Objectives: We studied the vascular effects of betamethasone (BM) and/or tracheal occlusion (TO) in fetal rabbits with surgically induced congenital diaphragmatic hernia (CDH). Methods: At day 23 (pseudoglandular phase; term = 31 d), 54 ovarian-end fetuses from 27 does underwent induction of CDH. Thirteen did receive either 0.05 mg/kg BM, on days 28 and 29 with a 24-h interval, or 14 saline [controls (CTR)]. At day 28, one ovarian-end fetus underwent TO and harvesting was at term. In total, we compared (ANOVA) lung-to-body weight ratio (LBWR) and vascular morphometric indices in survivors from the following groups (n - number alive at delivery): CDH (9); CDH + TO (10); unoperated controls (14); CDH + BM (10); CDH + TO (9); controls CTR + BM (13). Results: Maternal BM had no effect on LBWR. LBWR was comparable to normal in CDH fetuses undergoing TO. Both TO and BM have an effect on medial thickening due to CDH which is larger when both interventions are combined. Conclusions: Both TO and BM lessen peripheric muscularization present in CDH lungs and their effect is cumulative. Copyright

Congenital diaphragmatic hernia, Glucocorticoids, Pulmonary hypoplasia, Rabbit model, Tracheal occlusion, Vascular morphometry
dx.doi.org/10.1002/pd.2243, hdl.handle.net/1765/24113
Prenatal Diagnosis
Erasmus MC: University Medical Center Rotterdam

Roubliova, X.I, Lewi, P.J, Verbeken, E.K, Vaast, P, Jani, J.C, Lu, H, … Deprest, J.A. (2009). The effect of maternal betamethasone and fetal tracheal occlusion on pulmonary vascular morphometry in fetal rabbits with surgically induced diaphragmatic hernia: A placebo controlled morphologic study. Prenatal Diagnosis, 29(7), 674–681. doi:10.1002/pd.2243