Department of Development and Regeneration, Organ Systems, University Hospital Gasthuisberg, Leuven, Belgium.
Department of Obstetrics and Gynecology, Division Woman and Child, Fetal Medicine Unit, University Hospital Gasthuisberg, Leuven, Belgium.
Prenat Diagn. 2018 Jan;38(2):99-105. doi: 10.1002/pd.5191. Epub 2017 Dec 11.
To evaluate novel sealing techniques for their biocompatibility and sealing capacity of iatrogenic fetal membrane defects in a pregnant rabbit model.
At day 23 of gestation (term = d31), a standardized fetoscopy was performed through a 14G cannula. The resulting fetal membrane defect was closed with condensed collagen, collagen with fibrinogen, Tissuepatch, Duraseal, or a conventional collagen plug (Lyostypt) as reference. At d30, the fetuses were harvested and full thickness fetal membrane samples were analyzed. The study consisted of 2 consecutive parts: (1) biocompatibility testing by fetal survival, apoptosis, and infiltration of polymorphonuclear cells in the membranes and (2) the efficacy to seal fetal membrane defects.
Three sealants (collagen with fibrinogen, Duraseal, or Lyostypt) were associated with a higher fetal mortality compared to control unmanipulated littermates and hence were excluded from further analysis. Tissuepatch was biocompatible, and amniotic fluid levels were comparable to those of control untouched littermates. Compared to the condensed collagen, Tissuepatch was also easier in surgical handling and induced limited cell proliferation.
Tissuepatch had the best biocompatibility and efficacy in sealing an iatrogenic fetal membrane defect in the pregnant rabbit compared to other readily available sealants.
评估新型密封技术的生物相容性及其在妊娠兔模型中封闭医源性胎膜缺陷的能力。
在妊娠第 23 天(足月=第 31 天),通过 14G 套管进行标准化的羊膜镜检查。使用浓缩胶原、含纤维蛋白原的胶原、Tissuepatch、Duraseal 或传统胶原塞(Lyostypt)作为对照,封闭由此产生的胎膜缺陷。在第 30 天,收获胎儿并分析全层胎膜样本。该研究包括 2 个连续部分:(1)通过膜内胎儿存活率、细胞凋亡和多形核细胞浸润来测试生物相容性;(2)评估封闭胎膜缺陷的效果。
三种密封剂(含纤维蛋白原的胶原、Duraseal 或 Lyostypt)与对照组未处理的同窝仔相比,胎儿死亡率更高,因此被排除在进一步分析之外。Tissuepatch 具有生物相容性,羊水水平与对照组未受干扰的同窝仔相当。与浓缩胶原相比,Tissuepatch 还更容易手术操作,且诱导的细胞增殖有限。
与其他现成的密封剂相比,Tissuepatch 在妊娠兔中封闭医源性胎膜缺陷具有最佳的生物相容性和效果。