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US Doctors Use Sophisticated Technology to Care for Fragile Babies


Jason Torres is a young father caught in a terrible dilemma. On one hand, he is anxiously awaiting the birth of his baby girl, but at the same time dreading it because it will mean the loss of his wife Susan, the baby's mother. This young family is the center of media attention as advancements in medical science help improve prospects for developing infants.

This was Jason and Susan Torres on their wedding day. Now Susan is on life-support, after losing consciousness from a previously undiagnosed brain tumor.

Susan Torres is being kept alive artificially at a hospital just outside Washington, D.C., as her baby continues to grow inside her. Her husband Jason says his wife would agree it's the right thing to do, "Without question, I know that Susan would walk through hell and back just to give our child a chance," he said.

Susan Torres has melanoma. Though the cancer has spread in her body, the baby is still safe and has made it past the initial 24-week stage of gestation. For premature babies, each additional week in the womb makes a big difference in terms of survival, says Dr. Siva Subramanian, the Chief of Neonatal Medicine at Georgetown University Hospital.

Dr. Subramanian says development of the lungs is the first critical stage of maturation. "These babies have, because they are growing up, have immature lungs," he explained, "and they do not have a substance, it's called surfactant, this is a combination of protein and fat, that is necessary to line the air sacs for them to be, to keep the lungs open."

There are medical options for lung development after the 24-week stage. If a mother goes into pre-term labor, she can be given steroids. Once a baby is delivered, surfactant might be given through a tube inserted in the baby's lungs.

Another option: ventilators that expand the lungs and help the baby breathe. It is possible that if the Torres infant survives, it could come to Georgetown University Hospital, which treats many high-risk babies in the Washington area.

For the first few weeks after birth, Deidre Fitzpatrick visited her baby Liam daily in Georgetown's neonatal care unit. He struggled from small birth weight, difficulty breathing and eating on his own. "Now he looks like a newborn," she said. "He's just grown to look like a normal baby, instead of a skinny old man."

Georgetown University Hospital is one of a number of medical facilities in the United States with highly sophisticated technology and staff able to care for fragile babies. Yet the overall rate of infant mortality in the United States puts it somewhere in the middle of developed countries.

Dr. Siva Subramanian says other countries like Singapore, Japan and Sweden have better rates of infant survival. "We have to do a lot more in terms of prevention, access to care for the pregnant women, removing the barriers that exist, and make sure the best care is available for the women and the infant," he said.

While the United States has a lower infant mortality rate than India, for example, Dr. Subramanian said India has made much progress toward getting more prenatal and newborn care into remote villages. "Reducing the infection in both mothers and the babies has made a tremendous contribution," he said, "in terms of the significant progress that has been made in India in terms of the infant mortality reduction."

As each new medical breakthrough becomes available around the world, there will be more complex questions concerning the ethics of giving, and prolonging life.

Dr. Subramanian believes Jason Torres' decision to keep his wife alive long enough for the birth of his child is wise. "If you're looking in terms of morally, it is the right thing and appropriate thing to do," he said. He says it is certain that complex medical cases like that involving the Torres baby will be more frequent as medical technology evolves.

While each situation will have its own set of ethical and medical issues, one basic principle remains: the best start for any baby is always good prenatal care.

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