Preliminary Discussion Of The Obstetric Management Of The Open Fetal Surgery In The Second Trimester

ObjectiveTaking the intrauterine fetal lamb surgery in the second trimester to conclude a reasonable and feasible ambisurgerical obstetric management and to discuss the instructive significance for the open fetal intrauterine surgery.MethodsFour lambs underwent intrauterine surgery at 85-100 days of gestation (term 140-160 days). After maternal laparotomy and hysterotomy,fetal lamb's model of birth defect was established. Gave the obstetric management,including giving Magnesium Sulfate to debase the uterine seneitivity pre-operation; using Magnesium Sulfate to restrain uterine contract, establishing amniotic fluid circulation, preventing uterine bleeding and establishing maternal-fetal monitoring mid-operation; giving Progesterone and (32 receptor agonist to restrain uterine contract, preventing abortion and premature delivery, using penicillin to prevent infection post-operation.Surveyed the gestational termination and the prognosis of ewes and lambs.ResultThree ewes aborted on 44th.hour,4th ang 4th day after operation respectively, one ewe delivered full term lambs. Fetal wounds healed without scar formation.Maternal uterus recovered without rupture.ConclusionThe reasonable and effective obstetric management including debasing the uterine seneitivity pre-operation; restraining uterine contract, establishing amniotic fluid circulation, preventing uterine bleeding and establishing maternal-fetal monitoring mid-operation; restraining uterine contract, preventing abortion and premature delivery, preventing infection post-operation can ensure a success of the intrauterine surgery in the animal experiment and instruct clinical open fetal intrauterine surgery.