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Eur J Pediatr Surg 2011; 21(3): 183-187
DOI: 10.1055/s-0031-1271708
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Induction of Fetal Diuresis with Intraamniotic Furosemide Injection Reduces Intestinal Damage in a Rat Model of Gastroschisis

G. Hakguder1 , M. Olguner1 , D. Gürel2 , F. M. Akgür1 , A. W. Flake3
  • 1Dokuz Eylul University School of Medicine, Department of Pediatric Surgery, Izmir, Turkey
  • 2Dokuz Eylul University School of Medicine, Department of Pathology, Izmir, Turkey
  • 3The Children's Hospital of Philadelphia, and The University of Pennsylvania School of Medicine, The Center for Fetal Diagnosis and Treatment, Philadelphia, United States
Further Information

Publication History

received November 22, 2010

accepted after revision January 6, 2011

Publication Date:
21 February 2011 (online)

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Abstract

Background/Purpose: Contact with amniotic fluid causes intestinal damage (ID) in fetuses with gastroschisis. Intraamniotic meconium has been shown to be responsible for ID, and ID has been shown to correlate with intraamniotic meconium concentrations. ID can be prevented by lowering the intraamniotic meconium concentration. A new method to lower intraamniotic meconium concentration might consist in the induction of fetal diuresis with intraamniotic diuretic injection. This hypothesis was tested in a rat model.

Materials and Method: There were 4 experimental groups.

Control group: Rat fetuses without any manipulation. Fetuses were harvested by cesarean section for examination at E21.5 (Term).

Sham group: On E18.5, the hind limb of the rat fetuses were exteriorized by hysterotomy and replaced in the uterus.

Gastroschisis group: Gastroschisis was surgically created in rat fetuses on E18.5, under a dissection microscope (16×).

Gastroschisis+furosemide group: After surgical creation of gastroschisis on E18.5, intraamniotic furosemide (5 mg/kg) was administered to the fetuses on E20. All fetuses were harvested on E21.5.

Results: There was no significant difference between intestinal serosal thicknesses of the control and sham groups. The serosal thickness was significantly higher in the gastroschisis group compared to the control group. In the gastroschisis+furosemide group, the intestinal serosal thickness was found significantly decreased compared with the gastroschisis group.

Conclusion: Intraamniotic furosemide injection caused a substantial decrease in ID encountered in gastroschisis. The induction of fetal diuresis with intraamniotic furosemide injection seems promising as a prenatal treatment modality.

Key words

gastroschisis - amniotic fluid - intestinal damage - intraamniotic furosemide injection - prenatal treatment

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Correspondence

Dr. Gulce Hakguder

Dokuz Eylul University School

of Medicine

Department of Pediatric

Surgery

Dokuz Eylul Universitesi tıp

fakultesi

35340 Izmir

Turkey

Phone: +90 232 412 3005

Fax: +90 232 279 2101

Email: gulce.hakguder@deu.edu.tr