The effect of amniocentesis and drainage of amniotic fluid on lung development in Macacafascicularis

Hislop, Alison A.; Fairweather, D. V. I.; Blackwell, R. J.; Howard, S.

doi:10.1111/j.1471-0528.1984.tb03693.x

Cited by 48 publications

(20 citation statements)

References 14 publications

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“…Total alveolar number is significantly reduced in fetal monkeys following amniocentesis. In contrast to our finding, alveolar size is increased; this may be due to the use ofdifferent species or to the longer interval between intervention and examination in the study of Hislop et al (25).…”

Section: Discussioncontrasting

confidence: 99%

“…In their study of the effect of amniocentesis on monkey lung development, Hislop et al (25) did not report lung:body weight ratio. Total lung volume at term was reduced following amniocentesis at a time corresponding to the late pseudoglandularearly canalicular phase of human lung development, but not following amniocentesis in the late canalicular-early saccular phase of lung development.…”

Section: Discussionmentioning

confidence: 96%

“…Also, our work examines the effect of oligohydramnios on lung development. Hislop et al (25) do not state if the magnitude of their changes is greater after oligohydramnios as opposed to amniocentesis without fluid drainage. Respiratory bronchioles were decreased in number and size in monkey lungs following amniocentesis.…”

Section: Discussionmentioning

confidence: 98%

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Morphometry of Hypoplastic Fetal Guinea Pig Lungs following Amniotic Fluid Leak

et al. 1986

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ABSTRACf. Deficient quantity of amniotic fluid causes fetal guinea pig lung hypoplasia. Oligohydramnios that lasts only 5 days in early gestation is sufficient to reduce fetal lung growth significantly. We quantitated lung structural alterations at 50 days gestation (term is 67 days) of fetal guinea pigs whose amniotic fluid was drained on day 45 gestation. The study period spans the late canalicularearly saccular phases of guinea pig lung growth. Compared to littermate controls (n = 4), experimental fetuses (n = 5) have reduced lung:body weight ratio (2.81 ± 0.16 versus 3.21 ± 0.20 x 10-2 , P < 0.01), indicating lung hypoplasia. Lung hypoplasia is a disorder of pulmonary growth resulting in lungs that are disproportionately small relative to body size. This condition is currently recognized in one of seven perinatal autopsies (I) and may be increasing in incidence (2).The clinical manifestations are likely to be determined by the degree of compromised pulmonary growth and range from tachypnea to irreversible pulmonary failure (3). Postmortem, hypoplasia is defined as reduced ratio of lung weight to body weight (4) and decreased lung DNA content (5). Radial alveolar count is a morphometric measurement of acinar complexity; in hypoplastic lungs counts are either reduced (4) or within normal range (6-9).There are multiple etiologies of lung hypoplasia and they can be categorized into disorders of amniotic fluid volume (10-12), disorders that compromise thoracic space (13-17), and disorders of the neuromuscular system (6, 18-21).Premature and prolonged rupture of fetal membranes with continuous leakage of amniotic fluid causes oligohydramnios and lung hypoplasia. The time of onset and the duration of oligohydramnios both influence lung growth. The incidence of fetal lung hypoplasia is greater following rupture of membranes early (prior to 26 wk) compared to late in gestation (22). Prolonged duration of oligohydramnios is associated with both greater incidence (22) and severity of pulmonary growth reduction (3) but lung hypoplasia has been diagnosed following oligohydramnios lasting less than 3 wk (i.e. less than 7.5% of gestation (3,22). Morphometric studies of lungs that are hypoplastic because of amniotic fluid leak have not been reported; in cases of renal agenesis and oligohydramnios, bronchi are reduced in number and alveoli are reduced in number and size (9).Over the last several years, we have developed a guinea pig model of fetal lung hypoplasia associated with oligohydramnios due to ruptured membranes (23). Our data show that in the guinea pig, as in the human, both early onset and prolonged duration influence the incidence and severity of fetal lung hypoplasia (24). Recently, Hislop et al. (25) reported the adverse effects of amniocentesis on fetal lung development in Macaca fascicularis; amniotic fluid, varying in amount from none to total volume, was withdrawn and the pulmonary sequelae were analyzed at term, 2 or more months following amniocentesis. Our study differs because we have induced complete o...

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 96%

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Morphometry of Hypoplastic Fetal Guinea Pig Lungs following Amniotic Fluid Leak

et al. 1986

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“…More recently, experimental evidence derived from work in various mammalian species confirmed this association (8)(9)(10)(11). Two important questions remain unanswered: I) what is the mechanism by which lack of amniotic fluid interferes with fetal lung growth?…”

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confidence: 82%

Oligohydramnios-Induced Lung Hypoplasia: The Influence of Timing and Duration in Gestation

