Unborn Baby Undergoes Surgery at 22 Weeks Gestation

by Susan Brinkmann, OCDS
Staff Writer

(June 10, 2008) Surgeons in Melbourne, Australia performed what is believed to be the earliest in-utero surgery of its kind in the world when they operated on an unborn child at only 22 weeks gestation.

Kylie Bowlen was 18 weeks pregnant when doctors told her that their baby girl suffered from a relatively rare condition known as Amniotic Band Syndrome (ABS). This syndrome occurs  when bands wrap around the child and constrict blood flow to various parts of the body. In the case of tiny Leah Bowlen, the bands had wrapped around her legs. Left untreated, it could have led to her having her legs amputated after birth, or even to her death.

Tests revealed that, other than the bands wrapped around her legs, Leah was a perfectly healthy child. Her parents decided not to risk their daughter being crippled for life and opted to try the ‘in utero’ surgery to remove the bands.

“It came down to knowing that the rest of Leah was pretty healthy and quite strong,” the baby’s father, Terry Bowlen, told The Age. “Everything was fine, it was just these legs. We basically came to the conclusion that if she was born with bung legs we could cope with that.”

Doctors performed the procedure using a telescopic needle, a laser and an electric current to cut the band from around the baby’s left leg. They could not operate on the right leg because it was swollen, infected and the bone was exposed.

“The right leg was so bad that I did not want to touch it,” said Chris Kimber, M.D., head of pediatric surgery at Monash Medical Center. “This foot was as close to dead as you could get; it was dangling on one tiny artery.”

Mrs. Bowlen carried Leah until 30 weeks and gave birth in January, 2008. By then, the baby’s right leg was almost gangrenous. However, microsurgeon Chris Coombs and Associate Professor Donnan of the Royal Children’s Hospital were able to reconstruct her nearly destroyed right foot.

Almost five months after her birth, doctors say Leah’s chances of one day walking on both feet are good, although she is still in need of follow-up surgery and monitoring as she grows.

“I think the wait’s over,” said Mrs. Bowlen. “Just hearing the doctor say she’ll have full function in that foot and basically be able to walk. Hearing that, I know I made the right decision, no matter what anyone else says.”

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