Reece E A, Goldstein I, Chatwani A, Brown R, Homko C, Wiznitzer A
Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University School of Medicine, Philadelphia, Pennsylvania.
Obstet Gynecol. 1994 Oct;84(4):634-6.
To explore the feasibility of using a newly devised needle endoscope to conduct transabdominal first-trimester endoscopy for both embryonic visualization and blood sampling.
Following informed consent, 12 patients at 8-12 weeks' gestation undergoing first-trimester termination were invited to participate in this study. Transabdominal needle embryofetoscopy was also performed in one continuing pregnancy. A specially designed 16-gauge, double-barrel instrument sheath equipped with 0.8-mm fiberoptic endoscope and a customized 27-gauge heparinized needle were passed transabdominally under ultrasound guidance through the uterine wall and into the exocoelomic space.
Using first-trimester transabdominal needle embryofetoscopy, we were able to identify the normal anatomical landmarks of the embryo and were also able to gain access to the embryonic circulation by advancing the 27-gauge needle into the umbilical vessels. In addition, we were able to infuse indigo carmine dye into the fetal circulation of three subjects. Needle embryofetoscopy was also used in a continuing pregnancy for prenatal diagnosis.
Our experience establishes the feasibility of first-trimester transabdominal needle embryofetoscopy for embryonic visualization and access to the circulation. This new development is expected to serve as a basis for further studies attempting to diagnose and treat congenital diseases in early pregnancy.
探讨使用新设计的针式内窥镜进行经腹孕早期内窥镜检查以观察胚胎及采集血液样本的可行性。
在获得知情同意后，邀请12例孕8 - 12周行孕早期终止妊娠的患者参与本研究。还对1例继续妊娠的孕妇进行了经腹针式胚胎胎儿镜检查。在超声引导下，将一根特制的16号双腔器械鞘，配备0.8毫米光纤内窥镜和定制的27号肝素化针经腹穿过子宫壁进入胚外体腔。
使用孕早期经腹针式胚胎胎儿镜检查，我们能够识别胚胎的正常解剖标志，还能够通过将27号针推进脐血管进入胚胎循环。此外，我们能够将靛胭脂染料注入3名受试者的胎儿循环中。针式胚胎胎儿镜检查也用于继续妊娠的产前诊断。
我们的经验证实了孕早期经腹针式胚胎胎儿镜检查用于观察胚胎及进入循环的可行性。这一新进展有望为进一步研究早期妊娠先天性疾病的诊断和治疗奠定基础。
