Abstract

Pulmonary hypoplasia is a common cause of neonatal respiratory disease. Despite evidence in humans that normal fetal lung growth depends on pulmonary arterial flow, this relationship has not been investigated. To determine whether pulmonary arterial flow is necessary for lung growth, the LPA was ligated in 5 fetal sheep during the canalicular stage of lung development (105-114d gestation). Lung growth at 140d gestation was compared to 4 sham operated (105-114d) and 5 term (139-144d) control fetuses. Fetal lungs were prepared for morphologic and morphometric analysis. LPA ligation markedly reduced all left lung weights and the amount of parenchymal tissue compared to both sham and control groups. Fetal surgery significantly reduced sham left lung weights compared to control, and LPA ligated and sham right lung weights compared to control (Table). Thus, pulmonary arterial flow is essential for normal lung growth. Investigation of causes of pulmonary hypoplasia should include consideration of pulmonary arterial flow, and unoperated controls should be used to evaluate normal lung growth.

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