Newcastle surgeons perform life-saving surgery on baby in her mother’s womb

An “amazing team of heroes” at The Newcastle upon Tyne Hospitals NHS Foundation Trust have performed in utero surgery to save the life of an unborn baby after it developed a rare fetal condition.

Ruth Elder, 32 from Chester le Street, County Durham had the revolutionary procedure at the Royal Victoria Infirmary (RVI) in Newcastle after an ultrasound showed that her unborn baby had developed a condition known as hydrops fetalis.

The condition is detected on a scan where there is an abnormal accumulation of fluid around the baby’s heart, lungs and inside the abdomen (tummy).

Ruth, Harriet and Ross Elder

Ruth had been suffering from severe pregnancy sickness, known as hyperemesis gravidarum and because of this had additional scans throughout her pregnancy.  It was during Ruth’s 28 week scan that the sonographer noticed a significant build-up of fluid around the baby’s heart and lungs.

Ruth and her husband Ross, 35 who are also parents to Henry, 3, were then referred to the fetal medicine team at the RVI.

Dr Therese Hannon, consultant in obstetrics and fetal medicine at the Newcastle Hospitals carried out an initial procedure to drain the fluid from the baby’s chest. Unfortunately the fluid re-accumulated and a more permanent solution was required.

A decision was therefore made to perform the life-saving in utero surgery. Ruth said: “It all happened really quickly so there wasn’t a great deal of time to worry about what the procedure would entail, I just wanted them to do whatever they needed to do to try to save our baby.”

The procedure was carried out during the 29th week of Ruth’s pregnancy by Professor Stephen Robson, honorary consultant obstetrician at the Newcastle Hospitals and Professor of Fetal Medicine at Newcastle University. Using ultrasound as a guide, Professor Robson placed a chest shunt (a small plastic tube) through Ruth’s abdomen, through the wall of the womb and into the baby’s chest wall to relieve the fluid around the lungs.

Professor Stephen Robson and Harriet Elder

Professor Robson said: “We have a very small but highly specialised team here at the RVI and we would usually see around 10 to 15 cases of hydrops fetalis a year, however only one in 10 of these cases are amenable to fetal surgery. The baby was very poorly and while placing the shunt carries a risk it was the only option available. Had this procedure not taken place, the chances of the baby surviving were very low.”

He added: “There aren’t a large number of fetal abnormalities that you can treat in the womb, but this option is sometimes available and intervention can be very effective. The intention with Ruth’s surgery was to place a shunt in both sides of the baby’s chest but because of the position of the baby in the womb we were only able to access the right side. The procedure was carried out under local anaesthetic so Ruth was very tough.”

The procedure was a success and six weeks later Ruth gave birth to a baby girl named Harriet on 10 July 2017, at 34 weeks via emergency C-section. After birth Harriet spent time on the RVI’s neonatal intensive care unit, then on the paediatric intensive care unit, and then ward 2 at the Great North Children’s Hospital (GNCH) and was finally discharged home on 19 September 2017.

Ruth said: “When Harriet was born we were terrified, we had a desperately ill baby and a two year old who wondered where his mummy was. We just couldn’t have got through it all without all of the amazing staff at the RVI and the Great North Children’s Hospital, they were all so kind and became like a second family to us.

“It was just genius what Professor Robson did, Harriet’s condition was so rare and she was so poorly we weren’t even given odds of survival but thanks to him, Dr Hannon and all of the amazing staff at the RVI and GNCH thankfully Harriet is here today and although she has complex medical conditions, with the excellent support and care led by the respiratory team at the GNCH she is doing really well.”

Ruth and Ross Elder present a cheque to the Newcastle Hospitals fetal medicine team

Ruth arranged a festive tea party to raise money for the Fetal Medicine Fund “to say thank you to the amazing team of heroes who are working so hard to save the lives of desperately ill babies in the womb, and caring for the mothers with the most difficult of pregnancies.” The event was a huge success and raised just over £5,000 for the fund.

Ruth, Ross and Harriet returned to the fetal medicine unit to present the team with a cheque, Ruth said: “You can’t put a price on the amazing care and support we received from the team and there’s no way we can ever thank them enough for what they did for our family but we are great believers in paying it forward and wanted a happy, positive ending to a really tough year.” Ross added: “We honestly can’t thank them enough for supporting us so amazingly during the most difficult time of our lives; they are the team you want on your side when Mother Nature sadly isn’t.”

If you would like to fundraise or make a donation to the Fetal Medicine fund (or any of the funds within Newcastle Hospitals NHS Charity) please contact the Charitable Funds Office on 0191 213 7235 or email charity.matters@nuth.nhs.uk

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