Embryo Project Encyclopedia

In 1949, Priscilla White published Pregnancy Complicating Diabetes, which described the results and implications of a fifteen-year study about pregnant diabetic women. Published in the American Journal of Medicine, the article details possible causes of and ways to prevent the high fetal mortality rate associated with pregnant diabetic women. Diabetes is a disease in which the body's ability to produce or respond to the hormone insulin is impaired, and it can be particularly dangerous during pregnancies. In her article, White reported that prematurely delivering infants for diabetic pregnant women reduces infant and maternal mortality rates. Pregnancy Complicating Diabetes helped make premature delivery of infants the standard of care for diabetic pregnant women, and it has contributed to the increased survival rate of infants born from diabetic mothers from less than fifty percent in the 1940s to over ninety percent in 2017.

In 1986, Vern L. Katz, Deborah J. Dotters, and William Droegemueller published “Perimortem Cesarean Delivery,” an article in which they developed the Four Minute Rule for perimortem cesarean sections. The Four Minute Rule states that if a pregnant woman’s heart stops beating, physicians should begin an operation to deliver the fetus within four minutes and aim to have the fetus delivered within five minutes of cardiac arrest. Although cardiac arrest during pregnancy is uncommon, it can happen when pregnant women experience trauma, blood clots, infection, or have preexisting heart conditions. In the article, the authors emphasize how the Four Minute Rule increased maternal and fetal survival rates and decreased cases of severe fetal brain damage. The article “Perimortem Cesarean Delivery” was the first article to present the Four Minute Rule, which has influenced international guidelines and become the standard for maternal resuscitation and fetal survival in emergency medicine, operating rooms, and many other aspects of medical practice.

In 2012, a team of scientists across the US conducted an experiment to find the mechanism that allowed a group of flatworms, planarians, to regenerate any body part. The group included Danielle Wenemoser, Sylvain Lapan, Alex Wilkinson, George Bell, and Peter Reddien. They aimed to identify genes that are expressed by planarians in response to wounds that initiated a regenerative mechanism. The researchers determined several genes as important for tissue regeneration. The investigation helped scientists explain how regeneration is initiated and describe the overall regenerative mechanism of whole organisms.

Regeneration is a fascinating phenomenon. The fact that many organisms have the capacity to regenerate lost parts and even remake complete copies of themselves is difficult to fathom; so difficult, in fact, that for a very long time people were reluctant to believe regeneration actually took place. It seemed unbelievable that some organisms could re-grow lost limbs, organs, and other body parts. If only we could do the same! Unfortunately, our regenerative capacities are limited to hair, nails, and skin, while the liver and a few other tissues display more restricted regenerative abilities. What if we could grow back lost limbs, or damaged organs? This question has inspired many stories, dating back to Greek mythology, wherein Prometheus was doomed to regenerate his liver after it had been devoured by birds. Regeneration has permeated many imaginations; it has appeared in many literary and religious texts, and has also provoked much interest from the scientific community.

In July 2015, Ana J. Torvie, Lisa S. Callegari, Melissa A. Schiff, and Katherine E. Debiec published “Labor and Delivery Outcomes Among Young Adolescents,” hereafter “Labor and Delivery Outcomes,” in the American Journal for Obstetrics and Gynecology. The authors conducted a study using birth certificate data and hospital records in the state of Washington to compare the frequency and outcomes of cesarean and surgically assisted vaginal births among different age groups of pregnant people. They found that adolescents aged eleven to fourteen years are less likely to require cesarean or surgically assisted births but that their neonates were more likely to have birth-related complications than those of adults aged twenty to twenty-four years. While previous studies had yielded conflicting results, “Labor and Delivery Outcomes” reports generalized trends about young adolescents in labor and delivery. The researchers’ findings support future physicians in making more informed considerations for the care of pregnant patients under the age of fifteen.

Edward Donnall Thomas, an American physician and scientist, gained recognition in the scientific community for conducting the first bone marrow transplant, a pioneering form of hematopoietic stem cell transplantation (HSCT). Bone marrow transplants are considered to be the first successful example of tissue engineering, a field within regenerative medicine that uses hematopoietic stem cells (HSCs) as a vehicle for treatment. Prior to Thomas's groundbreaking work, most blood-borne diseases, including certain inherited and autoimmune diseases, were considered lethal.

The gradient theory is recognized as Charles Manning Child's most significant scientific contribution. Gradients brought together Child's interest in development and his fascination with the origins of individuality and organization. The gradient theory grew from his studies of regeneration, which were largely based on work he conducted with marine invertebrates, such as the ascidian flat worm, planaria and the hydroid, tubularia. Child observed that regeneration occurred in a graded process along the axis of the organism, with the characteristics of each physiological process seemingly determined by its location along the axis. To explain these observations, Child posited the existence of physiological factors working to guide the regenerative process. He was convinced that these differences along the gradients could be explained quantitatively.

In 2010, the Catholic Church excommunicated Margaret McBride, a nun and ethics board member at St. Joseph’s Hospital and Medical Center in Phoenix, Arizona. McBride was excommunicated latae sententiae, or automatically, for approving a therapeutic abortion, which is an abortion that is required to save a pregnant woman’s life. McBride approved an abortion for a woman who was twenty-seven years old, eleven weeks pregnant with her fifth child, and suffered from pulmonary hypertension, a life-threatening condition during pregnancy. Following McBride’s decision, St. Joseph’s lost its affiliation with the Catholic Church, which it had maintained since the late 1800s. Affiliation with the Catholic Church required that the hospital abide by Canon Law, which is the law of the Catholic Church. Under Canon Law, abortion is serious wrongdoing that could result in excommunication, as it did in the case of McBride. McBride’s excommunication illustrated the impact that affiliation of Catholicism with hospitals had on patients’ ability to receive comprehensive reproductive health care.

In December 2011, the Stillbirth Collaborative Research Network, or SCRN, published the article “Causes of Death Among Stillbirths” in The Journal of the American Medical Association. The authors of the article investigate the causes of stillbirth and possible reasons for the racial, ethnic, and geographic disparities in stillbirth rates. According to the Centers for Disease Control and Prevention, or CDC, stillbirth is the death of a fetus at twenty or more weeks during pregnancy. “Causes of Death Among Stillbirths” explores the common causes of stillbirth in different racial and ethnic groups, and provides a framework for future research into medical interventions to help reduce racial and ethnic stillbirth disparity.

In April 1994, Elizabeth Raymond, Sven Cnattingius, and John Kiely published “Effects of Maternal Age, Parity, and Smoking on the Risk of Stillbirth” in the British Journal of Obstetrics and Gynecology, now known as BJOG: An International Journal of Obstetrics and Gynecology. The article examines how advanced maternal age, defined as delivery at thirty-five years old or older, cigarette smoking, and nulliparity, or the state of never having given birth, can negatively impact pregnancy. At the time of publication, according to Raymond and colleagues, stillbirths comprised over half of all perinatal, or close to birth, deaths and more than one-third of total fetal and infant deaths in Europe and North America. In the article, Raymond and her coauthors demonstrate how certain risk factors may increase the risk of stillbirth at different stages of pregnancy, which helped set a foundation for future research in interventions to prevent stillbirth.