Introduction: As part of an evidence-based reassessment of ventriculoamniotic shunting for fetal aqueductal stenosis, we developed an animal model for the induction of hydrocephalus, placement of a ventriculoamniotic shunt, and end of study analysis in fetal sheep. Methods: We made multiple revisions to both the animal model and the shunt over time. Regarding the animal model, we found that induction of hydrocephalus at 85 days gestation, shunt placement at 100 days gestation, and study end at 135 days gestation generated the most reproducible results. Conclusion: The purpose of this manuscript was to document step-by-step instructions for hydrocephalus induction, shunt placement, and end of study analysis so that those who wish to develop a fetal hydrocephalus model, repeat our experience with ventriculoamniotic shunting, or test other interventions may benefit from our experience. Moreover, standardization of methodology will allow for meaningful comparisons between investigators.

Journal Section:
Fetal Therapy
Keywords:
Fetus, Ventriculomegaly, Hydrocephalus, Ventriculoamniotic shunting, Methods, Animal model
1.
Nakayama
DK
,
Harrison
MR
,
Berger
MS
,
Chinn
DH
,
Halks-Miller
M
,
Edwards
MS
.
Correction of congenital hydrocephalus in utero I. The model: intracisternal kaolin produces hydrocephalus in fetal lambs and rhesus monkeys
.
J Pediatr Surg
.
1983
;
18
(
4
):
331
–
8
.
Google Scholar
Crossref
Search ADS
PubMed
 
2.
Chen
Y
,
Emery
SP
,
Maxey
AP
,
Gu
X
,
Wagner
WR
,
Chun
Y
.
A novel low-profile ventriculoamniotic shunt for foetal aqueductal stenosis
.
J Med Eng Technol
.
2016
;
40
(
4
):
186
–
98
.
Google Scholar
Crossref
Search ADS
PubMed
 
3.
Emery
SP
,
Greene
S
,
Elsisy
M
,
Chung
K
,
Ye
SH
,
Kim
S
, et al.
In vitro and in vivo assessment of a novel ultra-flexible ventriculoamniotic shunt for treating fetal hydrocephalus
.
J Biomater Appl
.
2023
;
37
(
8
):
1423
–
35
.
Google Scholar
Crossref
Search ADS
PubMed
 
4.
Emery
SP
,
Hogge
WA
,
Hill
LM
.
Accuracy of prenatal diagnosis of isolated aqueductal stenosis
.
Prenat Diagn
.
2015
;
35
(
4
):
319
–
24
.
Google Scholar
Crossref
Search ADS
PubMed
 
5.
Emery
SP
,
Greene
S
,
Hogge
WA
.
Fetal therapy for isolated aqueductal stenosis
.
Fetal Diagn Ther
.
2015
;
38
(
2
):
81
–
5
.
Google Scholar
Crossref
Search ADS
PubMed
 
6.
Emery
SP
,
Narayanan
S
,
Greene
S
.
Fetal aqueductal stenosis: prenatal diagnosis and intervention
.
Prenat Diagn
.
2020
;
40
(
1
):
58
–
65
.
Google Scholar
Crossref
Search ADS
PubMed
 
7.
Peiro
JL
,
Fabbro
MD
.
Fetal therapy for congenital hydrocephalus-where we came from and where we are going
.
Childs Nerv Syst
.
2020
;
36
(
8
):
1697
–
712
.
Google Scholar
Crossref
Search ADS
PubMed
 
8.
Emery
SP
,
Lopa
S
,
Peterson
E
,
Jelin
AC
,
Treadwell
M
,
Gebb
J
, et al.
Prenatal diagnosis of fetal aqueductal stenosis: a multicenter prospective observational study through the North American Fetal Therapy Network
.
Fetal Diagn Ther
.
2024
;
51
(
3
):
216
–
24
.
Google Scholar
Crossref
Search ADS
PubMed
 
9.
Oria
M
,
Duru
S
,
Scorletti
F
,
Vuletin
F
,
Encinas
J
,
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
.
Google Scholar
Crossref
Search ADS
PubMed
 
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