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- <text id=90TT1523>
- <title>
- June 11, 1990: Major Surgery Before Birth
- </title>
- <history>
- TIME--The Weekly Newsmagazine--1990
- June 11, 1990 Scott Turow:Making Crime Pay
- </history>
- <article>
- <source>Time Magazine</source>
- <hdr>
- MEDICINE, Page 55
- Major Surgery Before Birth
- </hdr>
- <body>
- <p>Doctors learn how to save lives by entering wombs
- </p>
- <p> Blake Schultz appeared to be doomed before he was even born.
- While he was in his mother's womb, a hole opened up in his
- diaphragm and allowed his stomach, spleen and intestines to
- press into his chest cavity and put pressure on his lungs. The
- grim prognosis: at birth, he would probably be unable to
- breathe.
- </p>
- <p> But Blake did breathe, and today he is a healthy
- nine-month-old--thanks to a dramatic operation carried out
- when he was still a fetus. This procedure, the most impressive
- achievement yet in the young field of fetal surgery, was
- performed by Dr. Michael Harrison and colleagues at the
- University of California, San Francisco and reported last week
- in the New England Journal of Medicine. Seven weeks before
- Blake was born, the doctors cut into his mother's uterus and
- partly removed the fetus. Then they opened his left side,
- patched the hole in his diaphragm and put his organs back in
- the right places.
- </p>
- <p> Since the early 1980s, doctors have operated on fetuses,
- fixing urinary-tract blockages, for example, or inserting
- needles to drain excess fluid from the brain. But never before
- had physicians successfully performed such major surgery in the
- womb. Harrison hopes that his technique can be used to correct
- other potentially fatal problems, including large lung or
- spinal tumors and certain heart conditions. Several experts
- echoed that optimism. "We're in a whole new era of fetal
- treatment," said Dr. Eugene Pergament, head of reproductive
- genetics at Northwestern Memorial Hospital.
- </p>
- <p> That era may take a while to unfold, however. For now, the
- procedure seems useful only for rare ailments. Blake Schultz's
- diaphragmatic hernia, for example, occurs in 1 out of every
- 2,200 births, and 90% of those cases are considered unsuitable
- for surgery. Moreover, while Harrison has proved that this
- operation is feasible, only long-term clinical trials can
- establish that the surgery will be effective for a majority of
- patients.
- </p>
- <p> Harrison spent five years practicing and refining his
- technique on hundreds of sheep and monkeys. Even so, his first
- six operations on human fetuses with problems similar to
- Blake's failed: he was unable to save the babies because of
- difficulties encountered in handling their organs. After his
- success with Blake, Harrison performed a comparable prenatal
- operation on a little girl, who was also born healthy.
- </p>
- <p> Not many surgeons are likely to develop similar expertise
- soon. Nonetheless, Harrison's work may herald a time when
- doctors can routinely help the unborn victims of nature's
- mistakes.
- </p>
- <p>By Andrew Purvis.
- </p>
-
- </body>
- </article>
- </text>
-
-