Foetal bladder neck ligation on experimental gastroschisis in rabbits

초록

It has been suggested that the pathological changes that occur in the intestine of infants with gastroschisis (GS) may be due to exposure to foetal urine in the amniotic fluid. Early Caesarean delivery of antenatally-diagnosed infants has been advocated to decrease the duration of exposure To investigate this, 25 time-mated New Zealand white rabbits underwent hysterotomy on gestation day 25 (normally a 31- to 33-day gestation) to partially expose one or both ovarian-end foetuses Control (C) foetuses underwent foetal manipulation only. GS foetuses developed right midabdominal wall defects In addition to intestinal evisceration, bladder ligation (BL) foetuses had bladder neck occlusion with a metal clip to completely block the passage of foetal urine into the amniotic cavity. Foetuses were delivered by Caesarean section on gestation day 30. Twenty-four of 25 does (96%), nine of 13 C foetuses (69%), 21 of 24 GS foetuses (88%) and seven of 12 GS with BL foetuses (58%) survived Successful surgical creation of GS was obtained with evisceration of abdominal organs in each foetus. At the time of Caesarean delivery five days later, GS and GS with BL foetuses had significantly lower bodyweights, intestinal lengths, and mucosa/submucosa height ratios (a measure of bowel wall oedema), and significantly greater intestinal density when compared with C foetuses (p < 0.05, t-test), but there was no significant difference between GS foetuses and GS with BL foetuses. This study demonstrates that GS abdominal wall defects were created with high survival rates; in comparable groups of rabbit foetuses, and that eviscerated intestine, exposed to amniotic fluid during the third trimester, showed no significant differences in length, mucosa/submucosa height ratio, or histology despite bladder neck ligation. No effect of foetal urine on intestine was demonstrated.

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