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Operation in the womb - what does it look like?

19-year-old Viktora and her roommate are expecting the birth of their first child. By the 28th week, the pregnancy was proceeding correctly. - My attending physician noticed swelling. He sent me for further research. After research, I found out that the swelling is caused by most likely a heart defect. It was a surprise, I didn't know anything about it,” Victoria recalled.

Victoria's baby has a rare genetic defect - valvular aortic stenosis, or aortic stenosis. This means that the valve in the heart is narrowed, making it difficult for blood to flow out of the left ventricle. In such cases, it is necessary to operate on the baby while still in the womb. - I felt sadness, pain, but I also felt joy that there is a chance that something can be done with this defect - said the 19-year-old.

This is a very complicated procedure, which consists in widening the heart valve with a special balloon. - The centers that perform this type of treatment are the few centers in the world - emphasized Prof. Mirosław Wielgoś, specialist in obstetrics and gynecology, perinatologist, University of Warsaw Medical University. - These operations are absolutely unusual, because we are dealing with two patients. There's a mother that I see, I'm talking to her, because my mom is awake, she's not sleeping. I look into her eyes and I know that in a moment I will pierce the heart of her baby - added Prof. Marzena Dębska, specialist in obstetrics and gynecology, perinatologist, UczKin WUM.

After anesthesia is administered, the doctor, under the control of ultrasound, inserts a needle through the mother's abdomen. He conducts it to the chest and heart of the baby. Warsaw doctors insert a special catheter through a needle, that is, a tube with a balloon. The balloon, expanding, widens the narrowed valve, thereby restoring the normal functioning of the heart. It is worth adding that the heart of such a small child is the size of a 50 penny coin.

- All this is very difficult. The needle must be in the right place. It must be stationary in the heart, which works all the time - explained Prof. Dębska. - This requires a lot of knowledge, great precision and experience - noted Prof. Wielgoś.

- When I saw Prof. Dębska above me, who was very supportive, she hugged me and said that the operation was successful. “You can't put it into words,” Victoria said. Although Victoria and her son are feeling well, they will need another operation in the womb and several procedures already performed after the birth.

- For me, every life saved is a great success. The most beautiful thing is when I can walk up to the patient and say, “Mrs. Victoria, the operation was successful,” and I see tears of happiness - summed up Prof. Dębska.

How often are such operations performed?

In Poland, there are still too few such treatments. Why?

- This is obviously a complex problem, a complex matter. (...) Of course, a matter of equipment, but equipment can always be obtained by some inhuman effort, but it can be done. More important is the experience, and the fact that there are not many of these operations - we wish there were none at all, because we operate on sick children. If this disease, this defect, if they exist, then first of all we want to detect it. So prenatal diagnosis is something we fight for. This has worked well in our country so far and we hope that it will continue to function. I hope that no one will prevent this,” Professor Mirosław Wielgoś told Dzień Dobry TVN.

However, it should be emphasized that not all heart defects in children are treated in this way. - Most either do not require intrauterine treatment, because they are stable defects that do not affect the development of the fetus and the baby can be treated after birth, or they are defects so complicated that they cannot be treated intrauterine, because they require opening the chest and performing complex procedures - said Prof. Mar. Debzena. What heart defects in a child can be treated while still in the womb? You will find out from the rest of our conversation.