Treating the Tiniest Patients: Dramatic Advances in Fetal Medicine-Especially in Utero Surgery-Have Changed What We Know and How We Think about the Unborn

By Kalb, Claudia | Newsweek, June 9, 2003 | Go to article overview

Treating the Tiniest Patients: Dramatic Advances in Fetal Medicine-Especially in Utero Surgery-Have Changed What We Know and How We Think about the Unborn


Kalb, Claudia, Newsweek


Byline: Claudia Kalb

Samuel Armas, a chattering, brown-eyed 3-year-old, has no idea what "fetus" means. Nor does he realize that he was one of the most celebrated in medical history. At a mere 21 weeks of gestational age--long before it was time to leave his mother's womb--Samuel underwent a bold and experimental surgical procedure to close a hole at the bottom of his spinal cord, the telltale characteristic of myelomeningocele, or spina bifida. Samuel's parents, Julie and Alex, could have terminated Julie's pregnancy at 15 weeks when they learned about their son's condition, which can result in lifelong physical and mental disabilities. But the Armases do not believe in abortion. Instead, in August 1999, they drove 250 miles from their home in Villa Rica, Ga., to Nashville, Tenn., where Dr. Joseph Bruner, of Vanderbilt University, performed a surgery bordering on the fantastical. Bruner cut into Julie's abdomen, lifted her balloonlike uterus out of her body, made an incision in the taut muscle, removed the fetus, sewed up the spinal defect and tucked him back inside. Fifteen weeks later Samuel Armas "came out screaming," says Julie.

That scream became a rallying cry for fetal-rights groups, which seized on a stunning photograph of Samuel's tiny hand emerging from his mother's uterus during surgery. Since then, anti-abortion activists have posted the image on dozens of Web sites to show just how real human fetuses are--even those that aren't yet viable. And that's just fine with the Armases. "We're very glad it's gotten visibility," says Alex. "That wasn't our fetus, that was Samuel."

No matter what legislators, activists, judges or even individual Americans decide about fetal rights, medicine has already granted unborn babies a unique form of personhood--as patients. Twenty-five years ago scientists knew little about the molecular and genetic journey from embryo to full-term fetus. Today, thanks to the biomedical revolution, they are gaining vast new insights into development, even envisioning a day when gene therapy will fix defects in the womb. Technology is introducing parents to their unborn children before they can see their toes. Expecting couples can now have amazing 3-D ultra--sound prints made in chain stores like Fetal Fotos. "Instead of some mysterious thing inside her belly, a mother and her family can now identify a little human being," says Bruner. In any other field of medicine, the impact of these dramatic improvements in treatment and technology would be limited largely to doctors, patients and their families. But 30 long and contentious years after Roe v. Wade, science that benefits fetuses cannot help but fuel ongoing political, moral and ethical debates.

Fetal surgery has raised the stakes to a whole new level. The very same tools--amniocentesis and ultrasound--that have made it possible to diagnose deformities early enough to terminate a pregnancy are now helping doctors in their quest to save lives. While fetal surgery is still rare and experimental, the possibility that a fetus that might have died or been aborted 10 years ago might now be saved strikes at the core of the abortion debate. And these operations also raise a fundamental question: whose life is more important--the mother's or the child's? While reluctant to take a stand in the political arena, doctors know they are players, like it or not. "We can be a lightning rod used to further a cause, either pro or con," says Diana Farmer, a fetal surgeon at the University of California, San Francisco, "but you can't let that deter you from your mission as a physician."

For decades pediatric surgeons like Michael Harrison, head of UCSF's Fetal Treatment Center, agonized over their inability to save babies from deadly defects after birth. Since 1981, when Harrison performed a pioneering in utero procedure to treat a fetal urinary-tract obstruction, hundreds of fetuses have undergone treatments ranging from tumor removal to spinal-cord repair. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Treating the Tiniest Patients: Dramatic Advances in Fetal Medicine-Especially in Utero Surgery-Have Changed What We Know and How We Think about the Unborn
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.