The Eighties in America - Salem Press (2009)

tal surgery in the United States on a fetus with uri-
nary tract obstruction, facilitating the flow of fetal
urine from the bladder into the amniotic sac.
Ultrasound imaging also facilitated antenatal di-
agnosis of hydrocephalus, a buildup of cerebro-
spinal fluid (CSF) within the skull that can lead to
mental retardation. In the second fetal surgery con-
ducted in the United States, William Clewell and his
colleagues placed a drain in a fetus with hydrocepha-
lus, thus allowing the CSF to empty into the amniotic
cavity.
Congenital diaphragmatic hernia (CDH) repre-
sents a defect in a fetus’s diaphragm that leads to en-
try of abdominal contents such as intestine, spleen,
or liver into the chest cavity. This malformation im-
pairs good lung growth and is associated with a high
mortality rate. The first repair of CDH in a fetus oc-
curred in 1983. Other fetal surgeries performed in
the 1980’s included removal of large spinal tumors
(sacrococcygeal teratomas) and resection of large
lung masses (congenital cystic adenomatoid malfor-
mation).
Identical twin pregnancies can be complicated by
twin-twin transfusion syndrome (TTTS). In such
cases, one twin will be very anemic while the other
twin is overwhelmed by excessive blood flow. Such a
condition can lead to the death of both fetuses. The
cause of TTTS appears to be an imbalance of blood
flow due to communicating blood vessels in the pla-
centa. In 1988, Julian De Lia, with the help of laser
therapy, was able to interrupt these vascular commu-
nications to treat TTTS effectively.

Impact During the 1980’s, the improved ability to
detect a fetus in distress led to a dramatic decline
in perinatal mortality. Routine screening of multi-
ple biochemical markers allowed early identifica-
tion of genetic disorders and brought issues such as
termination versus continuation of pregnancy to the
forefront of public consciousness. The ability to
transfuse a fetus greatly improved the survival of
Rhesus-sensitized babies. Even though the media
enthusiastically reported stories about “miracle” ba-
bies, however, only about 35 percent of fetuses actu-
ally survived surgery, and little is known about the
quality of life of those that lived. Moreover, although
medicine’s ability to provide health care for the un-
born seemed almost limitless, adequate prenatal
care was not universal, and fetal intervention was
limited to a select few. These rapid advances in fetal

medicine allowed unborn children to acquire the

status of patients in themselves.

Further Reading

Brunner, Joseph. “In Their Footsteps: A Brief His-

tory of Maternal-Fetal Surgery.”Clinics in Perina-

tology30, no. 3 (September, 2003): 439-447. Intro-

duces four pioneers of fetal surgery and their

accomplishments.

Caspar, Monica, ed. “Fetal Matters.” InThe Making of

the Unborn Patient. New Brunswick, N.J.: Rutgers

University Press, 1998. Critical analysis of fetal

surgery; discusses low success rates, risks to moth-

ers, and ethical issues.

Manning, F. A. “Reflections on Future Directions of

Perinatal Medicine.”Seminars in Perinatology13,

no. 4 (August, 1989): 342-351. Reports the impact

high-resolution ultrasound had on the rapid de-

velopment of maternal-fetal medicine.

Scioscia, Angela. “Prenatal Genetic Diagnosis.” In

Maternal-Fetal Medicine, edited by Robert Creasy

and Robert Resnik. Philadelphia: W. B. Saunders,

1999. Description of biochemical markers used to
      detect fetal anomalies.
      Elisabeth Faase

See also Abortion; Baby Fae heart transplanta-

tion; Genetics research; Health care in Canada;

Health care in the United States; Health mainte-

nance organizations (HMOs); Medicine; Transplan-

tation; Women’s rights.

Film in Canada

Definition Motion pictures produced by

Canadians and distributed in Canada

After the system of tax breaks for companies making films in

Canada underwent changes during the early 1980’s, the

Canadian film industr y suffered a brief slump, and some

promising directors left Canada for Hollywood. The indus-

tr y made a comeback in the later half of the decade, however:

Several major independent and art-house directors filmed

in Canada, and some American studio productions shot

there as well in order to save money.

Beginning in the mid-1970’s, Canada offered lucra-

tive tax breaks to production companies filming in

Canada, allowing people who invested in Canadian

feature films to deduct 100 percent of their invest-

The Eighties in America Film in Canada
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