L-R: Dr. Shai Porat, Dr. Dan Arbel, and Noa Ofek-Shloma'i, with the baby in her arms.
(Photo Credit: Hadassah-University Medical Center)
In an unprecedented medical feat, Hadassah Medical Center in Jerusalem has successfully saved both ovaries of a premature baby girl. The procedure, described as the first of its kind globally, involved an emergency cesarean section and surgery performed just 30 minutes after birth.
The case came to light when an ultrasound during the mother's 35th week of pregnancy revealed enormous cysts on both of the foetus's ovaries. These cysts were causing ovarian torsion, a severe condition that can lead to organ death if not treated promptly.
Dr. Shay Porat, director of the obstetrics and gynaecology ultrasound service at Hadassah, explained that ovarian torsion is rare in foetuses, and even rarer for both ovaries to be affected. While ovarian cysts in late-second and early third-trimester foetuses are not uncommon, they can become complicated, requiring immediate diagnosis and intervention.
Ovarian torsion, affecting approximately 6 per 100,000 women, is often caused by cysts on the ovary, leading to a twist that cuts off blood supply. The only treatment is urgent surgery to remove the cyst and untwist the ovary.
In this particular case, the cysts were so large that they were impossible to miss on the scan, each almost 4 centimetres in size. Typically, if only one ovary is affected, doctors might not intervene, but in this instance, both ovaries were involved, making the situation more critical.
Time was of the essence when Dr. Porat detected blood flow in both ovaries. An emergency C-section was performed, followed by immediate surgery. The paediatric surgeon, Dr. Dan Arbel, opted for a mini-laparotomy, making a small incision in the baby's abdomen to untwist the ovaries and drain the cysts.
According to Dr. Porat, there is no published medical literature on the surgical treatment of a newborn baby with simultaneous bilateral ovarian torsion. The only other known case resulted in the loss of the ovaries.
Fortunately, the story for the baby born at Hadassah ended differently. Now six months old, she has had follow-up checks at the hospital, and all indications suggest she should grow up with healthy ovaries. This remarkable case underscores the importance of timely intervention and the incredible strides being made in neonatal care.
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