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Amniotic membrane and placental histopathological findings after open and fetoscopic prenatal neural tube defect repair
Author(s) -
Sanz Cortes Magdalena,
Castro Eumenia,
Sharhan Dina,
Torres Paola,
Yepez Mayel,
Espinoza Jimmy,
Shamshirsaz Alireza A.,
Nassr Ahmed A.,
Popek Edwina,
Whitehead William,
Belfort Michael A.
Publication year - 2019
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.5414
Subject(s) - medicine , fetoscopy , histopathology , fetal surgery , neural tube defect , surgery , amniotic fluid , fetal membrane , fetus , hysterotomy , obstetrics , prenatal diagnosis , in utero , placenta , pregnancy , pathology , biology , genetics
Objectives To describe and compare placental and amniotic histology in women who underwent a fetoscopic myelomeningocele repair to those who underwent an open hysterotomy myelomeningocele repair. Also, we intended to compare findings from both prenatal repair groups to age‐matched control pregnant patients. Methods Placental and membrane histopathology from 43 prenatally repaired spina bifida cases (17 fetoscopic and 26 open) and 18 healthy controls were retrospectively assessed. Quantitative assessment of histopathology included apoptosis count and maternal and fetal underperfusion scores. Qualitative assessment included the detection of pigmented macrophages and/or signs of placental/amniotic inflammation. Associations between the duration of surgery or the duration of CO 2 insufflation and quantitative histological parameters were tested. Results Fetoscopic surgery cases did not show significant differences in any of the studied parameters when compared against controls. No differences were detected either when compared with open repaired cases, except for lower proportion of pigmented laden macrophages in the fetoscopic group (11.8% vs 61.5%, P < 0.01). No associations between the duration of surgery or the duration of CO 2 exposure and any of the quantitative histological parameters were detected. Conclusions These preliminary results support the lack of detrimental effects of the use of heated and humidified CO 2 gas for uterine insufflation to fetal membranes and placenta.