Surgical Sealants for Fetal Membrane Repair–Novel materials, Novel Devices

Aim: To develop a sealing method for preventive closure of fetoscopic access sites in fetal membranes.

Aims: Premature rupture of the fetal membranres is a devastating compolication of pregnancy. Medical invasions into the intrauterine cavity for diagnostic or surgical interventions carry a significant risk for persisting membrane leakage and subsequent rupture–which seriously limits the developing field of fetal surgery. The effort goes to take action before membrane rupture rather than react after obvious or symptomatic rupture:

Methods: Our direction of research concerns preventive plugging of fetoscopic access sites in fetal membranes at the time of intervention to inhibit leakage and rupture. Six injectible surgical sealants, five synthetic, one biological, were tested for their bonding and toxicity for human fetal membranes ex vivo [1]. We introduce a novel biomechanical test device that permits to test closure of fetal membrane under close to physiological conditions.

Results: One type of novel poly(ethylene glycol)-based hydrogel, mussel-mimetic tissue adhesive, showed efficient, non-disruptive, non-toxic bonding to fetal membranes. Mussel-mimetic tissue adhesive applied over membrane defects created with a 2mm trocar accomplished leak-proof closure that withstood membrane stretch in an ex vivo model. In conclusion, a synthetic hydrogel-type tissue adhesive evolved as potential sealing modality for iatrogenic membrane defects that merits further evaluation in vivo.

Literatur: 1 Bilic G, et al. Injectible candidate sealants for fetal membrane repair: Bonding and toxicity in vitro.

Endoscopic fetal surgery - Membrane Closure - iatrogenic PROM (Premature Rupture of Membranes)