Department of Gynaecology, Obstetrics and Oncological Gynaecology, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Bytom, Poland.
Higher School of Strategic Planning in Dąbrowa Górnicza, Katowice, Poland.
J Spinal Cord Med. 2022 Mar;45(2):180-185. doi: 10.1080/10790268.2020.1736434. Epub 2020 Mar 30.
Chemical and mechanical injury in myelomeningocele (MMC) during the fetal life results in functional disorders of multiple organs. Prenatal MMC repair reduces sequelae of spinal cord injury. Histopathological evaluation of dura mater and skin specimens to assess the severity of inflammatory changes. Histopathological laboratory and operated patients. 45 cases (Group I)-intrauterine surgery due to MMC and 42 cases (Group II)-postnatal surgery. Specimens of the skin and of the dura mater adjacent directly to the uncovered section of the spinal cord were collected for assessment. The specimens were histopathologically evaluated to assess the severity of inflammatory changes. The analysis of the severity of inflammatory changes in the skin and the dura mater showed only small lymphocytic infiltration in 5 fetuses (Group I). Medium and large infiltration in the skin and the dura mater was found in all children who underwent postnatal surgery (Group II). Lymphocytic and granulocytic infiltration in the skin and the dura mater were statistically significantly more prevalent in children who underwent postnatal surgery compared to the group of children who underwent prenatal surgery (P < 0.000003). By reducing the time of exposure to damaging factors, prenatal MMC repair statistically reduces the risk of inflammatory changes in the exposed spinal cord and spinal nerves. Prenatal closure of spina bifida before 24 week of gestation does not reduce the severity of inflammatory changes in the exposed spinal cord.
在胎儿期，脊膜膨出（MMC）中的化学和机械损伤会导致多个器官的功能障碍。产前 MMC 修复可减少脊髓损伤的后遗症。评估硬脑膜和皮肤标本的组织病理学变化，以评估炎症变化的严重程度。组织病理学实验室和接受手术的患者。45 例（I 组）-因 MMC 而宫内手术和 42 例（II 组）-产后手术。收集直接覆盖脊髓未覆盖部分的皮肤和硬脑膜标本进行评估。对标本进行组织病理学评估，以评估炎症变化的严重程度。对皮肤和硬脑膜炎症变化严重程度的分析表明，只有 5 例胎儿（I 组）存在小淋巴细胞浸润。所有接受产后手术的儿童（II 组）的皮肤和硬脑膜均存在中大和大浸润。与接受产前手术的儿童相比，接受产后手术的儿童的皮肤和硬脑膜中淋巴细胞和粒细胞浸润更为普遍（P<0.000003）。通过减少暴露于有害因素的时间，产前 MMC 修复可显著降低暴露脊髓和脊神经发生炎症变化的风险。在妊娠 24 周前对脊柱裂进行产前闭合并不能降低暴露脊髓的炎症变化的严重程度。
