Case Study : Samuel Armas

Photos snapped during a risky surgery on a 21-week-old fetus, gave evidence that the child in the womb is a living human being. Samuel Armas shows no signs of hydrocephalus, a common complication of spina bifida. His mother, Julie Armas, started to pray for a miracle as soon as the ultrasound technician told her he had spotted the telltale anomaly in her baby's brain.

Baby Samuel had been diagnosed with spina bifida, a devastating defect in which the developing fetus' backbone and spinal canal fail to close. The defect causes disabilities including paralysis of the legs, incontinence, learning problems and hydrocephalus, the accumulation of water on the brain. Still too small and fragile to survive outside his mother's womb, Samuel underwent a risky and unproven procedure on 19 August 1999. The operation was performed by a surgical team in Vanderbilt University in Nashville. Samuel was the 54th fetus to be operated on by the surgical team.

Because he was so young, Samuel could not survive outside his mother's womb. During the procedure, surgeons remove the uterus from the mother, drain the amniotic fluid, perform surgery on the tiny fetus, replace everything and put the entire package back inside the mother. The procedure on Samuel took about an hour.

In the picture, Samuel's hand looked like that of any newborn baby -- "except it was a much smaller baby. It was what people wouldn't consider viable." At 21 weeks, a fetus cannot yet survive outside the womb, but its organs are completely formed and "it looks like a tiny human," says Dr. Bruner. Just as surgeon Bruner was closing the incision in the uterus, Samuel's thumbnail-sized hand flopped out. The surgeon lifted it gently and tucked it back in.

Although just barely bigger than his 5-pound, 11-ounce birth weight, Samuel started physiotherapy for his legs. His parents were much comforted when a specialist examined him days after his birth and pronounced, without prompting, that their boy would walk.

Samuel, age 5, with his baby brother Zachary

Samuel, age 7, with his mother, father and younger brother