Pomini Francesco, Noia Giuseppe, Mancuso Salvatore
Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy.
Fetal Diagn Ther. 2007;22(2):94-9. doi: 10.1159/000097104. Epub 2006 Nov 27.
Preterm labor is one of the most important factors limiting the advancement of fetal surgery programs. While prostaglandins (PGs) have long been indicated as the key factor in the initiation of labor in humans, there is significant evidence showing that the chorionic membrane acts as a powerful barrier between the decidua/myometrium and amniotic PGs during normal pregnancy. After either open or endoscopic fetal surgery the imperfect, non-hermetical closure of the chorion permits leakage of PGs from the amnionic sac, allowing them to reach the decidua and myometrium. The surgical wound in the chorionic barrier could be the major factor involved in preterm labor and delivery after human fetal surgery.
早产是限制胎儿外科手术项目发展的最重要因素之一。虽然长期以来前列腺素（PGs）一直被认为是人类分娩启动的关键因素，但有大量证据表明，在正常妊娠期间，绒毛膜在蜕膜/肌层与羊膜PGs之间起到强大的屏障作用。无论是开放性还是内镜下胎儿手术后，绒毛膜的不完全、非密封闭合会使PGs从羊膜囊漏出，使其能够到达蜕膜和肌层。绒毛膜屏障上的手术伤口可能是人类胎儿手术后早产和分娩的主要相关因素。
