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Baby girl 'born twice' due to groundbreaking operation

Doctors operated on a tiny foetus, weighing just one pound and three ounces, to remove a tumour

Charlotte England
Monday 24 October 2016 21:11 BST
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A baby has been "born twice" after doctors took her out of the womb to remove a life-threatening tumour, and then put her back in again.

Margaret Boemer, from Texas, was 16-weeks pregnant with her third child when a routine ultrasound revealed a growth on the baby's tailbone.

As the tumour got bigger, doctors realised the only way to save the girl was to operate. This involved lifting the foetus out of her mother for around 20 minutes. The tiny baby weighed only one pound and three ounces at the time.

After being returned to the uterus, the foetus remained inside her mother for another 12 weeks. She was born for a second time at nearly 36 weeks — which is approaching full term — by caesarean section in June. She had grown to a small but healthy five pounds and five ounces.

Ms Boemer and her partner named the child, who is now four-months old, LynLee Hope after both their grandmothers.

Ms Boemer said when she was first told there was a problem visible in the ultrasound results, she feared the baby would die.

She told CNN: "They saw something on the scan, and the doctor came in and told us that there was something seriously wrong with our baby and that she had a sacrococcygeal teratoma. And it was very shocking and scary, because we didn’t know what that long word meant or what diagnosis that would bring".

Teratomas on the tailbone are the most common tumours seen in newborn babies, said Dr Darrell Cass, co-director of Texas Children's Foetal Centre, and one of the surgeons who carried out the operation on LynLee.

"Even though it’s the most common we see, it’s still pretty rare," he added.

The tumour occurs in girls four times more often than in boys, but the cause is unknown. The growth is seen in around one in every 35,000 live births.

Sometimes doctors can delay surgery until after the birth, but in LynLee’s case the tumour was competing with the foetus for the body’s blood flow, Dr Cass told CNN.

"In some instances, the tumour wins and the heart just can’t keep up and the heart goes into failure and the baby dies," he said.

In this case, the baby’s health deteriorated to the point at which doctors realised she would not survive without intervention.

Ms Boemer said: "LynLee didn’t have much of a chance. At 23 weeks, the tumour was shutting her heart down and causing her to go into cardiac failure, so it was a choice of allowing the tumour to take over her body or giving her a chance at life".

The couple were encouraged by some doctors to terminate the pregnancy, but they did not want to abort the foetus. Dr Cass said it might be possible to operate.

"It was an easy decision for us," Ms Boemer said. "We wanted to give her life."

By the time the foetus was 23 weeks and five days old, the tumour was almost as big as her. At this point Dr Cass and his partner surgeon, Dr Oluyinka Olutoye, went ahead with the five-hour operation.

Dr Cass said: "The part on the foetus we do very, very quickly. It’s only 20 minutes or so on the actual foetus".

He said most of the time was spent cutting into the uterus, which he described as “a big muscle lined with membranes”.

“We don't want the mom's health to be jeopardised,” Dr Cass said, explaining the enormous size of the tumour made the operation particularly difficult. The foetus had to be lifted completely from Ms Boemer's body in order to access and remove the growth.

"Essentially, the foetus is outside, like completely out, all the amniotic fluid falls out, it’s actually fairly dramatic," Dr Cass told CNN.

During the surgery, LynLee’s heart almost stopped, but she was kept alive by a specialist while doctors removed most of the lump.

When they had done as much as they could, the surgeons placed LynLee back inside the womb and sewed her mother’s uterus "as sealed and as water tight as possible".

Dr Cass said: "It’s kind of a miracle you’re able to open the uterus like that and seal it all back and the whole thing works".

LynLee needed to be operated on again at eight days old to remove a small bit of the tumour that could not be reached in the first operation.

Several weeks later, after Lynlee made a full recovery, Ms Boemer was allowed to take her daughter home.

"Baby Boemer is still an infant but is doing beautiful," said Dr Cass, adding that Lynlee was perfectly healthy. He said his one previous surgery of this kind had also been a success.

"I think she's about 7 now, and she sings karaoke to Taylor swift -- she's completely normal," he said.

Ms Boemer said in addition to the pregnancy and operation, the birth and first few weeks afterwards had been extremely difficult — but it was worth it.

She said: "It was her second birth, basically. I was willing to endure all those risks to give her a chance at life".

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