An American girl who was born at 27 weeks and weighed only 280 grams has grown into a healthy 14-year-old, according to a report in the New England Journal of Medicine. Although IVF baby Madeline Mann is small for her age -- only 136 cm, compared to an average of 163 cm -- she is in the top 20% academically. "I think her development is a miracle," says the doctor who helped deliver her, Jonathan Muraskas. Other doctors agree. They say that Madeleine's case is a rare exception and that most extremely premature and low birth- weight babies have serious problems -- if they survive at all. According to Nature journalist Helen Pearson, 23 weeks is the threshold of survival and experts feel that this is unlikely to be pushed back.

The happy, if exceptional, outcome for Madeline makes all the more thought-provoking a recent article in the Journal of Medical Ethics which calls for a reform of the UK's abortion law. Dr Robert Boyle, relates the case of a woman whose waters broke at 23 weeks with a high probability that she would deliver at 26 weeks. Since the cut- off point for abortion in the UK is 24 weeks, she had to decide whether to abort the child at 23 weeks or have a possibly disabled child at 25 weeks when doctors would be forced to do all they could to save it. She decided on an abortion. Dr Boyle warns that "a time may come when a woman who miscarries at six weeks will see the foetus resuscitated against her wishes".