Birth after reimplantation of a human embryo [letter]
Birth after reimplantation of a human embryo [letter]
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人类胚胎再植入后的出生[信件]
DOI：
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发表时间：
1978
期刊：
影响因子：
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通讯作者：
Edwards Rg
中科院分区：
文献类型：
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作者：
Steptoe Pc;Edwards Rg
我们报告1例患者，30岁未产妇，1978年7月25日经剖宫产安全产下一名体重2700克的正常健康女婴。1976年有9年不孕症、输卵管闭塞和1970年输卵管吻合术失败的病史，切除双侧输卵管壶腹部后持续阻塞输卵管。1977年2月的腹腔镜术发现输卵管残端严重扭曲，闭塞，输卵管周围和卵巢粘连。1977年8月行开腹手术，切除双侧输卵管残端，粘连溶解，悬吊卵巢以恢复卵母细胞。1977年11月10日，在体外受精，培养液中卵裂正常，两天半后将8-细胞胚胎重新植入子宫后，在腹腔镜下获取卵母细胞，即可妊娠。妊娠16周的羊膜穿刺术显示，46例XX胎儿甲胎蛋白水平正常，无染色体异常。在分娩当天，母亲从她最后一次月经开始算起有38周零5天，她患有先兆子痫毒血症。血压波动在140/95左右，双腿及膝、腹部、背部、手部、面部肿胀，血尿酸390mcmol/L，白蛋白0.5g/L尿。超声扫描和X线片显示，胎儿从第30周开始缓慢生长了几个星期。在此期间，血液雌三醇和人类胎盘催乳素水平也降至正常水平以下。然而，在分娩前的最后10天内，胎儿生长显着，而胎盘功能也有了很大改善。分娩当天，双顶径已达9.6 cm，超声控制下安全取出羊水5ml。卵磷脂和鞘磷脂的比例为3.9：1，表明成熟，呼吸窘迫综合征的风险较低。我们希望以后在你们的专栏中发表更多的医学和科学细节。(全文)
We wish to report that 1 of our patients a 30-year-old nulliparous married woman was safely delivered by cesarean section on July 25 1978 of a normal healthy infant girl weighing 2700 g. The patient had been referred to 1 of us (P.C.S.) in 1976 with a history of 9 years infertility tubal occlusions and unsuccessful salpingostomies done in 1970 with excision of the ampullae of both oviducts followed by persistent tubal blockages. Laparoscopy in February 1977 revealed grossly distorted tubal remnants with occlusion and peritubal and ovarian adhesions. Laparotomy in August 1977 was done with excision of the remains of both tubes adhesolysis and suspension of the ovaries in good position for oocyte recovery. Pregnancy was established after laparoscopic recovery of an oocyte on November 10 1977 in-vitro fertilization and normal cleavage in culture media and the reimplantation of the 8-cell embryo into the uterus 2 1/2 days later. Amiocentesis at 16 weeks pregnancy revealed normal alpha-fetoprotein levels with no chromosome abnormalities in a 46 XX fetus. On the day of delivery the mother was 38 weeks and 5 days by dates from her last menstrual period and she had preeclamptic toxemia. Blood-pressure was fluctuating around 140/95 edema involved both legs up to knee level together with the abdomen back hands and face; the blood-uric-acid was 390 mcmol/l and albumin 0.5 g/l of urine. Ultrasonic scanning and radiographic appearances showed that the fetus had grown slowly for several weeks from week 30. Blood-estriols and human placental lactogen levels also dropped below the normal levels during this period. However the fetus grew considerably during the last 10 days before delivery while placental function improved greatly. On the day of delivery the biparietal diameter had reached 9.6 cm and 5 ml of amniotic fluid was safely removed under sonic control. The lecithin:sphingomyelin ratio was 3.9:1 indicative of maturity and a low risk of the respiratory-distress syndrome. We hope to publish further medical and scientific details in your columns at a later date. (full text)