Physicians at Georgetown University Hospital in Washington, D.C., on Thursday night delivered the world's third set of septuplets known to survive birth, the Washington Post reports. The team of 50 doctors and nurses delivering the five boys and two girls between 11:25 p.m. and 11:28 p.m. reported that there were "no serious complications" with the three-minute Caesarean delivery. The infants, who range in weight from two pounds to two pounds seven ounces, were delivered about 11 weeks premature of a full-term pregnancy, the Post reports. Because of their "severe prematurity," the babies' internal organs, such as the lungs and intestines, are not fully developed and most of the infants have been placed on respirators. All of the babies are being fed intravenously, and none appear to have suffered birth defects.

'Selective Reduction'
The infants' mother -- who has requested anonymity -- conceived the children through fertility treatments administered by Mutahar Fauzia, an Arlington, Va.-based OB/GYN who specializes in treating infertility. Fauzia stated that she told the parents that one or more of the fetuses might have to be surgically removed during pregnancy -- in a process known as "selective reduction" -- if complications arose that might jeopardize the health of the woman or the fetuses. However, the parents, who are Muslim, said that their religious beliefs "forbade" them from exercising this option. "The patient did not believe in taking the lives of the babies," Fauzia said (Goldstein, Washington Post, 7/14). As of yesterday, five of the septuplets were able to breathe without the aid of a respirator. However, doctors stated that the babies are likely to remain in critical condition for several days (Amon/St. George, Washington Post, 7/16). Siva Subramanian, chief of Georgetown Hospital's neonatology unit, added that the infants could remain in the hospital for up to nine weeks. The Post reports that the long-term outlook for the babies is "unclear," since the death rate for infants between 1.7 and 2.8 pounds -- the range in which all of the children fall -- is about 11%. The death rate for quintuplets and "higher-order" births is about 20% and increases with the size of the birth. Multiple births account for about 2.9% of all live births in the United States, but are responsible for about 16% of all infant deaths "soon after birth" and 15% of all cerebral palsy cases (Goldstein, Washington Post, 7/14).

Reducing Multiple Births
The seven infants are the third known surviving set of septuplets in the world, and their births are likely to "renew a debate" over the use of fertility drugs, the New York Times reports (Stolberg, New York Times, 7/14). Since 1980, the number of births of three or more infants has increased nearly five-fold, and 75% of this increase can be attributed to fertility treatments, Barbara Luke, an epidemiologist at the University of Michigan, said. The Washington Post reports that as fertility treatments continue to rise in popularity, many physicians are examining ways to reduce the number of resulting multiple births. One such method is selective reduction, through which a physician terminates one or more of the fetuses through an injection administered during the first trimester of pregnancy. In nearly all cases, the pregnancy is reduced to a twin gestation, decreasing by about two-thirds the likelihood that a pregnancy will end in miscarriage. Mark Evans, an obstetrician at Philadelphia's MCP Hahnemann University, stated that about 1,000 selective reduction procedures are performed in the United States each year. But John Elliott, director of maternal-fetal medicine at Good Samaritan Regional Medical Center in Phoenix, said that a higher number of fetuses does not necessarily raise the risk of pregnancy-related complications, adding that there is "little difference in long term complications" in quadruplets when compared to twins. "I think the infertility physicians are protecting themselves. They feel responsible that they have gotten the person pregnant with an excessive number of embryos, and that if the patient has a bad outcome they will sort of be held to blame" (Brown, Washington Post, 7/14). A transcript of a discussion with Fauzia on NPR's "All Things Considered" is available online (NPR, "All Things Considered," 7/14).