Australian docs perform successful ‘in utero’ operation

Melbourne, Australia, Jun 13, 2008 / 01:19 am

Australian doctors have successfully performed the country’s earliest in-utero surgery by saving an unborn girl’s left foot from a blood constriction.

Kylie Bowlen and her husband Terry were told that their unborn child, then 18 weeks into the pregnancy, might lose her feet after an ultrasound revealed the child, who was later named Leah, suffered from Amniotic Band Syndrome, The Age reports.

In such cases, the lining of the amniotic sac tears away and constricts the fetus’ limbs. The condition occurs in one in 15,000 live births and if left untreated can result in limb amputation or even death.

Two bands of tissue had wrapped around Leah’s legs, restricting circulation to her feet.

Doctors said they could operate on Leah at 22 weeks into the pregnancy, the earliest such surgery on an unborn child in Australia and possibly in the world.

"It came down to knowing that the rest of Leah was pretty healthy and quite strong," Terry Bowlen said. "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."

In the operation, Doctors pierced Kylie Bowlen’s uterus and then the amniotic sac with a telescopic needle. A laser and electric current cut the band around Leah’s left leg. Doctors did not operate on Leah’s right foot, which had become swollen and infected and a right leg bone had been exposed.

At the time of the operation, Leah was between six and eight inches long. Her mother carried her 30 weeks into pregnancy, and she was born at a weight of about 3.6 pounds.

At birth, Leah’s right leg was almost gangrenous but was saved by microsurgeon Chris Coombs and Associate Professor Donnan of the Royal Children's Hospital. The doctors removed muscle, tissue, and some bone to promote the flow of blood.

Three weeks after she was born, Leah contracted meningitis. Now four and a half months after birth, her parents are confident they made the right decision.

"I think the wait's over," Kylie Bowlen said, according to The Age. "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."

Doctors say Leah has a good chance to walk on two feet, though she will need follow-up surgery later this year and monitoring as she grows up.