A baby born with a life-threatening birth defect is thriving after doctors performed a groundbreaking operation while he was still in the womb, marking a major milestone in fetal surgery.
The pioneering procedure, carried out in the United States as part of a first-of-its-kind clinical trial, corrected the condition before birth and dramatically improved the baby's chances of a healthy life.
Five-month-old Theo is now doing well after becoming only the third baby in the world to undergo the innovative prenatal surgery.
Theo was diagnosed with gastroschisis, a serious birth defect in which the belly button does not develop properly, causing the intestines to grow outside the baby's body.
His mother, 29-year-old Maisie Savage from London, underwent surgery at 26 weeks of pregnancy in the United States. During the operation, surgeons partially exposed her womb and used minimally invasive keyhole surgery to gently place Theo's organs back inside his abdomen before stitching the opening closed.
The operation was performed as part of the world's first clinical trial for prenatal repair of complex gastroschisis, making Theo only the third baby to benefit from the experimental treatment.
Parents describe Theo as 'little miracle'
Theo's parents, Maisie Savage and Josh French, 36, both teachers, said they remain overwhelmed by the success of the pioneering procedure.
"He's a little miracle, isn't he?" Maisie told BBC News.
The couple admitted they often think about how different the outcome could have been without the surgery.
Gastroschisis affects approximately one in every 3,000 babies born in the UK each year. Even in less severe cases, newborns often require weeks in intensive care, tube or intravenous feeding, and corrective surgery after birth.
For babies with complex gastroschisis, like Theo, the outlook is significantly more serious. Many spend up to six months in neonatal intensive care, undergo multiple surgeries, require IV nutrition for up to two years, and may even need an intestinal transplant.
Doctors say that despite advanced medical care, one in 10 babies with the condition does not survive.
Shock diagnosis after routine pregnancy scan
Theo's parents initially believed everything was progressing normally.
Josh recalled that they attended the routine 20-week scan simply excited to see their baby for the first time and had not even learned the baby's gender.
Instead, doctors discovered Theo had gastroschisis, leaving the couple shocked and frightened.
"It was incredibly scary," Josh said.
By the 24th week of pregnancy, specialists at Great Ormond Street Hospital (GOSH) in London had begun preparing the couple for what they expected would be an extremely challenging first six months of Theo's life.
However, after diagnosing complex gastroschisis, doctors referred the family to Texas Children's Hospital in Houston, where a pioneering clinical trial was underway to repair the condition before birth.
The fetal and pediatric surgery team was led by Dr Michael Belfort, who had previously pioneered similar in-utero procedures for babies with spina bifida.
Journey from Belgium to Texas
Maisie was told she needed to travel immediately to Texas and remain there until the birth of her baby.
"It was a huge decision," she said.
Before the surgery could take place, the family first travelled to Leuven Hospital in Belgium, where specialists administered a Botox injection through the womb into Theo's abdominal wall. The injection relaxed the muscles, making the surgical repair easier.
The family then flew to Texas, where the groundbreaking operation was performed in November last year, when Maisie was 26 weeks pregnant.
Inside pioneering fetal operation
Josh described the day of the surgery as one of the longest and most stressful of his life.
"The length of that day, it felt like a week," he said. "The waiting and just not knowing exactly what was going on at each and every stage."
During the procedure, surgeons partially exposed Maisie's uterus to correctly position both mother and baby.
The amniotic fluid was temporarily drained and replaced with carbon dioxide (CO₂) gas to create enough working space for the minimally invasive surgery.
Using keyhole surgical instruments, doctors carefully returned Theo's intestines to his abdomen before closing the abdominal wall.
Difficult recovery but successful outcome
Maisie was left with a surgical scar twice the size of a typical Caesarean section incision.
Unlike women recovering after a C-section, however, she still had to carry her baby for another 14 weeks.
She said Theo frequently kicked against the scar during the remainder of the pregnancy, making recovery painful.
"It was a hard recovery," Maisie said. "But it was worth it."
The surgery proved to be a complete success. Theo remained safely in the womb until full term and was born by vaginal delivery in Texas in February.
Now five months old, he is thriving.
Doctors praise remarkable results
Dr Michael Belfort, obstetrician and gynaecologist-in-chief at Texas Children's Hospital and clinical lead of the trial, described the outcome as extraordinary.
"The mother, the baby, the surgery, the time of the surgery, the fact that we had zero complications during the foetal surgery and after the foetal surgery, just remarkable," he said.
If the clinical trial continues to prove successful, Professor Paolo de Coppi, professor of paediatric surgery at Great Ormond Street Hospital and head of stem cells and regenerative medicine at University College London, hopes to introduce the procedure in the UK.
"We hope that we will be able to offer this to patients on a larger scale very soon," he said.
Dr Belfort welcomed the growing partnership between Texas Children's Hospital and Great Ormond Street Hospital, saying the collaboration would create a formidable team for advancing fetal surgery.
He also believes this breakthrough opens the door to treating many other conditions before birth.
"The inside of the uterus is now a new surgical space for innovation," Belfort said. "Spina bifida and gastroschisis are just two, but I believe that we could actually do certain cardiac surgeries in utero, and I think we can also do some lung surgeries in utero."
Family grateful for new beginning
Back home in London, Maisie says Theo is doing exceptionally well.
"Everything they did just completely reversed what could have been a really horrible start to his life and he's just the best. He's a completely normal baby essentially," she said.
Josh said the family feels incredibly fortunate and remains deeply thankful to the medical teams in both the UK and the United States.
"The impact that they've had on us as a family is incredible. They made us feel so welcome from the team at Great Ormond Street to Dr Belfort and the team," he said.
"Whilst we were over there, the level of care was amazing, and they made a very traumatic time of our lives so much easier, and we've got this little man — we couldn't be happier."
