Experimental fetal neurosurgery: the normal neurology of neonatal lambs and abnormal findings after in utero manipulation
No abstract available
Journal: Contemporary Topics in Laboratory Animal Science 1996 Jan;35(1):53-6Date: 01/01/1996
1 Animal Care Facility, University of California, San Francisco, CA 94143, USA.
Fetal reconstructive surgery: experimental use of the latissimus dorsi flap to correct myelomeningocele in utero
A recent study in human fetuses with myelomeningocele produced evidence that nonclosure of the spine leads to progressive damage of the exposed spinal cord during pregnancy. Thus in utero coverage might spare function. We tested the use of the latissimus dorsi flap for fetal myelomeningocele repair. In seven sheep fetuses, a lumbar myelomeningocele type of lesion was created at 75 days' gestation and was covered with a "reversed" latissimus dorsi flap at 100 days. At term, the three survivors had healed cutaneous wounds and normal hindlimb function. The vascular pedicle of the latissimus dorsi flap was patent, the viable flap covered the entire lesion, and the underlying spinal cord was grossly intact. We conclude that the latissimus dorsi flap repair is suitable for fetal surgery and provides efficient coverage of the lesion. These results have clinical implications, since fetal myelomeningocele repair may be a compelling way to reduce the severe neurologic deficit in humans.
Journal: Plastic and reconstructive surgery 1995 Oct;96(5):1007-11Date: 01/10/1995
1 Fetal Treatment Center, University of California, San Francisco, USA.
Exogenous transforming growth factor-beta amplifies its own expression and induces scar formation in a model of human fetal skin repair.
etal skin wounds heal without scarring. To determine the role of TGF-beta 1 in fetal wound healing, mRNA expression of TGF-beta 1 was analyzed in human fetal and adult skin wounds.
Journal: PubMedDate: 01/08/1995
Department of Surgery, University of California-San Francisco, USA.
Exogenous transforming growth factor-beta amplifies its own expression and induces scar formation in a model of human fetal skin repair
Fetal skin wounds heal without scarring. To determine the role of TGF-beta 1 in fetal wound healing, mRNA expression of TGF-beta 1 was analyzed in human fetal and adult skin wounds.
Journal: Annals of Surgery (Vol. 222, No. 2, 146-154)Date: 01/08/1995
1 Department of Surgery, University of California-San Francisco, USA.
Fetal endoscopic ('Fetendo') surgery: the relationship between insufflating pressure and the fetoplacental circulation
Application of video-endoscopic surgery to the gravid uterus provides a new treatment option for the fetus with a correctable congenital anomaly. “Fetendo” surgery requires temporary enlargement of the uterine cavity to create a working space. Volume expansion of the amniotic space raises intrauterine pressure, which could increase placental vascular resistance and thereby reduce placental blood flow. To test this hypothesis, the authors developed a fetal sheep model to examine the relationship between insufflating pressure and flow in the placental circulation. Fetoplacental blood flow was measured via ultrasonic flow probes placed around the fetal common umbilical artery and the maternal uterine artery in five anesthetized 120-day-gestation ewes. Invasive feto-maternal monitoring permitted synchronous measurement of fetal mean arterial pressure, fetal central venous pressure, maternal mean arterial pressure, amniotic pressure, and fetal oxygen saturation, with calculated values for fetal and maternal placental vascular resistance. Amniotic pressure was raised from 10 mm Hg to 40 mm Hg in 5-mm Hg increments by a combination of saline amnioinfusion and external uterine compression. At amniotic pressures of 20 mm Hg or less, placental blood flow was preserved; however, elevation of amniotic pressure above 20 mm Hg resulted in a significant decrease in placental flow, with concomitant fetal hypoxia. The authors conclude that the relationship between intrauterine pressure, flow in the placental circulation, and fetal oxygen delivery must be considered when selecting intrauterine insufflation pressures for hysteroscopic intervention.
Journal: Journal of Pediatric Surgery (Volume 30, Issue 8, Pages 1165-1168)Date: 01/08/1995
1 Fetal Treatment Center, University of California, San Francisco 94143-0570, USA.