European Stars And Stripes (Newspaper) - October 27, 1986, Darmstadt, Hesse                                Fetus returned to womb after by Sandra Blakeslee new York times in a pioneering operation a team of  rom overt a 23-Weok-old Letus from his Mother s womb successfully operated to Correct blocked urinary tract and then returned the unborn baby to the Tucius and sewed the womb Back up nine weeks later. Baby Mil chill was born alive and Well at a Texas Hospital near ins parents Home in october a Tew weeks alter his first birthday. Mitchell was Back in san Francisco Lor minor surgery that completed repairs on his urinary a act according to or Michnar r Harrison paediatric surgeon from the University of California at san Francisco who led the learn. Mitchell would have died in the uterus without surgery today he s doing Linn said Harrison he May have some kidney problems in the Buluro but i m confident he do of " experts say Mitchell s operation is a dramatic Milestone in the controversial now Field of Telal therapy and fell surgery. The surgery was remarkable for having removed the child irom the womb but a also occurred against a backdrop to which Here is growing excitement and significant qualms Over the possibilities of fetal surgery. Only in recent years have other techniques been developed in which Lor example doctors use Long noodles to install Shunis to Drain excess fluid from in lands bladders or brains baby Mitchell s successful operation is a remarkable in cynical achievement said or. Frederic Frigoletto. Professor of obstetrics and gynaecology at Harvard University and chief of maternal and fetal Medicine at Brigham and women s Hospital in Boston Bui. He added much More needs to be Learned about How to determine which fetuses will Benefit from surgical inner Verlion and which will not. The safely and Efficacy of Lelal surgery Are not proven he said. Naw Yogi tilt i Phola the overriding question is. Are you really doing any Good Wilh these therapies said or. John c. Flelcher. Chief of Tho bioethics program n the clinical censer of the National institutes of health in by Thesda. My. Ii is time to Bilo the Bullet and do a properly controlled clinical trial on the use of Shunis said Flelcher who said he spoke Lor himself and not Nih according to experts in Bio civics and Law. If fetal treatment Ever does become routine it will join a Lisl of controversial social issues such As regulations Tor the Ireat men of handicapped infants court of dared caesarean operations on women unwilling to have them and the rights of Frozen embryos whose parents have died. This is essentially an uncharted area where the Basic values of maternal autonomy and of fetal welfare May come into  said George j. Annas a professor of health Law at Boston University school of Public he allot. Fetal surgery is a now medical Field being pioneered a1 13 centers in live countries according to or. Frank Manning director of an International fetal treatment registry at women s Hospital in Winnipeg Canada. Manning said baby Mitchell was Iho third infant treated since 1932 with open surgery All fit Harrison s group in san Francisco. Two other be lusts with blocked urinary tracts were Given bladder Shunis Hal were sewn into place. One died at birth because the procedure had been performed Loo Lale to proven i lung and kidney damage the other lived for about six months but died of complications of another birth defect but Mitchell is thriving in his Case a Hole was surgically created in his Abdomen through which his bladder could Drain. Manning said 124 other fetus of have been Given shunts Lille lubes about the Sie of dry Spaghetti placed by Way of a Catheter Mlo fetal bladders and brains to Drain away fluids in addition new thoracic arc developing to medically Ireal lotuses by giving Mol inns drugs vitamins hormones or special diets to Cor incl a specific defect in her  fetuses have been Given therapy in the form of blood transfusions since the Early 1960s, newer therapies Are driving physicians As never before to View the unborn child As a Futi find cd patient. There arc two the mss in Medicine that have brought us to think about the fetus As a pal enl Harrison said in a recent interview. One came irom people like me who Lake care of babies after birth to took at them and realize we re too  if the problem could be lined earlier he said some babies could be saved. The second thrust came from advances in detection. Using the non invasive imaging technique of ultrasound. Harrison said people have become incredibly Slick Al seeing fetuses and at diagnosing fetal  birth defects can now to detected after just nine or 10 weeks of pregnancy. Prenatal diagnosis which has prompted controversy because in can Lead to elective Burlion was never meant to be merely a search and destroy Mission. Harrison said. Diagnosis can now make fetal therapy possible. Eight years ago Harrison Wilh his colleagues or. Roy a. Filly and or. Mitchell s. Golbus. Formed a fetal treatment program that led first to extensive animal experiments with open total surgery techniques. We asked ourselves what diseases would be amenable to  Harrison said and found Hal each Falls along a spectrum. At one end is the doomed  the other end is the fetus who has problems but we know from experience it will be All right. Most birth defects in fact Are Best created after birth in Between Are conditions that Call lot Active management of the pregnancy sometimes babies Are delivered prematurely by caesarean Section Harrison said because defects produce on going trouble and the longer the fetus stays in the womb the worse off it  some anatomic malformations if severe enough will destroy an Organ system such As the kidneys brain lungs or heart before an induced Early delivery is possible. We can now in some cases prevent that Mal development by surgical intervention either Shunis of open surgery. Harrison said. Three conditions that All along such a spectrum and that might in carefully selected cases be surgically corrected Are hydrocephalus or water on the  a i Page 14 the stars and stripes