BEHIND THE HEADLINES

Sinai's Quints

Hours of planning and practice preceded last week's smooth
delivery of the Wilson quintuplets.

ARTHUR M. HORWITZ

Associate Publisher

A

crisp, white sheet sepa-
rates Mary Jo Wilson's
tired gaze from the
tangle of limbs and life
about to emerge from
her clamped, gaping uterus.
Like magicians pulling rabbits
from a top hat, the latex-gloved hands
of Dr. Alan Goldsmith and Dr.
Michael Salesin disappear into the
red-black darkness, emerging seconds
later with a boy. Gently suctioning his
heaving nostrils of mucous, senior
resident Dr. Susan Sherman passes
him into the blanket-draped arms of
a waiting nurse who whisks him out
of the ,delivery room and into the em-
brace of a neonatological team.
Again, the gloved hands enter
and, voila, another boy, loudly pro-
testing his abrupt removal from cozy
surroundings. Once his nostrils are
suctioned and his umbilical cord
clamped, he, too, is passed into
another set of waiting arms for the
same trip to a second neonatological
team.
Again, the hands go in. This time,
the backside of a girl emerges, follow-
ed by arms, legs, a hair-capped head
and a lusty cry.
And again.
And again.
Finally, the hands of the magi-
cians rest. In less than three minutes,
five births. No time for hocus-pocus.
For Mary Jo Wilson and husband
Bill, the birth of their quintuplets on
Jan. 5 ended 31 weeks on an emo-
tional roller coaster — joy and excite-
ment one moment and trepidation the
next. For Sinai Hospital of Detroit,
it's the culmination of weeks of inten-
sive planning. And for Drs. Goldsmith
and Salesin, it concludes a drama for
life that started last spring with ef-
forts to coax Mary Jo Wilson's
reproductive organs into producing
ovum ripe for fertilization.

T

26

he Wilsons first sought assist-
ance from Dr. Salesin and
Dr. Goldsmith in 1984. Follow-

FRIDAY, JANUARY 13, 1989

ing a review of her medical records
and their own evaluation, the doctors
decided to utilize fertility drugs.
"We induced a cycle with Perganol
(a follicle-stimulating hormone) and
she didn't get pregnant," Dr.
Goldsmith recalled. "Then, the next
month, there was some sort of re-
bound or stimulatory effect on her
own body and she came in pregnant."
Dr. Goldsmith delivered Brad
Wilson by Caesarean section in June
of 1986.
When the Wilsons' newest at-
tempts to conceive failed, Dr. Salesin
and Dr. Goldsmith used Perganol for
one cycle. If Mrs. Wilson didn't
become pregnant, they would wait a
month or two for any stimulatory ef-
fect before trying again.
"When we followed her
throughout the Perganol — there is a
particular regimen and protocol for
this drug — she had basically the
same estrogen values as the first
month two years ago, and they were
not significantly high," Dr. Goldsmith
said. "We induced ovulation with
hCG (human chrionic gonadotropin)
and she came in, obviously, preg-
nant!'
At that time, Drs. Salesin and
Goldsmith didn't know just how preg-
nant Mrs. Wilson was.
An ultrasound revealed a multi-
ple pregnancy which, according to Dr.
David Schwartz, chairman of Sinai's
Department of Obstetrics and
Gynecology and director of maternal-
fetal medicine, occurs in 6 to 30 per-
cent of cases where a regimen similar
to that followed by Drs. Salesin and
Goldsmith is undertaken.
"We originally thought there
were six, but then we lost one sac
after a week," Dr. Goldsmith said.
"Throughout all this, Mary Jo knew
the risks and benefits of taking the
drug and when we had an accurate
ultrasound on the number of children,
we sat with her and had a long, long
discussion and ongoing discussions

Dr. Alan Goldsmith, center, and a neonatal team check Baby A.