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Documentation of lung growth after tracheal occlusion to reverse pulmonary hypoplasia in congenital diaphragmatic hernia. Experimental studies in the rat and clinical implications of fetal therapy

Final Report Summary - FETALPROJECT2010 (Documentation of lung growth after tracheal occlusion to reverse pulmonary hypoplasia in congenital diaphragmatic hernia. Experimental studies in the rat and clinical implications of fetal therapy.)


The primary research goal and objective of the “Fetalproject2010” was to advance existing knowledge in invasive fetal medicine. For this purpose we focused on pulmonary hypoplasia in the context of congenital diaphragmatic hernia (CDH) and its relatively new prenatal treatment option, tracheal occlusion (TO). We selected a number of different facets in this field to conduct research on which included the optimal timing of fetal surgery, potential drug side effects on lung development, the application of innovative technologies in fetal diagnostics and the psychosocial impact of fetal medicine on affected parents. The institutions that worked in close cooperation on these projects were the University of Tuebingen, Germany and the Katholieke Universiteit (KU) Leuven, Belgium.

In summary our results so far are:

(1) Increased lung proliferation is dependent on the length not the time-point of tracheal occlusion in the nitrofen rat model for pulmonary hypoplasia in congenital diaphragmatic hernia.
(2) Maternal nifedipine administration does not impact fetal lung growth in the nitrofen rat model of congenital diaphragmatic hernia.
(3) Pregnant women awaiting invasive prenatal diagnosis and fetal therapy face higher levels of state-anxiety than women undergoing noninvasive procedures. Traits of depression and high state-anxiety are found in at least one third of women undergoing fetal therapy.
(4) High resolution 1H NMR spectroscopy successfully discriminates amniotic fluid of fetuses with congenital diaphragmatic hernia from healthy controls.

These results will facilitate the planning and conducting of future studies in the field of fetal medicine. They identified new areas of interest and could weaken doubts about drug safety in the case of nifedipine tocolysis for mothers carrying an infant with pulmonary hypoplasia.

The experienced researcher was after her trans-national mobility phase reintegrated in her home country. She successfully established her own working group, hence, transferring knowledge and skills from the old to the new host organization. This new working group comprises of doctoral students and multiple co-operations linking departments at the University of Tuebingen as well as the Katholieke Universiteit Leuven. The robust new research structure will support the ongoing career of the fellow further linking two big European research centers. Multiple publications have already been the result of this collaboration and more will follow.