Journal Title: تابستان 86
Article title: Amniotic Fluid Effect on Spinal Cord Histopathologic Changes in Fetal Sheep with Myelomeningocele

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Article abstract:
Introduction & Objective: Experimental studies in myelomeningocele (MMC) suggested that the primary malformation is not neural but neural tissue damage is acquired as a result of exposure of neural tissue to amniotic fluid (AF). In this study the effects of amniotic fluid on spinal cord and histopathologic changes in fetal sheep with MMC were evaluated. Materials & Methods: In an experimental clinical trial,10 fetal sheep in two group 5 cases and 5 controls were studied. In sheep at 90-100 days gestational age (term = 145-150 days) in lumbar area skin and paraspinal soft tissues excised and laminectomy was the performed at L2 – L4 and we opened duramater. In case group fetal sheep was dorsally with nonclosed dura and thus with open exposure of the spinal cord to amniotic fluid (AF) and in control group immediately the skin was closed. Lambs were delivered near term by cesarean section. They were assessed clinically and morphologically for paraplegia, paraparesia, urine and stool incontinency, pathology of spinal cord, thigh and rectal muscles and anal sphincter muscles. Results: In case group, all lambs (n=5) had a complete or incomplete flaccid sensorimotor paraplegia, were incontinent for urine and 4 animals were incontinent of stool but only one lamb in control group (n=4) had paraparesia (P=0.048) and all lambs were continent for urine and stool. In case group, all lambs had a hypoplastic longitudinal muscles in rectum but well developed circular muscles. Anal sphincter muscles did not develop normally but in control group all lambs had well developed longitudinal and circular muscles and anal sphincter muscles developed normally (P=0.008). Spinal histopathologic changes were edema, focal calcification, fibrosis and capillary cell proliferation in case group but in control group were not seen. The number of ganglion cells was significantly higher in the control group, comparing with case group (P< 0.0005). Conclusions: Exposure of MMC to AF, causes structural neural tissue damage that can be prevented by fetal surgery with repair of the MMC.
Article KeyWords:
Myelomeningocele, Amniotic Fluid, Fetal Sheep, Fetal Surgery
Article Authors:

	دكتر محمـود اشرفي	First Author	meh_hosseinpour@Yahoo.com
	دكتر عبدالحميد عمويي	Other Author
	دكتر مهدي فـريد	Other Author
	دكتر محمـدحسين صانعي	Other Author
	دكتر سارنگ سروري	Other Author
	دكتر مهـرداد يادگاري	Other Author
	دكتر اليـاس واحد	Other Author