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Monday, 31 March 2008

German hospital pioneers intra-womb surgery

The university hospital Bonn saved the life of a baby by applying an innovative technique for antenatal surgery in womb.

When her mother's foetal membrane burst in the 20th week of pregnancy, there was immediate danger that the baby Miriam would die, as his liquid cushion is usually absolutely essential for survival of the foetus.

Without the fluid, the organs pressed on the lung and the baby's development would have been fatally impaired. She was also unprotected against germs in the womb, leaving her susceptible to life-threatening infection.

Most babies are aborted after a rupture at such an early stage, but Miriam's parents jumped at the chance after the hospital offered them what is normally high-risk pre-natal surgery.

'But here we were dealing with a healthy child and it was a question of significantly increasing its chances of survival,' said Professor Thomas Kohl, the head of the German Centre of Foetal Surgery and Minimally Invasive Therapy at Bonn University Clinic.

Surgeons inserted the operating device, which is the size of a ballpoint pen, into the foetal membranes through a small opening in the stomach of Miriam's mother Lori.

Assisted by a camera and ultrasonic apparatus, they carefully moved this 'foetoscope' via the mouth and into the trachea of the unborn baby.

There a miniature latex balloon was inflated, blocking the respiratory channel so that the fluid which is continuously produced by the prenatal lung cannot drain away. This build-up of the fluid stimulated the growth of Miriam's lung.

Miriam's case was the first in which Professor Kohl also used the protein serum albumin, which increases the amount of water collected in the lung and increases the effect of the balloon.

'Our little patient's lungs rose like yeast cake. The balloon stayed in the lungs for five days and during this period the volume of the lungs nearly doubled,' said Professor Kohl.

Miriam was born in the 33rd week of the pregnancy and is now a healthy one-year-old.

The operation that saved her life was to be reported in the scientific journal Fetal Diagnosis and Therapy.

This AFP-Report is brought to you by German Hospital Service to describe the high level of expertise that can be found in german hospitals.

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