MELISSA BLOCK, host:
A woman who was declared brain-dead and spent three months on life support gave birth to a 1 pound, 13 ounce baby girl yesterday at a hospital in Arlington, Virginia. Doctors say the baby is in very good condition, considering she was born at 27 weeks. The mother, Susan Torres, was 26 years old. This morning she was taken off life support and died. Her brother-in-law, Justin Torres, read a statement from the family.
Mr. JUSTIN TORRES (Brother-in-Law): (Reading) `This is obviously a bittersweet time for our family. We are overjoyed at the birth of baby Susan and deeply grieved at the loss of her mother. From the beginning, we knew that two things would get us through to the baby's birth: God's providence and Susan's determination. Susan was always the toughest person in that ICU room. Her passing is a testament to the truth that human life is a gift from God and that children are always to be fought for, even if life requires, as it did of Susan, the last full measure of devotion.'
BLOCK: Susan Torres was 15 weeks pregnant when she suddenly lost consciousness and stopped breathing. Doctors discovered she had melanoma that had spread through her body and caused a brain hemorrhage. The three months she spent on life support were a race against the clock for the fetus to reach a point of viability before the cancer spread to the placenta.
For thoughts on this exceptional case, we called Dr. Frank Chervenak, director of maternal fetal medicine at New York-Presbyterian Hospital. He's co-author of the book "Ethics in Obstetrics and Gynecology."
Dr. FRANK CHERVENAK (Director of Maternal Fetal Medicine, New York-Presbyterian Hospital; Co-author, "Ethics in Obstetrics and Gynecology"): One of the greatest challenge in obstetrics, to put in very simple terms, is balancing taking the baby out and leaving the baby in. It sounds very simple, but it's much, much more complex than this. I think the doctor should be congratulated who managed this case. In this particular case, it was a very delicate balancing because every day they kept the baby inside the mother, the baby was growing and was maturing. On the other hand, you want to minimize any dangers from a mother whose condition was deteriorating. So this was a very delicate balancing, and I think the doctor should be congratulated for doing this balancing very well in a difficult case.
BLOCK: And in the case of Susan Torres--and she did have advanced malignant melanoma--the fear there would have been that that could have crossed through the placenta and affected the fetus as well?
Dr. CHERVENAK: That is a possibility, yes.
BLOCK: Dr. Chervenak, you write about ethical issues in obstetric. Are there ethical questions raised by this case, do you think, or is this really just one positive outcome of what was a very tragic story?
Dr. CHERVENAK: Well, yes, there are ethical dimensions. The good news is there was no ethical conflict here in that if we put in ethical terms, the ethical principle of beneficence means to do the best you can for the patients. And in this case, you have two patients. You have the mother and the fetal patient. You have to balance among these. In this case, clearly, the mother did not have a prognosis. So it was just the medical interest of the fetal patient. This had to be balanced against what we term, in ethical terms--is respect for maternal autonomy, what the pregnant woman would want. So in this particular case, it was clear the woman wanted everything done to optimize the outcome for the child. So what medicine had to do was very straightforward to do everything that could be done.
BLOCK: Would there be any way of knowing, at this point, the long-term prognosis for this baby, 1 pound, 13 ounces, born at 27 weeks?
Dr. CHERVENAK: Well, 1 pound, 13 ounces sounds small, and it is small. However, neonatology has advanced greatly during the past 10, 20 years. As you remember, JFK had a child that was lost that was much bigger than this because of immaturity. But today there have been such advances in the science that at 1 pound, 13 ounces, there's still a risk of serious morbidity, but the probability is this child will do very well in all respects.
BLOCK: Dr. Chervenak, thanks for talking with us today.
Dr. CHERVENAK: Thank you.
BLOCK: Dr. Frank Chervenak is director of maternal fetal medicine at New York-Presbyterian Hospital. The baby, delivered by cesarean section yesterday at Virginia Hospital Center, is named Susan Anne Catherine Torres after her mother.
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