A TIME TO BE BORN - IMPLICATIONS OF ANIMAL STUDIES IN MATERNAL-FETAL MEDICINE
A TIME TO BE BORN - IMPLICATIONS OF ANIMAL STUDIES IN MATERNAL-FETAL MEDICINE
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DOI：
10.1111/j.1523-536x.1994.tb00516.x
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发表时间：
1994-09-01
影响因子：
2.5
通讯作者：
NATHANIELSZ, PW
中科院分区：
文献类型：
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作者：
NATHANIELSZ, PW
最近对妊娠最后三分之一胎儿能力的研究表明，胎儿积极地为进入宫外环境做准备。这些准备工作中最值得注意的是，胎儿大脑发出信号，开始分娩过程。一些研究，特别是在绵羊身上进行的研究表明，来自胎儿大脑的内分泌信号被发送到胎盘，以刺激雌激素的增加。增加的雌激素产生启动子宫收缩，并开始分娩过程。母亲的催产素的产生也起到了作用，它决定了婴儿出生的确切时间。这些研究对胎儿和子宫生理学产生了引人入胜的见解，并已开始用于临床护理。应用这一新知识的一个主要例子是了解胎儿产生表面活性物质的内分泌调节，以治疗早产妇女，并生产用于治疗早产婴儿的人工表面活性物质。重要的是获得和使用从严格控制的动物实验中获得的可重复性的数据，以使临床管理实践合理化。基础研究应该先于临床管理的变化，而不是像经常发生的那样跟随它们。
Recent studies on the capabilities of the fetus in the last third of gestation demonstrated that the fetus actively prepares for its journey to the extrauterine environment. The most remarkable of these preparations is that the fetal brain gives the signal to begin the birth process. Several studies, particularly those conducted in sheep, showed that endocrine signals from the fetal brain are sent to the placenta to stimulate increased estrogen production. The increased estrogen production initiates uterine contractility, and starts the labor process. The mother's oxytocin production also plays a role by determining the precise time of the day that the baby is born. These studies produced fascinating insights into fetal and uterine physiology that have already begun to be employed in clinical care. One primary example in the application of this new knowledge obtained originally from studies on fetal sheep is in understanding the endocrine regulation of fetal production of surfactant to treat women in preterm labor and to produce artificial surfactants for the treatment of babies delivered too early. It is important to obtain and use reproducible data gained from carefully controlled animal experiments to rationalize clinical management practices. Basic research should precede changes in clinical management, rather than follow them, as is so often the case.