Tiny miracles saved by surgery in the womb
THERE could barely be worse news for a mother-tobe to receive. And because of pandemic regulations, Becky had to hear it alone. ‘The sonographer said: “I’m so sorry, there’s something seriously wrong with your baby and she is in imminent danger,” ’ the 28-year-old recalls. ‘I couldn’t stop crying.’ What should have been a routine midpregnancy scan revealed that Becky’s baby’s lungs were unable to form properly and her heart was failing.
Becky and husband Richard, who run a storage firm on the Isle of Wight, were immediately referred to Princess Anne Hospital in Southampton, where a followup scan the next day — this time with Richard in attendance — confirmed there was a life-threatening tumour on their unborn daughter’s lung.
The rare condition, known as a congenital cystic adenomatoid malformation of the lung, occurs when growths form in the air sacs. It was so advanced there was no way that the baby girl — then only 19 weeks — could survive the pregnancy.
‘The doctors sent us home to think about whether to terminate or allow the baby to die naturally over the next few days,’ Becky recalls, who has a six-yearold son from a previous relationship.
‘ We were utterly heartbroken,’ she recalls. ‘In two days, we had gone from assuming everything would be fine to the worst news you can imagine.’
It’s hard to reconcile that desolate situation confronting Becky and Richard with the chubby-cheeked six-month-old Annie who happily poses for photos with her proud parents today.
What happened owes everything to the skill of a team of doctors in London, whose work on unborn babies is the subject of a new Channel 4 series.
Their patients can be just centimetres long, yet each year Professor Basky Thilaganathan (who prefers to be known as Professor Basky), director of fetal medicine at St George’s Hospital in Tooting, and his team perform hundreds of intricate procedures in the womb to help give these unborn babies a chance of life.
‘It’s not always possible to tell the parents what they want to hear,’ says Professor Basky. ‘But AdAy we try to give hope.’
after their shock news, Becky and Richard received a call from their hospital telling them there was a professor in London who might be able to help them.
‘ We were happy to listen to anything he had to say,’ says Becky. ‘We were so desperate to give our baby a chance.’
She and Richard travelled straight to London to meet Professor Basky, who told them he believed their baby had a chance if he were to undertake delicate in-utero surgery, using a needle and laser to block off the blood vessel feeding the tumour.
He’d operate on their tiny baby in the womb, accessing her via a small needle inserted through Becky’s abdomen.
However, there was a chance their baby would not survive the stress of the procedure.
‘Her heart could have stopped at any moment,’ recalls Becky. ‘But we knew this was our only hope.’
The couple consented to the procedure being filmed, despite not knowing the outcome.
‘My feeling was that whatever happened, it could help other people in my position — to know that this happens, and the feelings around it,’ says Becky.
The viewer shares every moment as Professor Basky inserts a needle into a blood vessel less than the thickness of a matchstick — an error of just 1mm could be fatal.
‘It was incredibly intense,’ recalls Becky of the procedure. ‘Professor Basky was always hopeful, but there were no guarantees about the ultimate outcome, so it was a very tough pregnancy.’
Becky gave birth naturally last October, and baby Annie spent just ten hours in the neo-natal intensive care unit before she was allowed to leave hospital with her parents. ‘We practically floated home,’ says Becky.
That rollercoaster of emotions is one that Noreen, 37, and IT consultant Andrew, 41, from South-West London recognise.
They arrived at St George’s Hospital after learning there was a problem with their unborn baby’s hands during the 12-week scan.
‘I had already had one miscarriage, so this pregnancy was very precious,’ Noreen recalls.
Her unborn son had a rare condition called amniotic band syndrome. It meant the blood supply had been cut to his fingers and his right foot was swelling and at risk of dying.
At St George’s, Noreen and Andrew learned that by placing a small telescope inside the womb, doctors might release the band, hopefully saving the baby’s foot.
However, the procedure came with a risk of miscarriage. Choosing whether or not to go ahead with the surgery was, Noreen says, the most challenging decision she and Andrew have ever faced.
‘There was a lot of soul searching,’ she recalls. ‘Ultimately, we decided we wanted to help give our baby a free life.’
The nerve-wracking procedure was performed by Professor Asma Khalil, 41. A consultant in fetal medicine for nine years, she has seen extraordinary advances in that time, allowing interventions on babies smaller than a finger.
‘The earliest we might do laser treatment to a foetus would be around 12 weeks, when it’s the size of a plum,’ she says.
‘A fetal blood transfusion is usually not done before around 20 weeks when the umbilical cord is still just a few millimetres in diameter. you have to be so precise.’
Noreen’s baby’s lower limb was saved. However, at 30 weeks pregnant, Noreen’s amniotic fluid started to leak when she and Andrew were visiting family on the Isle of Wight.
Transferred to hospital in Portsmouth, she underwent an emergency caesarean.
Happily, baby Paolo arrived safely, spending two months in the neo-natal unit. Now a healthy sixmonth-old, he will one day require surgery on his hands and right foot, but Noreen and Andrew are ‘so grateful’ that he is here.
Sadly, not every life can be saved. Among the anxious parents-to-be featured on the programme are Ann Marie and husband Paul. They had discovered at the 12week scan that they were expecting triplets, but that one of them had died three weeks earlier.
The pregnancy had ongoing challenges, as one of the remaining triplets had selective growth restriction, leading to a risk of stillbirth and early labour.
It was Professor Basky’s job to keep the couple’s babies in the womb as long as possible without collateral damage to the larger baby, named Poppy.
But two weeks later, the smaller baby, whom they had called Emily Marie, passed away.
Ann Marie went into labour nine days later, at 30 weeks, and had to give birth to Emily and Poppy together.
Emily will never be forgotten — her surviving sister now bears her name, too. ‘We named her Poppy Emily Marie — so that she will always have her sister with her,’ says Ann Marie.
For Professor Basky, having children of his own brings an ‘ extra dimension’ to how he talks to parents and how he feels about his work.
‘We see the hurt when things don’t go well — but also the joy when someone fulfils their dreams of becoming a family,’ he says.
And that is what has happened to Becky and Richard. While the growth on Annie’s lungs is still present and may require intervention in the future, she is thriving.
‘We can never thank Professor Basky enough,’ Becky says. n BaBy Surgeons, Monday, May 3, 9pm, C4. Watch the first episode on all 4.