Ford W D, Cool J C, Byard R, Allanson M
Department of Paediatric Surgery, Women's and Children's Hospital, Adelaide, Australia.
Fetal Diagn Ther. 1997 May-Jun;12(3):145-8. doi: 10.1159/000264455.
Carbon dioxide insufflation of the uterine cavity in sheep enables electrocautery to the surface and superficial tissues of the fetal lamb, using minimally invasive surgery. Absorption of the CO2, however, causes a potentially lethal acidosis. To enable the use of electrocautery dissection of the fetal sheep, without using gas, we have partially replaced the amniotic fluid with 0.5% glycine. To determine whether glycine would have any short- or long-term deleterious effects on the developing fetus, we replaced amniotic fluid with 0.5% glycine in 10 normal fetuses at 101 days of gestation (normal gestation 145-149 days), without later replacing it with the removed amniotic fluid. Histological changes were then sought in the skin, gastrointestinal tract, and pulmonary tree, at 2 ('early', n = 5) or 6 weeks ('late', n = 5) after the introduction of the glycine. There were no histological differences between these and normal sheep at either time point. The use of glycine as a replacement for amniotic fluid subsequently enabled us to carry out electrocautery dissection of the sheep fetus and electrocoagulation of any bleeding vessel. Its use was not associated with any apparent untoward effects. Therefore, it has the potential to be used in minimally invasive surgery on the fetal trachea or on an enlarged fetal bladder.
对绵羊子宫腔进行二氧化碳注入，能够在使用微创手术的情况下，对胎羊的表面和浅表组织进行电灼。然而，二氧化碳的吸收会导致潜在致命的酸中毒。为了在不使用气体的情况下对胎羊进行电灼解剖，我们用0.5%的甘氨酸部分替代了羊水。为了确定甘氨酸是否会对发育中的胎儿产生任何短期或长期的有害影响，我们在妊娠101天（正常妊娠期为145 - 149天）时，用0.5%的甘氨酸替代了10只正常胎儿的羊水，且之后未用移除的羊水进行替换。然后在引入甘氨酸后的2周（“早期”，n = 5）或6周（“晚期”，n = 5），观察皮肤、胃肠道和肺树的组织学变化。在这两个时间点，这些胎儿与正常绵羊之间均无组织学差异。随后，使用甘氨酸替代羊水使我们能够对绵羊胎儿进行电灼解剖，并对任何出血血管进行电凝。其使用未出现任何明显的不良影响。因此，它有潜力用于胎儿气管或扩大的胎儿膀胱的微创手术。
