Harrison M R, Anderson J, Rosen M A, Ross N A, Hendrickx A G
J Pediatr Surg. 1982 Apr;17(2):115-22. doi: 10.1016/s0022-3468(82)80193-0.
There are compelling physiologic arguments for correcting certain malformations before birth. Although fetal surgery has been successful in sheep and lower animals, it has proven difficult in primates because the gravid uterus is exquisitely sensitive to induction of preterm labor and abortion. Because the feasibility of fetal intervention can be determined only in a primate model, we have investigated the variables affecting fetal-neonatal survival after fetal surgery in 25 monkeys. As we improved our anesthetic and surgical techniques and refined our tocolytic therapy, mortality fell from 73.3% (11/15) to 20% (2/10). Since spontaneous perinatal loss in 56 controls was 21.4% we can now operate on the late second and early third trimester fetal monkey without increasing maternal or fetal-neonatal mortality. Success in this rigorous model is a requisite for attempted correction of human malformations in utero.
有令人信服的生理学依据支持在出生前纠正某些畸形。尽管胎儿手术在绵羊和低等动物中已取得成功，但在灵长类动物中却被证明困难重重，因为妊娠子宫对早产和流产的诱导极为敏感。由于胎儿干预的可行性只能在灵长类动物模型中确定，我们研究了25只猴子在接受胎儿手术后影响胎儿-新生儿存活的各种变量。随着我们改进麻醉和手术技术并完善宫缩抑制疗法，死亡率从73.3%（11/15）降至20%（2/10）。由于56只对照猴子的围产期自然损失率为21.4%，我们现在可以在孕中期晚期和孕晚期早期对胎儿猴子进行手术，而不会增加母体或胎儿-新生儿死亡率。在这个严格的模型中取得成功是尝试在子宫内纠正人类畸形的必要条件。
