Miller R K
University of Rochester Medical Center, New York.
Clin Obstet Gynecol. 1991 Jun;34(2):241-50. doi: 10.1097/00003081-199106000-00004.
The 1990s may revolutionize the care of the fetus and create new options in gene control, immunotherapy, and drug therapy not only to identify susceptible populations but to treat selectively that population without increasing the risk to the mother. Fetal therapy is a notable goal, even now somewhat within our grasp. No longer is the womb an isolated, forbidding environment, but it is accessible with such tools as magnetic resonance imaging, ultrasonography, CVS, Doppler, and sound clinical judgement. Current limitations in our understanding of the pharmacokinetics associated with these chemical temper our enthusiasm. The development of biomarkers for appropriate fetal drug therapy is to be encouraged, but also the development of fetal and maternal biomarkers that will assist the physician in actively avoiding inappropriate fetal drug therapy is necessary, whether dose or chemical dependent.
20世纪90年代可能会给胎儿护理带来一场革命，并在基因控制、免疫疗法和药物治疗方面创造新的选择，不仅用于识别易感人群，还能在不增加母亲风险的情况下对该人群进行选择性治疗。胎儿治疗是一个显著的目标，即使在现在也在一定程度上可以实现。子宫不再是一个孤立、令人生畏的环境，借助磁共振成像、超声检查、绒毛取样、多普勒技术以及合理的临床判断等工具，子宫已能够被触及。目前我们对与这些化学物质相关的药代动力学的理解存在局限性，这减弱了我们的热情。鼓励开发用于适当胎儿药物治疗的生物标志物，但同样有必要开发胎儿和母体生物标志物，以帮助医生积极避免不适当的胎儿药物治疗，无论这种不适当是与剂量还是化学物质有关。
