Papadopulos Nikolaos A, Klotz Susanne, Raith Andreas, Foehn Matthias, Schillinger Ulrike, Henke Julia, Kovacs Laszlo, Horch Raymund E, Biemer Edgar
Department of Plastic and Reconstructive Surgery, Technical University of Munich, Munich, Germany.
Fetal Diagn Ther. 2006;21(6):494-500. doi: 10.1159/000095660. Epub 2006 Sep 12.
In this study we aimed to set up an in vitro culture of the rabbit amnion in order to support in vivo fetal membrane healing capacity following fetoscopy. Fetal membranes were collected from a mid-gestational rabbit, and cultured on collagen support material for 14 days. 34 rabbits at 22-23 days gestational age (GA) underwent fetoscopy. The entry site was randomly allocated to 4 closure technique study groups: group I, human amnion membrane (n = 23); group II, collagen foil (n = 16); group III, collagen plug (n = 19), and group IV, collagen plug with cultured amnion cells (n = 19). In all groups membrane access sites were additionally sealed with fibrin sealant, and the myometrium was closed with sutures. Fetal survival, amnion membrane integrity, and the presence of amniotic fluid were evaluated at 30 days GA. Cultures showed good survival in the collagen support material. Increased cellularity, survival and proliferations were observed. The amnion at the access site resealed in 58-64% of cases in groups II-IV, but none of the tested techniques was significantly better than the other. Histological examination indirectly revealed the anatomic repair of the membranes, since no entrapment of the membranes could be demonstrated in the myometrial wound.
在本研究中，我们旨在建立兔羊膜的体外培养体系，以支持胎儿镜检查后体内胎膜的愈合能力。从妊娠中期的兔子收集胎膜，并在胶原蛋白支持材料上培养14天。34只妊娠22 - 23天的兔子接受了胎儿镜检查。进入部位被随机分配到4个闭合技术研究组：第一组，人羊膜（n = 23）；第二组，胶原箔（n = 16）；第三组，胶原塞（n = 19）；第四组，含培养羊膜细胞的胶原塞（n = 19）。在所有组中，膜进入部位均额外用纤维蛋白密封剂密封，子宫肌层用缝线缝合。在妊娠30天时评估胎儿存活情况、羊膜完整性和羊水情况。培养物在胶原蛋白支持材料中显示出良好的存活情况。观察到细胞数量增加、存活和增殖。在第二至第四组中，58% - 64%的病例中进入部位的羊膜重新封闭，但所测试的技术中没有一种明显优于其他技术。组织学检查间接显示了胎膜的解剖修复，因为在子宫肌层伤口中未发现胎膜嵌顿。
