Infertile mother has 'miracle' baby: Celia Hall reports on the work of a hospital that staff fear could be destroyed under plans to rationalise the capital's health care

A BABY has been born in a London hospital to a mother made infertile by radiotherapy for leukaemia. Doctors believe it is the first time a couple has been able to have a child after such treatment.

Matilda was born five weeks ago at the Hammersmith Hospital in west London. Her mother, Joana, was diagnosed with leukaemia when she was 22, just over five years ago. Her treatment involved total body irradiation - making her infertile - and then a bone marrow transplant.

The baby was conceived last June from an embryo, which had been stored for four years waiting for Joana to be cured.

Even when the family seemed to be home and dry and following an uneventful pregnancy, Matilda was born six weeks prematurely after an emergency Caesarean operation when her mother's blood pressure soared threatening both their lives. The baby spent the first 10 days of her life in an incubator.

Joana, who has asked for her surname not to be used, says she has the baby today because of her own faith, the skill and kindness of doctors and the support of her family.

The story began when Joana and her husband, Francisco, both from Lisbon, Portugal, were expecting their first child, Veronica, now aged five.

A routine antenatal blood test revealed that Joana had myeloid leukaemia. It was in the chronic rather than the acute, malignant, phase which meant she had no symptoms. Because of her pregnancy, her haematologist in Lisbon referred her to Professor John Goldman, director of the Adult Leukaemia Centre, at the Hammersmith for a second opinion.

Joana did not take anti-cancer drugs because of her pregnancy but had regular blood and platelet transfusions for her leukaemia. During the pregnancy her doctors in London planned her bone marrow transplant, which would use a donation of bone marrow from one of her sisters, for as soon as she had recovered from the birth.

But knowing of the couple's desire for another child they suggested that they collect her eggs, fertilise them with her husband's sperm and store them. The couple was referred to Professor Robert Winston, head of the hospital's in- vitro fertilisation unit. Thirteen embryos were stored.

'I had the bone marrow transplant in October 1989. It was a pretty horrible time . . . and it was about two years before I felt OK again,' Joana said. During this time she also had chemotherapy.

In May 1992, her leukaemia cured she was in London again to start the fertility treatment. But because of her illness and her treatment her womb lining was too thin to sustain a pregnancy and it was decided not to go ahead.

'I went home again and everyone said I should not worry anymore - I had one daughter already. But I thought I would spend the rest of my life thinking I had never tried,' Joana said.

She returned to London in April 1993 'to have one last go'. All her embryos were unfrozen, five survived. The 'best' three were transplanted in June last year. A scan five weeks later showed Joana was pregnant with twins. By the tenth week of her pregnancy one stopped growing and was absorbed by her body, as sometimes happens. Her pregnancy was uneventful until the dramatic rise in her blood pressure at 34 weeks.

Matilda weighed in at 1.9 kilo (4lb 1oz) and spent three weeks in hospital. Part of Joana's treatments were paid for by her government and part from private sources. 'Veronica was a miracle in her own way because of my illness. Matilda really is one,' Joana said.

The Hammersmith Hospital, home of the Royal Postgraduate Medical School, is described as a unique establishment in Britain for the way in which it combines the fruits of academic medical research with patient care. An independent review for the Government last year (Review of Research and Development taking place in the London Postgraduate Special Health Authorities) decribed the 'quality of research planning and management' as the best in London.

Now the Hammersmith faces major disruption under the plans to rationalise London's hospitals, involving a possible merger with Charing Cross Hospital. Staff believe it will destroy the Hammersmith and its work. Tomorrow a campaign begins to preserve it.

(Photograph omitted)

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