The purpose of this prospective study was to determine the oxygen saturation of blood in the fetal brain based on T2 and T2* measurements in a fetal sheep model. Five sheep fetuses were investigated during normoxia and hypoxia by 3T MRI. Multi-echo gradient-echo and turbo-spin-echo sequences were performed on the fetal brain. MR-determined oxygen saturation (MR-sO(2)) of blood in the fetal brain was calculated based on T2 and T2* values. Fetal arterial blood oxygen saturation (blood-sO(2)) was measured during the two experimental phases. The slope of MR-sO(2) as a function of blood-sO(2) was estimated and tested for compatibility using the one-sample t-test. During normoxia, mean values for carotid blood oxygen saturation were 67%, 83 ms for T2*, 202 ms for T2 and 96% for MR-sO(2). During hypoxia, arterial blood oxygen saturation, T2* and calculated MR-sO(2) decreased to 22%, 64 ms, and 68% respectively. The one-sample t-test revealed the slope to be significantly different from 0 (T = 5.023, df = 4, P = 0.007). It is feasible to perform quantitative T2 and T2* measurements in the fetal brain. MR-sO(2) and fetal arterial blood oxygen saturation correlated significantly. However, based on these data a reliable quantification of fetal brain tissue oxygenation is not possible.

Peel formation and ICC derangement were significantly reduced by prenatal coverage of gastroschisis. Moreover, this animal model mimics the histopathological bowel changes as seen in human gastroschisis and may, therefore, be used for further research on the pathophysiology and fetal therapy of this malformation.

Although technically demanding, we were able to produce and reassess six cases of gastroschisis by fetoscopy. As primary repositioning appears unfavorable, fetoscopic prosthetic bag placement may become an alternative.

Introduction: The embryogenesis of gastroschisis is not completely understood. The aim of our study was to evaluate the impact of a simple abdominal wall defect versus a defect including eviscerated intestine or omentum for the development of gastroschisis in a fetal lamb model. Material and Methods: At mid-gestation (day 77) an abdominal wall defect was fetoscopically created with three different approaches in 19 German blackhead sheep. The intestine was eviscerated in 7 fetuses (group 1). The peritoneum was incised and a patch of the omentum pulled through the incision in 5 fetuses (group 2). In 7 fetuses (group 3) the skin and rectus muscle were incised until the peritoneum was visible. In this group, no abdominal contents were exteriorized and the peritoneum was left intact. A second fetoscopic procedure was performed 21 days later, assessing the condition and extension of eviscerated bowel. The fetus was retrieved by Cesarean section on day 132 and evaluated. Results: The second fetoscopy acting as a control for the creation of gastroschisis demonstrated eviscerated and inflamed intestine in all 3 groups. The amount of eviscerated intestine did not appear to depend on the size of the defect nor on its duration. Discussion: It appears that a simple incision of the abdominal wall with intact peritoneum is sufficient for the development of gastroschisis in a fetal sheep model. This finding may improve the understanding of the etiology of gastroschisis.

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