News↗Woman has pioneering womb surgery to fix 'miracle' baby with intestines outside its body
