DC 2007-05-04, In The Womb 子宫日记 15

But sometimes things do go wrong. This 26-week-old fetus has developed a hole in his diaphragm, the membrane that separates the lungs from the abdomen. (Baby is facing a completely wrong position.) It's not a problem now but his intestines will grow into the lung cavity which will stop the lungs from developing properly. When he's born, he will almost certainly be unable to breathe and will die. Professor Kiklers Nicoladis is a world-renowned pioneer of fetal surgery at King's College Hospital in London. He's developed a technique to block the windpipe of fetus with an inflatable bladder which forces the intestines back where they belong and allows the lungs to develop properly.

This surgical procedure relies on a fetoscope to operate on the fetus inside the womb. A fetoscope is a long narrow tube filled with fiber optic filaments. Light travels down one side of fibers to illuminate inside the uterus and is sent back to a camera so the surgeon can see what he's doing. It also carries the delicate instruments to conduct the operation. The first step is to inject an anesthetic into the fetus to keep it from moving. The mother is awake during the entire procedure with only a local anesthetic to numb her. A general anesthetic will be too harmful for the baby. Professor Nicoladis then inserts the fetoscope through an incision in the mother's abdomen into the amniotic cavity.

Once he safely reaches the fetus, he gently pushes the fetoscope into the mouth and down the back of the throat. Inside the trachea, he inflates a tiny balloon that traps fluid inside the lungs. As the fetus grows, the lungs produce more fluid which stimulates the lung tissue to grow and expand forcing the intestines out of the chest cavity. The balloon is left in place for two months to give the lungs time to mature. Then the procedure is repeated and the balloon is removed in time for what everyone hopes will be a normal birth. Since this operation to treat babies with this defect has been available, it has increased their chance of survival by 50 percent. At 28 weeks or 7 months, the baby is over 2/3 of the way through her time in the womb and is gaining weight fast as she lays down a layer of fat under her skin. Her senses are buzzing and her cerebral cortex has matured enough to support consciousness.

Over the next four weeks, her nervous system will become as advanced as a newborn baby. She is becoming aware of the world around her and for the first time her brain is beginning to create memory. (Now, we were really screaming. First, I thought...) The fetus has spent so much time listening to her mother's voice, she is familiar with its rhythms. (...going to her mother, and talk agree.) With this constant exposure, she absorbs enough of these patterns to recognize and even respond to it. Researchers analyzing the cries of the newborns found that they already contain some of the rhythms and patterns of their mothers' speech. (Yeah, you can find.) The fetus can now hear, taste, smell and touch.