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Intact dilation and extraction (IDX) is an extraction procedure used for a fetus where dilation is done so it can be removed intact. The procedure is used both after late-term miscarriages and in late-term abortions. It is also known as intact dilation and evacuation, dilation and extraction (D&X, or DNX), intrauterine cranial decompression and, in some cases, as the legal term in the United States, as "partial-birth abortion". The procedure may also be used to remove a fetus that is developed enough to require dilation of the cervix for its extraction.〔''Gonzales v. Carhart'', (550 U.S. ____ (2007) ). Findlaw.com. Retrieved 2007-04-30. ("If the intact D&E procedure is truly necessary in some circumstances, it appears likely an injection that kills the fetus is an alternative under the Act that allows the doctor to perform the procedure.")〕 Though the procedure has had a low rate of use, representing 0.17% (2,232 of 1,313,000) of all abortions in the United States in the year 2000 according to voluntary responses to an Alan Guttmacher Institute survey,〔Guttmacher.org (Abortion Incidence and Services in the United States in 2000 )〕 it has developed into a focal point of the abortion debate. In the United States, intact dilation and extraction of a live fetus was made illegal in most circumstances by the Partial-Birth Abortion Ban Act in 2003, which the U.S. Supreme Court upheld in the case of ''Gonzales v. Carhart''. ==Intact D&X surgery== Under the Intact D&X method, the largest part of the fetus (the head) is reduced in diameter to allow ease of passage through the uterine cervix and vagina. According to the American Medical Association, this procedure has four main elements.〔(Late-Term Pregnancy Termination Techniques ) ''American Medical Association''. H-5.982 Retrieved April 24, 2007.〕 Usually, preliminary procedures are performed over a period of two to three days, to gradually dilate the cervix using laminaria tents (sticks of seaweed which absorb fluid and swell). Sometimes drugs such as pitocin, a synthetic form of oxytocin, are used to induce labor. Once the cervix is sufficiently dilated, the doctor uses an ultrasound and forceps to grasp the fetus's leg. The fetus is turned to a breech position, if necessary, and the doctor pulls one or both legs out of the cervix, which some refer to as "partial birth" of the fetus. The doctor subsequently extracts the rest of the fetus, leaving only the head still inside the uterus. An incision is made at the base of the skull, a blunt dissector (such as a Kelly clamp) is inserted into the incision and opened to widen the opening,〔''Gonzales v. Carhart'', (550 U.S. ____ (2007) ). Findlaw.com. Retrieved 2007-04-19.〕 and then a suction catheter is inserted into the opening. The brain is suctioned out, which causes the skull to collapse and allows the fetus to pass more easily through the cervix. The placenta is removed and the uterine wall is vacuum aspirated using a cannula.〔("Surgical Abortion Procedures" ) American Pregnancy Association. Accessed April 14, 2006. Haskell, Martin. "(Dilation and Extraction for Late Second Trimester Abortion. )" Presented at the National Abortion Federation Risk Management Seminar, September 13, 1992〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Intact dilation and extraction」の詳細全文を読む スポンサード リンク
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