Experimental Study of Extrauterine Fetal Teatment for Congenital Diaphragmatic Hernia

我们已经开发了一种宫外胚胎孵化系统，通过宫颈血管使用V-A ECMO来治疗一例患有先天性膈疝的胎儿。为探讨人工胎盘体外孵化早产羔羊的可行性，将125~140天的早产羔羊置于含VA ECMO的人工羊水中孵化，将胎儿从孵化器中取出，通过气管切开进行机械通气。通过血气分析和彩色多普勒超声检查评价胚胎在孵化至机械通气过程中的循环和呼吸状态。结果表明，颈椎VA ECMO可以有效地支持孤立早产儿的宫外插管。

We have developed an extrauterine fetal incubation system using V-A ECMO via cervical vessels for the treatment of a fetus with a congenital diaphragmatic hernia. The purpose of this study was to examine the feasibility of extrauterine incubation of an isolated premature fetal lamb in the artificial placenta.The fetuses were(125〜140 days gestational age) were incubated in an isolated artificial amniotic fluid with VA ECMO.The fetuses were then removed from the incubator and ventilated through a tracheostomy.The circulation and respiratory state of fetuses during the incubation to ventilation were evaluated by blood gas analysis and colour Doppler ultrasonographic examinations revealed stablecondition undepended on hemodynaniic change of the ductus arteriosus and foramen ovale.These resuls may indicate that the cervical VA ECMO can effectively support extrauterine intubation of isolated premature fetuses.