FSBI "National Medical Research Centre for Obstetrics, Gynecology and Perinatology named after academician V.I.Kulakov" of the Ministry of Health of the Russian Federation, Moscow, Russia.
GBUZ NSO Novosibirsk City Clinical Perinatal Centre, Novosibirsk, Russia.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):7523-7525. doi: 10.1080/14767058.2021.1951213. Epub 2021 Aug 4.
The rate of cesarean deliveries is steadily growing worldwide as a result of increasing maternal age at first delivery. Ensuring optimal recovery after surgery, specifically the development of a functionally competent uterine scar to facilitate vaginal birth after a cesarean delivery (VBAC), is one of the challenges in modern obstetrics. Extracellular microvesicles (EMVs) are secreted by multiple cell types and act as mediators of intercellular interaction during tissue reparation. The immunomodulatory and regenerative effects of EMVs of mesenchymal stromal cells (MSCs) have been studied shown in pre-clinical studies.
To evaluate the safety profile of EMVs of mesenchymal stromal placental cells (MSPCs) injected during the cesarean delivery and the impact of this pilot approach on post-surgery recovery.
This pilot study included 53 women undergoing cesarean delivery with ( = 23) or without ( = 30) an injection of 500 µl of MSC EMVs after closing the uterine incision with a single continuous Vicryl suture.
All study participants had uncomplicated post-surgery period. The mean inpatient stay duration in women receiving the EMV injection was 4.26 ± 0.09 days vs. 5.33 ± 0.38 in the control group (<.05). There were no postpartum inflammatory complications in the study group compared with two cases (6.7%) by postpartum endometritis/myometrial infection and one case (3.3%) of lochiometra in the control group.
Intra-surgery injection of MSC EMVs was well-tolerated and associated with a lower rate of infectious post-partum complications in women undergoing cesarean delivery.
由于初产妇年龄的增加，全球剖宫产率稳步上升。确保手术后的最佳恢复，特别是形成功能健全的子宫瘢痕，以促进剖宫产后阴道分娩（VBAC），是现代产科的挑战之一。细胞外微泡（EMVs）由多种细胞类型分泌，并在组织修复过程中作为细胞间相互作用的介质。间充质基质细胞（MSCs）的 EMVs 的免疫调节和再生作用已在临床前研究中得到证实。
评估在剖宫产时注射间充质基质胎盘细胞（MSPC）的 EMVs 的安全性，并评估这种试验方法对手术后恢复的影响。
这项初步研究包括 53 名接受剖宫产的妇女，其中 23 名在关闭子宫切口时注射 500 µl 的 MSC EMVs，而 30 名则单独使用连续 Vicryl 缝线。
所有研究参与者术后均无并发症。接受 EMV 注射的女性平均住院时间为 4.26 ± 0.09 天，而对照组为 5.33 ± 0.38 天（<0.05）。与对照组中 2 例（6.7%）产后子宫内膜炎/子宫肌炎和 1 例（3.3%）恶露不绝相比，研究组中无产后炎症性并发症。
在剖宫产术中注射 MSC EMVs 耐受性良好，与对照组相比，可降低剖宫产妇女产后感染性并发症的发生率。