et al. 1986

Pediatr Res

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MATERIALS AND METHODSplasia is also found as an isolated anomaly (3,4) or in association with minor deformities compatible with survival, i.e. oligohydramnios deformation sequence following prolonged rupture of the fetal membranes (5).Over 20 years ago, both Blanc et al. (6) and Bain et al. (7) demonstrated, using perinatal autopsy data, that prolonged oligohydramnios, irrespective of its cause, was associated with fetal lung hypoplasia. More recently, experimental evidence derived from work in various mammalian species confirmed this association (8-11). Two important questions remain unanswered: I) what is the mechanism by which lack of amniotic fluid interferes with fetal lung growth? 2) What are the influences of both gestational age at the onset of oligohydramnios, and its duration, on the degree of lung hypoplasia? This report focuses on the latter question using the guinea pig model of oligohydramnios. A preliminary account of these experiments has been published previously (12).Fetal lung growth proceeds in three consecutive stages, i.e. the pseudoglandular, canalicular, and terminal sac stages. Although this sequence is invariable, its timing in gestation varies among species. We induced oligohydramnios between days 40 and 55 of gestation in the guinea pig, a period roughly corresponding to 18 to 29 wk of gestation in the human. The five time-frames studied are illustrated in Figure I, along with the stages of fetal lung development involved. More specifically, the experiments were as follows: experiment A: drainage between days 40 and 45 (5 days); experiment B: drainage between 45 and 50 (5 days); experiment C: drainage between days 50 and 55 (5 days); experiment D: drainage between days 40 and 50 (10 days); experiment E: drainage between days 45 and 55 (10 days).All fetuses were sacrificed at the end of the 5-or 10-days study period to assess fetal and lung growth. In order to overcome the effects of variation between litters, we used untouched littermate fetuses as controls. Whenever possible, untouched littermate fetuses located at the same level in the opposite uterine horn were chosen as paired controls in order to control for the naturally occurring intralitter variation in fetal size.Pregnant guinea pigs (Cavia porcellus, Camm-Hartley strain) were obtained 30 days after mating from the Camm Research Laboratory, Wayne, NJ. Pregnant animals were caged individually and provided with guinea pig chow no. 5025 (Ralston Purina Co.) and tap water ad libitum. Following an overnight fast, the animals were anesthetized with intramuscular injections of ketamine hydrochloride (40 mg/kg) (Ketaset, Bristol Lab.) and acepromazine maleate (3 mg/kg) (Tech America Group, Inc.). After local anesthesia with lidocaine, a midline laparotomy was performed. Both uterine horns were exteriorized and the position of each fetus was recorded. Half the litter was randomly assigned to the experimental group and the other half served as 951 ABSTRACf. We drained amniotic fluid for periods of 5 and 10 days at various times in g...

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“…Experimentally induced oligohydramnios retards fetal lung growth in guinea pigs (36), monkeys (25), rabbits (1), rats (35) and sheep (12). The likely mechanism by which oligohydramnios retards lung growth is by reducing the volume of fluid in the potential airways and air spaces (12,40), thereby reducing distension of the fetal lung.…”

mentioning

confidence: 99%

Effects of oligohydramnios on lung growth and maturation in the fetal rat

Kitterman

Chapin

Vanderbilt

et al. 2002

American Journal of Physiology-Lung Cellular and Molecular Phys

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Oligohydramnios (OH) retards fetal lung growth by producing less lung distension than normal. To examine effects of decreased distension on fetal lung development, we produced OH in rats by puncture of uterus and fetal membranes at 16 days of gestation; fetuses were delivered at 21 or 22 days of gestation. Controls were position-matched littermates in the opposite uterine horn. OH lungs had lower weights and less DNA, protein, and water, but no differences in saturated phosphatidylcholine, surfactant proteins (SP)-A and -B, and mRNA for SP-A, -B, -C, and -D. To evaluate effects on epithelial differentiation, we used RTI 40 and RTII70, proteins specific in lung to luminal surfaces of alveolar type I and II cells, respectively. At 22 days of gestation, OH lungs had less RTI40 mRNA (P Ͻ 0.05) and protein (P Ͻ 0.001), but RTII70 did not differ from controls. With OH, type I cells (in proportion to type II cells) covered less distal air space perimeter (P Ͻ 0.01). We conclude that OH, which retards lung growth, has little effect on surfactant and impedes formation of type I cells relative to type II cells. fetal lung development; lung distension; pulmonary epithelial differentiation; pulmonary hypoplasia; pulmonary surfactant IN LATE GESTATION, the fetal lung undergoes marked changes in preparation for the transition to extrauterine life. These changes include growth, enlargement of distal potential air spaces, thinning of the septa, maturation of the surfactant system, and differentiation of distal pulmonary epithelium into mature alveolar type I and type II cells. Several studies have shown that fetal lung growth is controlled primarily by mechanical factors, especially distension of the lung (for reviews, see Refs. 26 and 29) and that maturation of the surfactant system is controlled primarily by endocrine factors (for reviews, see Refs. 3 and 48). In contrast, relatively little is known about factors that regulate differentiation of the alveolar epithelium.In 1977, Alcorn and associates (2) reported that tracheal ligation in fetal sheep, which increased lung distension, caused accelerated lung growth and a qualitative reduction in the number of alveolar type II cells; conversely, chronic drainage of tracheal fluid, which inhibited lung distension, retarded lung growth and increased the number of type II cells. However, they reported neither quantitative data for cell counts nor measurements of indicators of surfactant, which is produced by type II cells. Subsequently, other investigators have studied tracheal ligation in fetal sheep and have confirmed that an increase in lung distension results in a lower number of type II cells (6,11,37) and a higher percentage of type I cells (18). Tracheal ligation also results in lower concentrations in the lung of surfactant protein (SP)-A and saturated phosphatidylcholine (SatPC), the major surface-active lipid in pulmonary surfactant (28), as well as mRNA for SP-A, -B, and -C (32). Conversely, transection of the cervical spinal cord (which abolishes fetal breathing movemen...

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The effect of amniocentesis and drainage of amniotic fluid on lung development in Macacafascicularis

Cited by 48 publications

References 14 publications

Morphometry of Hypoplastic Fetal Guinea Pig Lungs following Amniotic Fluid Leak

Morphometry of Hypoplastic Fetal Guinea Pig Lungs following Amniotic Fluid Leak

Oligohydramnios-Induced Lung Hypoplasia: The Influence of Timing and Duration in Gestation

Effects of oligohydramnios on lung growth and maturation in the fetal rat

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