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Another Septuplet Birth: What Are the Risks?

An unidentified mother gave birth to the second surviving set of septuplets in the US last Thursday evening at the Georgetown University Hospital in Washington, DC.

The septuplets--five boys and two girls--were delivered between 11:25 and 11:28 Thursday night at Georgetown University Hospital. The infants were placed in the hospital's Neonatal Intensive Care Unit (NICU). The mother, who at this time has requested anonymity, is in good condition.

This was a team event: There were approximately 50 members of the Georgetown medical staff involved in the process. Twenty-five worked on the labor and delivery and an additional 25 in neonatal care. According to the hospital press release, "Three doctors, eleven nurses and one clinical technician delivered the septuplets by cesarean section. The births took place over three minutes and combined the efforts of 25 medical professionals who are experts in the care of high-risk mothers and premature infants. Each baby was assigned a 'medical swat team' comprised of a neonatologist, nurse, neonatal fellow, pediatric resident, neonatal nurse practitioner and respiratory therapist who stabilized the infants in the first moments of life."

Doctors did confirm that the mother received some sort of fertility treatment that resulted in these multiple births--though they would not specify exactly which approach or drugs were used. On Friday, the mother's personal physician, Dr. Mutahar Fauzia--who previous to this was not affiliated with Georgetown--said that when she informed the parents that they were expecting seven babies they felt "fear and hope together." She added that although she presented all their medical options, the mother would not consider taking steps to terminate any of the fetuses because as a Muslim she does not believe in that.

As the pregnancy progressed, Dr. Fauzia sought the help of Georgetown. The mother was on bedrest at home and then entered the hospital a month ago. The babies were born at 28_ weeks. A full-term pregnancy generally is approximately 40 weeks.

The septuplets face an uncertain future as far as their health and development are concerned. Dr. Emily Senay talked with the Early Show about the types of risks typically associated with multiple births.

Judging from what we heard from their doctors, how are these babies doing compared to some of the high multiple births we've seen in the past?

This is still somewhat uncharted territory. The best example we have right now is the famed McCaughey septuplets, who were born in 1997 in Iowa. The McCaughey's were about 10 weeks premature. The Washington babies were 12 weeks premature. And the infants were on average around the same birth weight as the Iowa babies. Three of the seven McCaugheys are facing health and developmental problems, which they could have for life. Whether or not these infants will face similar difficulties remains to be seen. It's much too early to tell. They are stil not out of the woods yet. The first days are critical, and they will need constant monitoring until their basic functions stabilize.

How can these multiple births be avoided?

Well, these high multiple births are almost always the result of the use of fertility drugs--where a woman's ovaries are stimulated to produce eggs and then inseminated by the father. But careful monitoring of the ovaries is required to make sure that there are not too many eggs produced at one time. If there are too many eggs, insemination should really be delayed to avoid a chance of a high multiple births.

Are their any other options available to parents who find themselves expecting a high number of births?

One controversial option is selective reduction of some of the fetuses to allow greater chance of survival for those remaining, but the parents in Washington last week were opposed to that option on religious grounds. But it's a hard decision either way. Not only ar their huge risks for the babies, the risks are also much greater to the mother with these pregnancies.
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