Embryo Project Encyclopedia Articles

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.

From 1993 to 1995 researchers led by Robert J. Berry from the US Centers for Disease Control headquartered in Atlanta, Georgia, and Zhu Li from Beijing Medical University in Beijing, China, conducted a collaborative study in China on the prevention of neural tube defects or NTDs using folic acid supplements. NTDs are birth defects in which openings in the spinal cord or the brain that occur during early development remain after birth. Neural-tube formation occurs in early pregnancy, often before a woman knows she is pregnant and therefore before she has begun taking prenatal vitamins. The researchers presented their findings in the article “Prevention of the Neural Tube Defects with Folic Acid in China” published in 1999 in The New England Journal of Medicine. The researchers from The China-US study found that women who took folic acid in the periconceptional period, or the time before conception through the first twenty-eight days after conception, reduced the occurrence of NTDs.