To Mend a Birth Defect, Surgeons Operate on the Patient Within the Patient
Denise Grady | The New York Times
Denise Grady has been a reporter in the science news department of The New York Times since September 1998, and has also worked as a health editor there. She wrote for The Times for several years before that as a freelancer. Grady has written more than 1,000 articles about medicine and biology for The Times; she edited two Times books, one on women’s health and one on alternative medicine; and is the author of “Deadly Invaders,” a book about emerging viruses that was published in October 2006.
In her article: “To Mend a Birth Defect, Surgeons Operate on the Patient Within the Patient,” author Denise Grady discusses innovations in the field of fetal surgery through the explanation of case in Houston, Texas. Previously, prenatal surgery was reserved for fetuses with congenital birth defects that would cause death unless operated on. In this article however, Grady claims that by expanding the use of this technique to treat less lethal, but still debilitating, conditions, the amount of babies being born preterm can decrease, with their quality of life being improved drastically.
To prove this claim, Grady walks through the treatment of a 24-week fetus with Spina Bifida, a birth defect in which there is a small hole in the back exposing the spine and spinal cord. While Spina Bifida is the most common neural tube defect in the U.S. (affecting 4,000 babies each year) the previous course of treatment had not been reformed in over fifty years. These babies were forced to be delivered around the 25-week mark (normal gestational term is 40-weeks) and immediately undergo surgery to fix the whole and prevent damage to the spinal cord. However, the mortality rate for fetuses born before 25 weeks hovers around 65 percent, and that is without the added complications and risks of a major operation.
This is where fetal surgery comes in. Grady discusses two doctors, Dr. Belfort and Dr. Whitehead at Baylor college of medicine, who spearheaded a new technique to treat Spina Bifida, one that “some in the field are eager to learn, but that others regard warily, questioning its long-term safety for the fetus.” Instead of operating after a preterm birth the hole is closed in utero by placing two fetoscopes in small incisions on either side of the uterus, allowing the mother to carry the baby to full-term while also preventing the nerve damage the can occur if leaving the defect until the baby is fully-cooked so to speak.
Grady uses this study to prove her claim the fetal surgery should be expanded to fix a greater variety of birth defects. She is able to do this by using persuasive language and examples that show its possible benefits far outweigh its consequences.
The Future is Fetal - an Exploration in Neonatal Surgery 