Buchmiller T L, Kim C S, Chopourian H L, Fonkalsrud E W
Department of Surgery, University of California at Los Angeles School of Medicine.
Surgery. 1994 Jul;116(1):36-41.
Transamniotic fetal feeding has been proposed as prenatal treatment for intrauterine growth retardation as substrates infused into the amniotic cavity are swallowed and absorbed. The rabbit provides an optimal model of intrauterine growth retardation in that a consistent weight ratio of the runt to the favored fetus is found at term.
Thirty growth-retarded rabbit fetuses underwent transamniotic catheterization in the third trimester with incremental infusion of either dextrose, dextrose plus amino acids, or bovine amniotic fluid. One week later fetal weights were determined. The ipsilateral favored fetus served as an operated, noninfused control.
Fetuses receiving amniotic fluid showed significantly increased somatic growth when analyzed by absolute body weight and by weight ratio versus control. Increases in the liver, lung, and small intestinal weights of the fetuses receiving amniotic fluid paralleled the overall increase in somatic weight. No differences were found in the dextrose or dextrose plus amino acid-infused groups.
The increased amount of ingested amniotic fluid, or fetal "force feeding," appears responsible for enhanced growth because bovine and native rabbit amniotic fluid have only negligible differences. This study provides the first report of successful growth augmentation of a fetal rabbit runt with prenatal transamniotic fetal feeding.
羊膜腔内胎儿喂养已被提议作为治疗宫内生长受限的产前方法,因为注入羊膜腔的底物会被胎儿吞咽并吸收。兔子是宫内生长受限的理想模型,因为在足月时可以发现发育迟缓胎儿与发育良好胎儿的体重比始终保持一致。
在孕晚期,对30只生长受限的兔子胎儿进行羊膜腔插管,并逐步输注葡萄糖、葡萄糖加氨基酸或牛羊水。一周后测定胎儿体重。同侧发育良好的胎儿作为未输注的手术对照。
通过绝对体重和与对照组的体重比分析,接受羊水输注的胎儿体生长显著增加。接受羊水输注的胎儿肝脏、肺和小肠重量的增加与总体体重增加情况相似。输注葡萄糖或葡萄糖加氨基酸的组未发现差异。
摄入的羊水量增加,即胎儿“强制喂养”,似乎是生长增强的原因,因为牛羊水和天然兔羊水的差异可忽略不计。本研究首次报道了通过产前羊膜腔内胎儿喂养成功增加发育迟缓兔胎儿体重的情况。