Z Geburtshilfe Neonatol 2013; 217 - V03_4
DOI: 10.1055/s-0033-1361202

Mussel mimetic tissue adhesive (mussel glue) for fetal membrane repair in vivo

N Ochsenbein-Kölble 1, AS Kivelio 1, P Dekoninck 2, M Perrini 1, C Brubaker 3, DG Barrett 3, P Messersmith 4, E Mazza 5, J Deprest 2, M Ehrbar 1, R Zimmermann 1
  • 1University Hospital Zurich, Division of Obstetrics, Zurich, Switzerland
  • 2University Hospitals Leuven, Division of Woman and Child, Fetal Diagnosis and Therapy Unit, Leuven, Belgium
  • 3Northwestern University, Biomedical Engineering Department, Evanston, United States
  • 4Northwestern University, Evanston, United States
  • 5Swiss Federal Institute of Technology, Mechanical Engineering Department, Zurich, Switzerland

Introduction: Iatrogenic preterm prelabour rupture of the fetal membranes (iPPROM) remains the Achilles heel of fetoscopic procedures. The aim was to evaluate and compare the sealing properties of a mussel-mimetic tissue adhesive (mussel glue) with fibrin glue on punctured fetal membranes in the rabbit model.

Material and methods: Fetal membrane defects were created by a 14G needle puncture at day 23 and closed with mussel glue alone (N = 10), mussel glue with decellularized amnion scaffold (DAM; N = 10) or commercially available fibrin glue with DAM (N = 15) or left unclosed (positive control; N = 11). Ninety-three unoperated sacs served as negative controls. At day 30 fetal survival, fetal membrane integrity and histology of the membranes were evaluated.

Results: Fetal survival was not compromised by any treatment. Mussel glue and fibrin glue were found in all cases. No adhesions or amniotic bands were detected. Membrane integrity was higher in all treatment groups (75 – 100%) compared to the positive control (25%). Cellular infiltration, mostly of mesenchymal cells, was seen in fibrin glue and DAM but not in mussel glue. CD68 positive macrophages were found clustered around all the plugging materials, but in the mussel group their numbers were significantly higher compared to negative controls.

Conclusions: Mussel glue sealing of fetoscopic defects is as effective as fibrin glue. The sealing capacity of mussel glue justifies further evaluation of this product.