The amniotic fluid surrounding babies in the womb contains fetal mesenchymal stem cells (MSCs) that can differentiate into many cell types and tissues. More than a decade ago, Dario Fauza, MD, PhD, a surgeon and researcher at Boston Children’s Hospital, proposed using these cells therapeutically. His lab has been exploring these cells’ healing properties ever since.
Replicated in great quantity in the lab and then reinfused into the amniotic fluid in animal models — a reverse amniocentesis if you will — MSCs derived from amniotic fluid have been shown to repair or mitigate congenital defects before birth. In spina bifida, they have induced skin to grow over the exposed spinal cord; in gastroschisis, they have reduced damage to the exposed bowel. Fauza calls this approach Trans-Amniotic Stem Cell Therapy, or TRASCET.
The question comes up when a pregnant woman has a serious medical condition: should she or shouldn’t she be treated? Are the indicated drugs safe for the baby?
Drugs are assigned pregnancy risk classes. Thalidomide, whose reputation for causing fetal malformations was chillingly established in the 1960s, is solidly in Class X (the most risky), as are the cholesterol-lowering drug lovastatin and the anti-coagulant warfarin. At the other extreme are Class A drugs that are widely recognized as safe in pregnancy.
But between these extremes is a huge group of drugs for which little is known. …