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Intestinal damage in gastroschisis correlates with the concentration of intraamniotic meconium
1Departments of Pediatric Surgery and Pathology, Dokuz Eylül University Medical School, Izmir, Turkey.
Background/Purpose:
Contact with amniotic fluid (AF) causes intestinal damage in gastroschisis, which has been shown to be caused by intraamniotic meconium. However, whether this intraamniotic meconium-induced intestinal damage is concentration dependent has not been investigated previously. The purpose of this study is to investigate the effects of intraamniotic human meconium at various concentrations on the intestines of chick embryo with gastroschisis.
Methods:
Five-day-old fertilized chick eggs were used. Gastroschisis was created through the amniotic cavity without opening the allantoic cavity. Sterile meconium was obtained from newborn humans. Meconium suspensions at various concentrations were prepared using saline and instilled into the amniotic cavity.
Results:
Intraamniotic 1:200 and 1:400 meconium was found to cause intestinal damage. Meconium concentrations lower than 1:400 did not cause intestinal damage. Histopathologic examination of the intestines of the 1:200 and 1:400 meconium groups showed serosal thickening, inflammation, focal fibrin, and collagen deposits. Histopathologic features of the intestines of the 1:600 and 1:800 meconium groups did not differ from the intestines of the control group.
Conclusion:
Intraamniotic meconium, which is responsible for intestinal damage in gastroschisis, must reach a threshold level to induce intestinal damage. J Pediatr Surg 36:1811-1815.
Insights
Intraamniotic meconium causes intestinal damage in gastroschisis, but only above a specific concentration threshold. Lower concentrations did not cause damage in chick embryo models, indicating a dose-dependent effect.
Area of Science:
- Developmental biology
- Gastroenterology
- Pediatric surgery
Background:
- Amniotic fluid (AF) contact causes intestinal damage in gastroschisis.
- Intraamniotic meconium is implicated as the cause of this damage.
Purpose of the Study:
- To investigate the concentration-dependent effects of intraamniotic human meconium on intestines in a chick embryo gastroschisis model.
Main Methods:
- Gastroschisis was surgically created in 5-day-old chick embryos.
- Sterile human meconium was prepared in saline at various concentrations (1:200 to 1:800).
- Meconium suspensions were instilled into the amniotic cavity.
Main Results:
- Intraamniotic meconium at 1:200 and 1:400 concentrations caused significant intestinal damage.
- Histopathology revealed serosal thickening, inflammation, fibrin, and collagen deposits.
- Meconium concentrations below 1:400 (1:600, 1:800) did not result in intestinal damage compared to controls.
Conclusions:
- Intraamniotic meconium requires a threshold concentration to induce intestinal damage in gastroschisis.
- This finding suggests a dose-dependent mechanism for meconium-induced injury.