Does a large abdominal wall defect affect lung growth?
OBJECTIVE
Respiratory distress in babies with large abdominal wall defects suggests a relationship to decreased diaphragmatic movement. We evaluated pulmonary development in a fetal lamb gastroschisis model.


METHODS
We created gastroschisis in 25 fetal lambs at 60days gestation (group A). Controls were 14 nonoperated lambs. (Group B) were all delivered at term. Lung volume, histology, and type 1 (AT1)/type 2 (AT2) cell ratios (AT1 ratio) were determined. We subdivided group A, comparing lambs with a large defect and scoliosis [group A (S)] with the remainder [group A (NS)].


RESULTS
Twenty-five lambs survived (11 fetuses in group A and 14 fetuses in group B). Lung volume in group A (S) was less than in group A (NS) (p<0.05). The AT1 ratio in group A was lower than in group B (p<0.01), without any difference in radial alveolar counts (RACs) or alveolar growth, and no association between scoliosis and alveolar differentiation.


CONCLUSIONS
Gastroschisis in a sheep model reduces the AT1 ratio but not the RAC. Severe scoliosis affects lung volume but not the AT1 ratio, suggesting reduced diaphragmatic movement in fetuses with large abdominal defects.
Division of Pediatric Surgery, St. Marianna University School of Medicine, Kawasaki, Japan; Department of Pathology, St. Marianna University School of Medicine, Kawasaki, Japan.
Juma
J
Obayashi
Division of Pediatric Surgery, St. Marianna University School of Medicine, Kawasaki, Japan.
Kunihide
K
Tanaka
Department of Pathology, St. Marianna University School of Medicine, Kawasaki, Japan.
Junki
J
Koike
Division of Pediatric Surgery, St. Marianna University School of Medicine, Kawasaki, Japan.
Yasuji
Y
Seki
Division of Pediatric Surgery, St. Marianna University School of Medicine, Kawasaki, Japan.
Hideki
H
Nagae
Division of Pediatric Surgery, St. Marianna University School of Medicine, Kawasaki, Japan.
Shutaro
S
Manabe
Division of Pediatric Surgery, St. Marianna University School of Medicine, Kawasaki, Japan.
Kei
K
Ohyama
Department of Obstetrics and Gynecology, School of Medicine & Health Sciences, University of Otago, Wellington, New Zealand.
Jane
J
Zuccollo
Department of Pathology, St. Marianna University School of Medicine, Kawasaki, Japan.
Masayuki
M
Takagi
Department of Obstetrics and Gynecology, School of Medicine & Health Sciences, University of Otago, Wellington, New Zealand.
Kevin C
KC
Pringle
Division of Pediatric Surgery, St. Marianna University School of Medicine, Kawasaki, Japan. Electronic address: h2kita@marianna-u.ac.jp.
Hiroaki
H
Kitagawa
D000818:Animals; D003964:Diaphragm / Q000503:physiopathology; D005260:Female; D020139:Gastroschisis / Q000150:complications / Q000196:embryology* / Q000503:physiopathology*; D008168:Lung / Q000196:embryology* / Q000473:pathology / Q000503:physiopathology*; D008176:Lung Volume Measurements; D012600:Scoliosis / Q000150:complications; D034561:Sheep, Domestic
Abdominal wall defect; Gastroschisis; Lung volume; Scoliosis; Type I; Type II cells