A medical team at SJD Barcelona Children’s Hospital and Hospital Clínic Barcelona performed Europe’s first operation on a foetus with its entire intestine developed outside its body. The surgery was done at 28 weeks’ gestation to prevent irreversible damage to the baby.
The baby had gastroschisis, a congenital malformation where the intestines develop outside the body through an opening in the abdominal wall. This condition can cause the intestines to become inflamed, lose blood supply, and suffer necrosis, leading to serious consequences for the baby after birth.
Diagnosis and Treatment
The foetal malformation was detected during a routine ultrasound scan in the 20th week of gestation. The mother, a 20-year-old Colombian woman, was referred to BCNatal, a leading centre in obstetrics and foetal medicine. After evaluating the options and consulting the ethics committee, the medical team proposed a foetal surgery that had only been performed in Colombia and the United States, but never in Europe.
The medical team made this decision after careful consideration. They proposed the surgery as it had been successfully performed in other countries. The foetal surgery took place on February 10 and lasted two and a half hours. The team made an incision in the mother’s abdomen to access the uterus and repositioned the foetus to allow access to its abdomen.
They then performed the procedure laparoscopically, inserting four trocars into the amniotic sac and repositioning the intestine within the abdominal wall. This procedure was complex and required great skill. The team’s expertise was key in the success of the operation.
Outcome and Prognosis
After the procedure, ultrasound scans confirmed that the inflammation in the intestine was subsiding, and the baby was delivered by caesarean section at 34 weeks’ gestation. Although the baby was underweight, the outcome was favourable, and the baby was discharged after a short stay in hospital. The baby is currently feeding normally.
Gastroschisis occurs in 2-3 out of every 10,000 births, which translates to 120 cases annually in Spain and 2,400 in Europe. However, foetal surgery would only be indicated in 10% of these cases.
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