Archives of Gynecology and Obstetrics

, Volume 271, Issue 3, pp 231–234

Evaluation of the development of lung hypoplasia in the premature lamb

  • L. Hellmeyer
  • A. Ballast
  • I. Tekesin
  • F. Sierra
  • A. Ramaswamy
  • P. Lukasewitz
  • C. Nies
  • S. Schmidt
Original Article

DOI: 10.1007/s00404-004-0658-2

Cite this article as:
Hellmeyer, L., Ballast, A., Tekesin, I. et al. Arch Gynecol Obstet (2005) 271: 231. doi:10.1007/s00404-004-0658-2
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Abstract

Background

The death rate from human diaphragmatic hernia (CDH) ranges from 50 to 80%, mainly due to the associated lung hypoplasia. To prevent these irreversible pathological and physical defects, the question of intrauterine surgical intervention arises. The histological changes of the lung tissue after inducement of a diaphragmatic hernia were examined. Of special interest was the time elapsing until the development of lung hypoplasia.

Methods

A model of intrauterine inducement of diaphragmatic hernia was established using five fetal lambs to study consecutive pulmonary hypoplasia. Inducement of a diaphragmatic hernia was undertaken between 105 and 108 days’ gestation. Lung tissue was examined histologically on postoperative days 8, 17, 21, 22, and 25 after inducement of the defect.

Results

On postoperative days 8, 17, and 21, no signs of pulmonary hypoplasia were found on histological examination. A pulmonary hypoplasia was found in two fetuses (on the 22nd and 25th postoperative day). The pathological and anatomical examination of a unilateral pulmonary hypoplasia after a short period of time shows that the artificially created diaphragmatic defect is a good model for producing a congenital diaphragmatic hernia.

Discussion

The severity of the pulmonary hypoplasia is related to the duration of lung compression by the herniated organs. The time elapsing until the development of lung hypoplasia is shorter than expected. Tracheal occlusion seems to be an effective strategy for treatment of the defect CDH, but the best technique for achieving occlusion, and particularly the ideal point in time to carry out “Fetendo,” are unknown. Further research into this congenital illness is required in order to treat it.

Keywords

Fetal surgery Lung hypoplasia Congenital diaphragmatic hernia 

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • L. Hellmeyer
    • 1
  • A. Ballast
    • 1
  • I. Tekesin
    • 1
  • F. Sierra
    • 1
  • A. Ramaswamy
    • 2
  • P. Lukasewitz
    • 3
  • C. Nies
    • 4
  • S. Schmidt
    • 1
  1. 1.Klinik für Geburtshilfe und PerinatalmedizinUniversity of MarburgMarburgGermany
  2. 2.Medizinisches Zentrum für PathologieUniversity of MarburgMarburgGermany
  3. 3.Klinik für Anästhesie und IntensivtherapieUniversity of MarburgMarburgGermany
  4. 4.Klinik für AllgemeinchirurgieUniversity of MarburgMarburgGermany

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