“Look, it’s not brain surgery” is a saying for a reason. Brain surgery is a delicate task that needs a lot of experience to do successfully. Which makes it even more amazing that doctors in Boston recently carried out brain surgery on a fetus – they did it on a baby while it was still in the womb.
To achieve this, doctors had to use ultrasound imaging to help them guide a needle into the mother’s abdomen, through the uterus wall, and into the fetal brain. This might sound terrifying to a mother, but the risk was worth taking. The particular problem that this surgery was trying to solve was a malformed blood vessel in the child’s brain, where a vein connected with an artery. Since arteries carry blood at higher pressure, blood coming directly from the heart, this blood can pool in the vein. The goal was to fix this malformation of the artery and vein before birth.
If you think this sounds complex and intricate, it certainly is! It was the first surgery of its kind ever performed, and proved this new technique is possible.
But why do it in the womb? Well, the process of birth changes how blood flows in the fetus, and after birth there was an increased likelihood that this connection between the artery and vein could have led to a cascade of other problems for the baby, including blood clots, heart failure, and effects on the brain. Doing a surgery in the womb meant that, rather than bracing for the multiple complications this kind of blood vessel malformation could cause the baby, surgeons could prevent these problems from ever happening.
This surgery adds an interesting wrinkle to the debate over when life begins. If we can do brain surgery on a fetus in the womb – and we think it is worth the danger and expense of treating a fetus – then it provides the world another piece of evidence that these living beings are valuable, long before birth.