In a first, US doctors perform brain surgery on baby still in womb; know about the rare malformation

It is estimated that VOGM, the most common congenital vascular brain malformation, occurs in as many as one in every 60,000 births.

What is a vein of Galen malformation?

Explaining this rare condition, Dr Bhupesh Kumar, Senior Consultant, Neurology, Artemis Hospital, Gurgaon, said, “VOGM is a rare prenatal condition that occurs when the blood vessel that carries blood from the brain to the heart, also known as the vein of Galen, does not develop properly. The malformation results in an overwhelming amount of blood stressing the veins and heart, and can lead to many health problems.”

Adding that there is no definite cause for the ailment, Dr Kumar said it is believed to be a result of genetics or a gene disorder. “The symptoms can range from headaches to subarachnoid haemorrhage in neonates. Malformations can also lead to low or more cardiac input/output. However, it must be noted that these signs are some common symptoms in other conditions as well.”

What is the treatment?

VOGM is a rare prenatal condition that occurs when the blood vessel that carries blood from the brain to the heart, also known as the vein of Galen, does not develop properly. (Source: Freepik)

“Intervention is the main treatment for VOGM. Firstly, we identify the area where it is happening through digital subtraction angiography. The standard of care is treatment after birth with embolisation, a catheter-based procedure to close off the direct artery-to-vein connections in the malformation and block the excess blood flow to the brain and heart. So, a shunt is required to reduce the blood flow,” Dr Kumar said.

Elaborating that the risks of embolisation compared to other procedures is less, he said the chances of side effects are higher in neonates.

According to reports, after the operation was successful, doctors induced labour in the women two days later. This is because the operations ruptured tissue surrounding the baby in the womb that holds fluids in — also known as ‘water breaking’. The child was born with limited complications at 4.2 pounds — light for a newborn baby.

“In our first treated case, we were thrilled to see that the aggressive decline usually seen after birth simply did not appear. We are pleased to report that at six weeks, the infant is progressing remarkable well, on no medications, eating normally, gaining weight and is back home. There are no signs of any negative effects on the brain,” said Dr Darren Orbach, a radiologist at Boston Children’s Hospital and lead study author, told CNN.

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