Danciu Bianca Mihaela, Oţelea Marina Ruxandra, Marincaş Marian Augustin, Niţescu Maria, Simionescu Anca Angela
Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of Obstetrics, Gynecology and Neonatology, "Dr. Alfred Rusescu" National Institute for Maternal and Child Health, 127715 Bucharest, Romania.
Biomedicines. 2023 Jul 4;11(7):1900. doi: 10.3390/biomedicines11071900.
There is still no curative treatment for the spontaneous preterm prelabor rupture of membranes (sPPROM), the main cause of premature birth. Here, we summarize the most recent methods and materials used for sealing membranes after sPPROM. A literature search was conducted between 2013 and 2023 on reported newborns after membranes were sealed or on animal or tissue culture models. Fourteen studies describing the outcomes after using an amniopatch, an immunologic sealant, or a mechanical cervical adapter were included. According to these studies, an increase in the volume of amniotic fluid and the lack of chorioamnionitis demonstrate a favorable neonatal outcome, with a lower incidence of respiratory distress syndrome and early neonatal sepsis, even if sealing is not complete and stable. In vivo and in vitro models demonstrated that amniotic stem cells, in combination with amniocytes, can spontaneously repair small defects; because of the heterogenicity of the data, it is too early to draw a thoughtful conclusion. Future therapies should focus on materials and methods for sealing fetal membranes that are biocompatible, absorbable, available, easy to apply, and easily adherent to the fetal membrane.
对于早产的主要原因——胎膜早破（sPPROM），目前仍没有治愈性的治疗方法。在此，我们总结了胎膜早破后用于封闭胎膜的最新方法和材料。我们于2013年至2023年间对胎膜封闭后报告的新生儿或动物及组织培养模型进行了文献检索。纳入了14项描述使用羊膜贴片、免疫密封剂或机械宫颈适配器后的结果的研究。根据这些研究，羊水增多且无绒毛膜羊膜炎表明新生儿预后良好，呼吸窘迫综合征和早期新生儿败血症的发生率较低，即使封闭不完全且不稳定也是如此。体内和体外模型表明，羊膜干细胞与羊膜细胞联合可自发修复小的缺损；由于数据的异质性，现在得出深思熟虑的结论还为时过早。未来的治疗应侧重于用于封闭胎膜的生物相容性、可吸收、可用、易于应用且易于粘附于胎膜的材料和方法。
