Experimental Study of Extrauterine Fetal Teatment for Congenital Diaphragmatic Hernia

我们开发了一种子宫外胎儿孵化系统，使用V-A ECMO经宫颈血管治疗先天性膈疝胎儿。本研究的目的是探讨在人工胎盘中体外培养离体早产儿羔羊的可行性。将胎龄125 ~ 140天的胎儿置于分离的人工羊水中，采用VA ECMO进行体外培养。然后将胎儿从培养箱中取出，并通过气管切开术进行通气。通过血气分析和彩色多普勒超声检查评估胎儿在通气潜伏期的循环和呼吸状态，发现胎儿的稳定状态不依赖于动脉导管和卵圆孔的血流动力学变化。提示宫颈VA ECMO可有效支持离体早产胎儿的宫外插管。

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.