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“Congenital diaphragmatic hernia”
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Our study aims to help researchers calculate resources based on a rat breeding colony for experiments on fetal lung development. The Wistar rat is commonly used in experimental research. In the context of fetal lung studies, the nitrofen rat is a model for pulmonary hypoplasia and congenital diaphragmatic hernia. Data needed to calculate resources for new experiments are not easily available. We prospectively acquired data on the reproductive performance and fetal outcome of 314 consecutive virgin Wistar dams in our fetal lung research breeding colony. We define the impact of breeding conditions on rat fertility and evaluate different methods to diagnose early rat gestation. Effects of nitrofen exposure as well as fetal surgery in terms of prenatal mortality and gross anatomical parameters of lung development are quantified in nitrofen-exposed and -unexposed fetuses from embryonic day 19 to 21 in 12h intervals. A reduced mating interval (1h) provides a great degree of experimental control with feasible pregnancy rates and a large litter size. Nitrofen exposure, as well as fetal surgery, depict high fetal survival rates. Fetal lung findings were very reproducible and could allow for reduction of animals utilized within experimental groups.
Introduction: Data support the use of both ultrasound (US) and magnetic resonance imaging (MRI) in the prenatal prognostication of congenital diaphragmatic hernia (CDH). The aim of this study was to examine our experience and learning curve with both of these diagnostic tools in the setting of a new fetal program. Materials and Methods: This is a case series performed as a quality improvement measure. Fetuses were identified at a single tertiary institution with both ultrasound lung-to-head ratio (LHR) and MRI fetal lung volume from December 2012 until July 2016. Prenatal and postnatal data were collected. Statistical analysis was performed and a p-value of <0.05 was considered significant. Results: Twenty-one patients met inclusion criteria. Inaccurate LHRs were found in 26.9% (7/26) of patients, with the lack of a four-chamber heart view as the most common inaccuracy (5/26, 19.2%). Patients with only some or no stomach in the thoracic cavity on fetal MRI had 100% survival to discharge. Discussion: Accurate prenatal prognostication of CDH is challenging. We identified a pitfall in attaining LHR that can be easily identified, and that may influence the accuracy of the measurement. Furthermore, stomach position on MRI is a relatively newly described quick, easy, and reproducible metric for predicting prognosis.