NEW STRATEGIES TO MATURE THE PREMATURE FETUS

此PERC应用程序旨在开发和测试新的 早产时实现胎儿成熟的策略 就在眼前。其目标是通过以下方式改善早产儿的结局 减少与器官功能相关的产后并发症 不成熟。重点是全球胎儿成熟，而不是 更传统的关注点仅限于肺成熟。研究项目 专注于只测试可以使用的激素治疗策略 从临床上看。早产羊将由核心单位进行治疗， 激素和激素组合，然后交付研究 后天适应和器官功能。胎儿治疗将在 通过超声引导注射直接给胎儿给药以允许我们 以评估成熟对非应激胎儿的影响。剂量 时间表将强调单剂制剂和联合使用 皮质类固醇、T3、TRH和EGF等药物。影响将是 通过出生后5小时内特定器官的研究项目进行评估 研究期间通过评估肺功能、肾功能、血管 音调调节和神经内分泌适应性反应。然后组织就会 被研究项目用来衡量成熟的影响 肺、肾、血管和神经内分泌系统。在最初的3年中 几年后，临床研究将评估肾脏、神经内分泌和 倍他米松对产妇的血管影响 或倍他米松+TRH，与未经治疗的对照组进行比较。 加州大学洛杉矶分校和King-Drew的产妇治疗方案正在进行中 医疗中心，将为重点临床提供科目 为PERC建议的评估。将在#年设计一项临床试验 提案的最后几年，纳入了所开发的概念 在早产羔羊中。

This PERC application is directed toward developing and testing new strategies for achieving fetal maturation when preterm delivery is imminent. The goal is to improve outcome for preterm infants by minimizing postnatal complications related to organ functional immaturity. The emphasis is on global fetal maturation rather than the more traditional focus on lung maturation only. The research projects focus on testing only hormone treatment strategies that could be used clinically. Preterm fetal sheep will be treated by the Core Unit with hormones and combinations of hormones followed by delivery for the study of postnatal adaptation and organ function. Fetal treatments will be by direct fetal administration by ultrasound guided injections to permit us to assess maturational effects on unstressed fetuses. The dosage schedules will emphasize single doses of agents and combinations of agents such as corticosteroid, T3, TRH, and EGF. Effects will be evaluated by organ specific Research Projects during a 5 hr postnatal study period by evaluating lung performance, kidney function, vascular tone regulation and neuroendocrine adaptive responses. tissue will then be used by the Research Projects to measure maturational effects in the lungs, kidneys, vascular and neuroendocrine systems. In the initial 3 years, the clinical studies will evaluate kidney, neuroendocrine and vascular effects resulting from maternal treatments with betamethasone or betamethasone plus TRH in comparison to an untreated comparison group. The maternal treatment protocol is ongoing at Harbor-UCLA and King-Drew Medical Center and will provide subjects for the focused clinical evaluations proposed for the PERC. A clinical trial will be designed in the final years of the proposal that incorporate the concepts developed in the preterm lambs.