Sasha Skinner |
School of Clinical Sciences at Monash Health (SCS) student
Ms Sasha Skinner is the highest achieving BMedSc(Hons) student in the entire
2016 cohort.
Supervised by Dr Ryan Hodges, The Ritchie Centre, Hudson
Institute of Medical Research and the Department of Obstetrics and Gynaecology,
Monash University, Sasha’s project investigated experimental
intra-amniotic carbon dioxide insufflation for fetal surgery to improve outcomes
of babies with spina bifida.
“Prenatal repair of spina bifida
improves neurological outcomes and prevents intracranial complications at birth,”
said Sasha.
“To reduce significant maternal morbidity and high rates of
preterm birth associated with open fetal surgery, fetoscopic spina bifida
repair is proposed as a minimally invasive alternative.”
“Partial amniotic carbon dioxide insufflation (PACI) is one
method to overcome the technical challenges of operating endoscopically in
amniotic fluid.”
PACI involves partially draining amniotic fluid and
insufflating the uterus with carbon dioxide—PACI increases space, improves
visualisation and allows the use of surgical glues.
Sasha said that evidence of fetal safety during PACI is not
well established and in sheep models, PACI causes fetal hypercapnia and
acidosis.
“The effects of PACI on fetal-placental circulation or the
developing fetal brain are unknown,” said Sasha.
“My project assessed the effect of PACI, at clinically used
insufflation pressures, on the fetal-placental circulation, fetal and maternal
acid base status and on the developing fetal brain in a sheep model.”
“We found PACI has detrimental implications for fetal
physiology including large reductions in uterine blood flow, severe fetal
hypercapnia, acidosis, hypoxia and lactic acidosis, increased fetal heart rate
and blood pressure.”
Sasha’s study found that PACI leads to cerebrovascular
changes on fetal brain histology and should not be performed in human fetuses
until further studies have addressed these safety concerns in animal models.
Sasha said her BMedSc(Hons) year had sparked a passion and
research will undoubtedly be something she remains involved in for many years to
come.
“I have learnt so much, not just about science and the
laboratory, but also an unexpectedly large amount about my personal ambitions
and capabilities.”
“I have had a fantastic year and thoroughly enjoyed working
with such passionate and dedicated people.”
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