A rare surgery was performed on Lucy, a 23-year-old teacher who was diagnosed with ovarian cancer by doctors at John Radcliffe Hospital, UK, where a fetus was temporarily taken out from the mother’s womb. After the surgery, 12 weeks later, the mother gave birth to a healthy baby.
What's the story?
During a routine follow-up scan, Lucy was informed that she had ovarian cancer. Doctors warned that postponing the treatment until after birth could pose a serious risk to her life, so waiting until delivery was not an option due to the increased danger. Also, conventional laparoscopic surgery during the second trimester was ruled out, as the pregnancy had progressed too far for standard treatment protocols to be implemented.
At John Radcliffe Hospital, Dr. Hooman Soleymani Majd, a consultant gynecologist and oncologist, planned the surgery as time was running short. With the intention to save both the mother and the child, a high-risk five-hour surgery was scheduled.
During the operation at 20 weeks, surgeons removed Lucy’s womb from her body—still carrying the unborn baby Rafferty—to access and remove the tumors.
The unborn baby remained inside the womb during the surgical procedure, staying connected to the mother’s blood supply through the uterine artery, ensuring nutrition reached the baby. Lucy’s uterus remained connected with vital structures, including the uterine artery, cervix, and umbilical cord. The doctors constantly monitored the fetal heartbeat.
The surgery was considered complicated, as the tumor had spread to surrounding tissues and was classified as grade 2 progression. Nevertheless, the surgeons successfully removed the tumor and carefully repositioned the womb.
The surgery was deemed a success, involving 15 team members including surgeons, nurses, and anesthetists. With the dedication of the doctors, a healthy baby boy was born. Lucy’s husband, Adams, was finally happy to hold Rafferty in his arms, reflecting their emotional and courageous journey.
It is very rare to plan surgeries in pregnant cancer patients unless the condition is life-threatening. A baby can survive outside the womb for about 6–8 hours with adequate support from vital organs. When planning such surgeries, a multidisciplinary team effort involving multiple clinicians and critical care support is essential to explain the complications and risks associated with the procedure. These rare cases are highly challenging. Such surgeries are considered high-risk for both mother and baby, as well as for the surgical team, and must be conducted in a well-equipped facility.
Dr. Pandala Sravanthi, MBBS, MS (Gynecology and Obstetrics), FAMS, FAART, DRM (Germany), Consultant Obstetrician & Gynaecologist, Laparoscopic Surgeon & Infertility Specialist, Apollo Speciality Hospitals, Nellore, Andhra Pradesh, India
This rare surgery is known as Extra-Corporeal Uterine Surgery—an extremely rare and complex procedure involving the temporary removal of the uterus while preserving fetal life.
To prevent fetal distress, uterine temperature and blood supply were maintained during the procedure. The uterus was kept encased in warm, sterile gauze, and the fetal heart rate was monitored throughout. The team used surgical planning strategies typically reserved for complex oncological operations, combined with advanced obstetric care.
We come across such a rare case, one in 5000. Generally, cases are operated at the 2nd trimester and fetal survival chances are 70% if the gestational age is greater than 26 weeks. The usual risks that we expect are preterm or anesthesia complications, which include neurological or respiratory complications. So, planning and monitoring of such cases are challenging, as the treatment depends on the type and stage of cancer, the mode of treatment approach, like surgery/chemo, or radiotherapy, and the timing of treatment (i.e., gestational age). Considering all these, we explain the risk of miscarriage, preterm, and sudden fetal demise.
Dr. Banka Soujanya, MBBS, DGO (Obstetrics and Gynecology), FMAS, DMAS, Diploma In ART (Germany), Reach Hospitals, Bachupally, Dr. Vivaswan's Indira Clinic, Pragathinagar, Hyderabad, Telangana, India.
MedBound Times connected with few gynecologists to share their insights.
Dr. Pandala Sravanthi Reddy, MBBS, MS in Gynecology and Obstetrics, shared her insights on how often such rare surgeries are planned, how long a baby can survive outside the womb, the measures needed to plan such surgeries, and her perspective on these cases.
In her words, “It’s very rare to plan surgeries in pregnant cancer patients unless the condition is life-threatening. A baby can survive outside the womb for about 6–8 hours with adequate support from vital organs. While planning that type of surgery, a multidisciplinary team effort involving multiple clinicians and critical care support should explain the complications and risks associated with the surgery.
Such rare cases are challenging. These surgeries are regarded as high-risk for both mother and baby and the surgical team. Such rare and complex surgeries need to be planned in a well-equipped facility.”
Dr. Banka Soujanya, MBBS, DGO (Obstetrics and Gynecology), shared her insights on how rare such cases are seen, measures needed to plan such surgeries and her perspective on such cases.
In her words, "We come across such a rare case, one in 5000. It all depends on the:
Type of cancer
The emergency/ stage of cancer
The gestation age of the pregnancy
Feasibility (approach), and
The risk to the fetus.
So, the Decision usually depends on the benefits and the risks of the procedure. Generally, cases are operated at the 2nd trimester and fetal survival chances are 70% if the gestational age is greater than 26 weeks. The usual risks that we expect are preterm or anesthesia complications, which include neurological or respiratory complications.
The risk factors include preterm, neurological, respiratory issues, and future developmental delays. So, planning and monitoring of such cases are challenging, as the treatment depends on the type and stage of cancer, the mode of treatment approach, like surgery/chemo, or radiotherapy, and the timing of treatment (i.e., gestational age). Considering all these, we explain the risk of miscarriage, preterm, and sudden fetal demise."
References:
1. Dutt, Tanya. “‘Miracle Baby’ Born Twice to a Mom With Cancer Mid-Pregnancy; Decoding the High- Risk Surgery.” Health and Me, April 22, 2025. https://www.healthandme.com/health-wellness/miracle-baby-born-twice-to-a-mom-with-cancer-mid-pregnancy-decoding-the-high-risk-surgery-article-151466818.
(Rehash/Dr. Lakshmi Sahithi Tanneru/MSM)
