Introduction: Congenital hydrocephalus often results in irreversible and severe damage to the brain despite postnatal interventions. The potential for prenatal intervention to mitigate these deleterious effects underscores the importance of a suitable animal model. We aimed assess the results of an ultrasound-guided transuterine approach to replicate the BioGlue injection fetal hydrocephalus model. Methods: Pregnant ewes were anesthetized at 95 days of gestation and BioGlue was injected into the fetal cisterna magna under ultrasound guidance through the uterus. Ventriculomegaly was assessed by MRI and histology. Results: Nine pregnant ewes were included in the study, and their fetuses were divided into the BioGlue intervention group (n = 9 fetuses) or the control group (n = 7 fetuses) who were not injected. Although hydrocephalus was noted in 5 of 9 fetuses in the intervention group, the ability to induce hydrocephalus went from 0% to 100% in the last 3 fetuses following technical modifications. None of the controls developed hydrocephalus. Fetal brains with hydrocephalus demonstrated increased IBA1+ compared to control animals. Conclusions: While technical challenges were noted, the ultrasound-guided transuterine approach to replicate the BioGlue fetal hydrocephalus model in sheep showed consistent and reproducible results. This model offers the advantage of directly visualizing the location of the needle tip and injection of the BioGlue. This technique offers an alternative for testing novel approaches for prenatal congenital hydrocephalus treatment.

1.
Raimondi
AJ
.
A unifying theory for the definition and classification of hydrocephalus
.
Childs Nerv Syst
.
1994
;
10
(
1
):
2
12
.
2.
Rekate
HL
.
The definition and classification of hydrocephalus: a personal recommendation to stimulate debate
.
Cerebrospinal Fluid Res
.
2008
;
5
:
2
.
3.
Tully
HM
,
Dobyns
WB
.
Infantile hydrocephalus: a review of epidemiology, classification and causes
.
Eur J Med Genet
.
2014
;
57
(
8
):
359
68
.
4.
Edwards
MS
,
Harrison
MR
,
Halks-Miller
M
,
Nakayama
DK
,
Berger
MS
,
Glick
PL
, et al
.
Kaolin-induced congenital hydrocephalus in utero in fetal lambs and rhesus monkeys
.
J Neurosurg
.
1984
;
60
(
1
):
115
22
.
5.
Stein
SC
,
Feldman
JG
,
Apfel
S
,
Kohl
SG
,
Casey
G
.
The epidemiology of congenital hydrocephalus. A study in Brooklyn, N.Y. 1968–1976
.
Childs Brain
.
1981
;
8
(
4
):
253
62
.
6.
Lorenz
HP
,
Lin
RY
,
Longaker
MT
,
Whitby
DJ
,
Adzick
NS
.
The fetal fibroblast: the effector cell of scarless fetal skin repair
.
Plast Reconstr Surg
.
1995
;
96
(
6
):
1251
61
; discussion 1260-1.
7.
Adzick
NS
,
Thom
EA
,
Spong
CY
,
Brock
JW
3rd
,
Burrows
PK
,
Johnson
MP
, et al
.
A randomized trial of prenatal versus postnatal repair of myelomeningocele
.
N Engl J Med
.
2011
;
364
(
11
):
993
1004
.
8.
Sutton
LN
,
Adzick
NS
,
Bilaniuk
LT
,
Johnson
MP
,
Crombleholme
TM
,
Flake
AW
.
Improvement in hindbrain herniation demonstrated by serial fetal magnetic resonance imaging following fetal surgery for myelomeningocele
.
Jama
.
1999
;
282
(
19
):
1826
31
.
9.
Michejda
M
,
Hodgen
GD
.
In utero diagnosis and treatment of non-human primate fetal skeletal anomalies. I. Hydrocephalus
.
Jama
.
1981
;
246
(
10
):
1093
7
.
10.
Cavalheiro
S
,
Moron
AF
,
Zymberg
ST
,
Dastoli
P
.
Fetal hydrocephalus: prenatal treatment
.
Childs Nerv Syst
.
2003
;
19
(
7–8
):
561
73
.
11.
Oria
M
,
Duru
S
,
Scorletti
F
,
Vuletin
F
,
Encinas
JL
,
Correa-Martín
L
, et al
.
Intracisternal BioGlue injection in the fetal lamb: a novel model for creation of obstructive congenital hydrocephalus without additional chemically induced neuroinflammation
.
J Neurosurg Pediatr
.
2019
;
24
(
6
):
652
62
.
12.
Duru
S
,
Oria
M
,
Arevalo
S
,
Rodo
C
,
Correa
L
,
Vuletin
F
, et al
.
Comparative study of intracisternal kaolin injection techniques to induce congenital hydrocephalus in fetal lamb
.
Childs Nerv Syst
.
2019
;
35
(
5
):
843
9
.
13.
Peiro
JL
,
Duru
S
,
Fernandez-Tome
B
,
Peiro
L
,
Encinas
JL
,
Sanchez-Margallo
FM
, et al
.
Fetal endoscopic third ventriculostomy is technically feasible in prenatally induced hydrocephalus ovine model
.
Neurosurgery
.
2023
;
92
(
6
):
1303
11
.
14.
Emery
SP
,
Greene
S
,
Murdoch
G
,
Wiley
CA
.
Histologic appearance of iatrogenic obstructive hydrocephalus in the fetal lamb model
.
Fetal Diagn Ther
.
2020
;
47
(
1
):
7
14
.
You do not currently have access to this content.