Embryo Project Encyclopedia

Jesse Bennett, sometimes spelled Bennet, practiced medicine in the US during the late eighteenth century and performed one of the first successful cesarean operations, later called cesarean sections, in 1794. Following complications during his wife’s childbirth, Bennett made an incision through her lower abdomen and uterus to deliver their infant. Bennett’s biographers report that his operation was the first cesarean section where both the pregnant woman and the infant survived. Previously, physicians used cesarean sections to save the fetus from a pregnant woman who had already died during childbirth. Bennett successfully performed a cesarean section, a procedure used worldwide in the twenty-first century when a vaginal delivery is not possible or would pose a risk to the woman or fetus.

In 1616 in Padua, Italy, Fortunio Liceti, a professor of natural philosophy and medicine, wrote and published the first edition of De Monstruorum Causis, Natura et Differentiis (On the Reasons, Nature, and Differences of Monsters), hereafter De monstruorum. In De monstruorum, Liceti chronologically documented cases of human and animal monsters from antiquity to the seventeenth century. During the seventeenth century, many people considered such monsters as frightening signs of evil cursed by spiritual or supernatural entities. Liceti categorized monsters based on their potential causes, several of which he claimed were unrelated to the supernatural. Historians later noted that some documented monsters were infants with birth defects. In De monstruorum, Liceti elevated the status of monsters to potential subjects of scientific inquiry and provided an early model for the study of birth defects, a field later called teratology.

In 1953, Virginia Apgar published the article "A Proposal for a New Method for Evaluation of the Newborn Infant" about her method for scoring newborn infants directly after birth to assess their health and whether medical intervention was necessary. Apgar worked at the Presbyterian Hospital in New York City, New York, as an obstetrical anesthesiologist, a physician who administers pain medication during childbirth. In that capacity, she sought to reestablish clear scoring guidelines for newborn infants so that she could compare which obstetric practices, pain relief methods, and resuscitation methods worked the best during and after childbirth. She published her article in Current Researches in Anesthesia and Analgesia in 1953, and the Apgar scoring system is still used in hospitals around the world as of 2016. In the article, Apgar establishes a scoring system for newborn infants that allows for quick assessment of their health directly after birth and therefore swift intervention by medical personnel to promote healthy development.

Walter Edward Dandy studied abnormalities in the developing human brain in the United States in the twentieth century. He collaborated with pediatrician Kenneth Blackfan to provide the first clinical description of Dandy-Walker Syndrome, a congenital brain malformation in which the medial part of the brain, called the cerebellar vermis, is absent. Dandy also described the circulation of cerebral spinal fluid, the clear, watery fluid that surrounds and cushions the brain and spinal cord. That description led Dandy to examine how the impeded flow of cerebral spinal fluid caused congenital hydrocephalus, which occurs when fluid accumulates in the brain causes it to swell. Dandy discovered brain anomalies that primarily develop during embryonic development, and his work helped to detect brain abnormalities.

In 2004 Mark Landon and his colleagues in the United States published “Maternal and Perinatal Outcomes Associated with a Trial of Labor after Prior Cesarean Delivery,” which compared the risks of vaginal delivery and cesarean section for delivery of a fetus after a previous cesarean delivery. During a cesarean section, a physician surgically removes a fetus from a pregnant woman through an incision in her abdomen. By the late 1900s, most clinical guidelines viewed attempting a vaginal birth after a previous cesarean delivery as a reasonable option for most women. Yet, physicians often noticed an increased risk of uterine ruptures as more patients underwent vaginal deliveries following previous cesarean sections. As such, many physicians continued to recommend cesarean deliveries for women who had a past cesarean section. Landon and his team evaluated the risks of both delivery methods and published their results in the New England Journal of Medicine in 2004. In “Maternal and Perinatal Outcomes,” the authors found that there was no significant difference between the risks of vaginal birth after cesarean and repeat cesarean sections, providing more evidence for clinical guidelines recommending vaginal births after cesarean sections.

In the May 1996 edition of The Annals of Surgery, John A. Morris and his collaborators published “Infant Survival After Cesarean Section for Trauma,” in which they evaluate the use of emergency cesarean sections for the treatment of pregnant trauma patients. During a cesarean section, a physician removes a fetus from a pregnant woman through an incision in her abdomen and uterus. When a pregnant woman experiences trauma, physicians can perform an emergency cesarean section to remove the fetus and administer medical treatments that would not be possible while the woman is pregnant. In their article, Morris and his colleagues examine the fetal outcomes following emergency cesarean sections to determine when the procedure should be used in a trauma setting. The authors support the use of emergency cesarean sections in trauma patients when those patients demonstrate high degrees of maternal and fetal distress. Morris and his team’s article is one of the first to focus on how trauma affects third trimester pregnancies and to develop an algorithm to help physicians treat those patients.

Fortunio Liceti studied natural philosophy and medicine in Italy during the first half of the seventeenth century. Liceti wrote greater than seventy works on a wide range of topics, including the human soul, reproduction, and birth defects observed in animals and human infants. In the seventeenth century, people commonly addressed birth defects using superstition and considered them as signs of evil, possibly caused by spiritual or supernatural entities. Liceti described infants with birth defects as prodigies and monsters to be admired and studied rather than feared. Liceti’s works established monsters as a possible subject of scientific inquiry and served as models for the future study of birth defects, a field later called teratology. Liceti was one of the first scholars to attempt to systematically categorize birth defects based on their causes, including multiple causes unrelated to the supernatural.

Fetus in fetu is a rare variety of parasitic twins , where the developmentally abnormal parasitic twin is completely encapsulated within the torso of the otherwise normally developed host twin. In the late eighteenth century, German anatomist Johann Friedrich Meckel was the first to described fetus in fetu, which translates to “fetus within fetus.” Fetus in fetu is thought to result from the unequal division of the totipotent inner cell mass , the mass of cells that is the ancestral precursor to all cells in the body. The unequal division is thought to occur during the formation of the blastocyst, which can also result in parasitic and conjoined twins . Fetus in fetu represents a developmental anomaly that has prompted developmental biologists to further examine the mechanisms for how twins arise.

In 1996, Michael R. Harrison published “Fetal Surgery” in the American Journal of Obstetrics and Gynecology. In the article, Harrison describes the importance of fetal surgery and the techniques used to correct defects in fetuses. As a fetus develops in the uterus, it can develop abnormalities that may become debilitating or fatal. Harrison discusses cases that show how physicians can use fetal surgery to repair such abnormalities, including obstructions in the heart or urinary tract, or organs or muscles whose malformations impair function. Harrison states where knowledge is lacking within the field or where surgery would be inappropriate, such as in the modification of a cleft lip, which can be fixed after birth and as such does not merit the risks of surgery. In the article, Harrison provides a summary of what information existed about fetal surgeries in 1996, which helped physicians explore fetal surgery and make further advancements.

Rh incompatibility occurs when a pregnant woman whose blood type is Rh-negative is exposed to Rh-positive blood from her fetus, leading to the mother s development of Rh antibodies. These antibodies have the potential to cross the placenta and attach to fetal red blood cells, resulting in hemolysis, or destruction of the fetus 's red blood cells. This causes the fetus to become anemic, which can lead to hemolytic disease of the newborn. In severe cases, an intrauterine blood transfusion for the fetus may be required to correct the anemia.