Maternity (House)
Encyclopedia
"Maternity" is the fourth episode of the first season of House
House (TV series)
House is an American television medical drama that debuted on the Fox network on November 16, 2004. The show's central character is Dr. Gregory House , an unconventional and misanthropic medical genius who heads a team of diagnosticians at the fictional Princeton-Plainsboro Teaching Hospital in...

, which premiered on the Fox
Fox Broadcasting Company
Fox Broadcasting Company, commonly referred to as Fox Network or simply Fox , is an American commercial broadcasting television network owned by Fox Entertainment Group, part of Rupert Murdoch's News Corporation. Launched on October 9, 1986, Fox was the highest-rated broadcast network in the...

 network on December 7, 2004. A number of newborn babies acquire unknown diseases simultaneously. House and his aides must race against the clock to save them and avoid further spread of the disease.

Plot

In the hospital, the Hartig parents are concerned because their baby girl, Maxine, is spitting up but hasn't eaten anything yet. Baby Maxine suffers a seizure.

House presents Maxine to Wilson as Exhibit A. Exhibit B is Baby Hausen, another newborn who is also ill. House thinks it is a nosocomial infection
Nosocomial infection
A nosocomial infection , also known as a hospital-acquired infection or HAI, is an infection whose development is favoured by a hospital environment, such as one acquired by a patient during a hospital visit or one developing among hospital staff...

, but Cuddy doesn't believe it's the beginning of an epidemic. House tours his team in the maternity ward to check the other newborns in the hospital, and they find one more baby with a sudden fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...

 and similar symptoms. Later, they find another infant who is developing symptoms as well. Cuddy finally realizes the truth of House's prediction and quarantines the maternity ward.

House and crew discuss four sick babies and the symptoms. With a spike in fever and low blood pressure
Blood pressure
Blood pressure is the pressure exerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. When used without further specification, "blood pressure" usually refers to the arterial pressure of the systemic circulation. During each heartbeat, BP varies...

, these children could be dead in one day. The group thinks it might be a bacterial infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...

. Since there's no time to wait for test results, House orders two treatments to be started. Each baby gets an MRI. Nothing shows up on the scan, so the doctors continue administering two antibacterials. One of them starts causing the kidneys to shut down in two of the four babies. House says there's no point in guessing, so they take Baby Hartig off the aztreonam
Aztreonam
Aztreonam is a synthetic monocyclic beta-lactam antibiotic , with the nucleus based on a simpler monobactam isolated from Chromobacterium violaceum. It was approved by the U.S. Food and Drug Administration in 1986...

 medication and Baby Chen-Lupino off the vancomycin
Vancomycin
Vancomycin INN is a glycopeptide antibiotic used in the prophylaxis and treatment of infections caused by Gram-positive bacteria. It has traditionally been reserved as a drug of "last resort", used only after treatment with other antibiotics had failed, although the emergence of...

, deciding which baby will get which drug with a coin toss.

Dr. Cuddy and a hospital administration refuse to allow House to change the treatments without informing the parents. He pleads that this experiment
Experiment
An experiment is a methodical procedure carried out with the goal of verifying, falsifying, or establishing the validity of a hypothesis. Experiments vary greatly in their goal and scale, but always rely on repeatable procedure and logical analysis of the results...

 will save at least five more babies, so after some thought, Cuddy painfully gives him the green light. Later, the Chen-Lupino baby's health begins to worsen with a falling heart rate and blood pressure
Blood pressure
Blood pressure is the pressure exerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. When used without further specification, "blood pressure" usually refers to the arterial pressure of the systemic circulation. During each heartbeat, BP varies...

. The doctors rush in and try to shock the baby back to life, to no avail. The aztreonam
Aztreonam
Aztreonam is a synthetic monocyclic beta-lactam antibiotic , with the nucleus based on a simpler monobactam isolated from Chromobacterium violaceum. It was approved by the U.S. Food and Drug Administration in 1986...

 doesn't work. House instructs his staff to cover the rest of the babies with vancomycin
Vancomycin
Vancomycin INN is a glycopeptide antibiotic used in the prophylaxis and treatment of infections caused by Gram-positive bacteria. It has traditionally been reserved as a drug of "last resort", used only after treatment with other antibiotics had failed, although the emergence of...

.

House instructs Cameron to tell the deceased baby's parents (Kim Chen and Judy Lupino), and that their son has saved five more babies' lives. But when she and Wilson approach the parents, Cameron tenses up, almost unable to speak, prompting Wilson (who, as an oncologist, breaks hard news to patients all the time) to reveal the shocking news. The two women are devastated, with Cameron feeling sorry for them and House completely disappointed with what she's done.

Chase nervously informs the team that the vancomycin isn't working either as Maxine is getting worse. House racks his brain to think of what this disease is, and decides to perform an autopsy on Baby Chen-Lupino and devises a theory that it is a virus that is affecting the babies' hearts. Foreman complains that the team is in trouble, as it could be any one of thousands of viruses, and would take months to test for them. Chase, who specializes in intensive care medicine, tells House that due to the smaller amount of blood they are dealing with, they can only run five or six tests on the babies. So House tries to narrow down the list of possibilities, and ends up with eight. House also has Cuddy take blood from the one healthy newborn in the hospital to use as a control group.

The doctors eventually settle on Echovirus 11 as the likely culprit. They have an experimental antiviral drug
Antiviral drug
Antiviral drugs are a class of medication used specifically for treating viral infections. Like antibiotics for bacteria, specific antivirals are used for specific viruses...

 from a company in Pennsylvania, and (with the parents' consent) administer it to the babies.

When Cameron is in House's office, he begins questioning her about her behavior concerning this case, and deduces that she has either gone through not a lot of death, or too much death. He hits a nerve with her when he suggests that she may have lost a baby. Calling him a bastard, she indignantly walks out on him. This is one of the few times that House is seen as truly caring about his employees, though it shows more in his face than in his actions.

That night, House observes an elderly hospital volunteer coughing and wiping her nose as she pushes around a cart of baby toys and blankets. He appears to realize that she was the original source of the virus. House's apparent visualization is that she had transferred the virus to plush stuffed animals, the virus then transferring from the stuffed animal to the baby when they came close to the baby.

See also

Foreman's line, "There's a company in Pennsylvania developing an antiviral" may be a reference to pleconaril, developed by ViroPharma
ViroPharma
ViroPharma Incorporated, a pharmaceutical company, develops and sells drugs that address serious diseases treated by physician specialists and in hospital settings...

. Viropharma has now ceased further development of this drug.

External links

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