Delayed intrauterine repair of an experimental spina bifida with a collagen biomatrix.
OBJECTIVE
The aim of the study was to evaluate whether a collagen biomatrix is useful for delayed intrauterine coverage of a surgically created spina bifida in a fetal lamb.


METHODS
In 20 fetal lambs, surgery was performed at 72 or 79 days' gestation. In 15 lambs a spina bifida was created surgically. In 8 lambs it was covered with a collagen biomatrix 2 weeks later and in 7 lambs it was left uncovered. Five lambs served as sham operated controls. Neurological examination was performed at 1 week of age and afterwards the lambs were sacrificed for further histological evaluation.


RESULTS
None of the 5 surviving lambs with the defect covered showed loss of spinal function and the architecture of the spinal cord was preserved in 4 of the 5 lambs. In the uncovered group, 1 of the 4 surviving lambs had loss of spinal function, 5 lambs were available for histological evaluation and 4 of them showed disturbance of the architecture of the spinal cord.


CONCLUSIONS
Collagen biomatrices can be used for intrauterine coverage of an experimental spina bifida and can preserve the architecture of the spinal cord. Neurological outcome is not different between fetuses with their spinal cord covered and fetuses with uncovered cords.
Eggink
A J
AJ
Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. A.Eggink@obgyn.umcn.nl
Roelofs
L A J
LA
Feitz
W F J
WF
Wijnen
R M H
RM
Lammens
M M Y
MM
Mullaart
R A
RA
van Moerkerk
H T B
HT
van Kuppevelt
T H
TH
Crevels
A J
AJ
Verrijp
K
K
Lotgering
F K
FK
van den Berg
P P
PP
D000818:Animals; D024042:Collagen Type I / Q000008:administration & dosage*; D004195:Disease Models, Animal; D005260:Female; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D034561:Sheep, Domestic; D016135:Spinal Dysraphism / Q000473:pathology / Q000601:surgery*; D013997:Time Factors
D024042:Collagen Type I