During a routine ultrasound at 34 weeks, doctors found a tiny abnormality inside baby denver’s brain. The rare one in 60,000 birth defect, known as a vein of Galen malformation (VOGM), causes fetal brain blood vessels to connect directly with veins rather than capillaries. Over time, this can cause a buildup of blood pressure that puts the fetus at risk of developing major health issues such as congestive heart failure or losing brain tissue.
To avoid those problems, Denver’s parents Derek and Kenyatta enrolled her in an experimental procedure being run by Boston Children’s and Brigham and Women’s Hospital. Maternal-fetal medicine specialist Dr. Louise Wilkins-Hang and endovascular neurosurgeon Darren Orbach worked together to perform the first-ever in-utero brain surgery on a fetus. The operation was an amazing success — and two days later, baby Denver was born healthy.
The complex surgery required multiple smaller successes to fall into place. For example, to reach the fetus’s brain, doctors had to position Kenyatta’s abdomen in just the right way. They also had to use a medication to keep Kenyatta still, because any movement could interfere with the procedure. Finally, they had to inject a special fluid into the fetus to make it easier for them to work on her delicate skull.
Once the team was ready, they used 3D fetal-brain imaging and a specialized phantom of a fetus’s skull-bone to plan out exactly how to perform the procedure. Then, on March 15, the day before St. Patrick’s Day, Kenyatta received spinal anesthesia and was transferred to Brigham and Women’s Hospital.
After confirming that they were in the right spot, Orbach and Wilkins-Hang injected a solution into Kenyatta’s stomach that would help them to see where they were working. They then inserted a needle through the mother’s abdominal wall, uterus and fetus’s skull and into the abnormal brain vessels. They injected a tiny coil into each vessel to stop blood flow.
The doctors monitored blood pressure in the fetus’s head as they worked, and were pleased when they saw that the high pressure was decreasing. But they were even more thrilled when the fetal brain showed no signs of long-term damage.
Once the procedure was complete, the doctors induced labor in Kenyatta, who gave birth to a girl named Denver with no complications. She’s doing well now, and her mom says that “she’s shown us from the start that she’s a fighter.”
Denver’s case is a huge step in a larger effort to reduce the risk of long-term complications after birth for babies with this condition. And her story is a reminder of how incredible it is to have medical breakthroughs like this. We wish her and her family all the best!