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In vitro sealing of iatrogenic fetal membrane defects by a collagen plug imbued with fibrinogen and plasma

Authors

  • A. C. Engels,

    1. Centre for Surgical Technologies, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
    2. Department of Development and Regeneration, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
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  • M. F. Hoylaerts,

    1. Center for Molecular and Vascular Biology, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
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  • M. Endo,

    1. Centre for Surgical Technologies, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
    2. Department of Development and Regeneration, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
    3. Department of Urology, University Hospitals Katholieke Universiteit Leuven, Leuven, Belgium
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  • S. Loyen,

    1. Center for Molecular and Vascular Biology, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
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  • G. Verbist,

    1. Department of Obstetrics and Gynaecology, Division Woman and Child, Fetal Medicine Unit, University Hospital Gasthuisberg, Leuven, Belgium
    2. Department of Development and Regeneration, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
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  • S. Manodoro,

    1. Centre for Surgical Technologies, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
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  • P. DeKoninck,

    1. Centre for Surgical Technologies, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
    2. Department of Obstetrics and Gynaecology, Division Woman and Child, Fetal Medicine Unit, University Hospital Gasthuisberg, Leuven, Belgium
    3. Department of Development and Regeneration, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
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  • J. Richter,

    1. Centre for Surgical Technologies, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
    2. Department of Obstetrics and Gynaecology, Division Woman and Child, Fetal Medicine Unit, University Hospital Gasthuisberg, Leuven, Belgium
    3. Department of Development and Regeneration, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
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  • J. A. Deprest

    Corresponding author
    1. Centre for Surgical Technologies, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
    2. Department of Development and Regeneration, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
    • Department of Obstetrics and Gynaecology, Division Woman and Child, Fetal Medicine Unit, University Hospital Gasthuisberg, Leuven, Belgium
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  • Funding sources: Our work on tissue engineering in perinatology including membrane wound healing is funded by the European Commission (EC) via the EuroSTEC project (LSHC-CT-2006-037409). M. E. is a beneficiary of a Marie Curie Industry-Academia Partnership and Pathways grant from the EC (251356). J. P. D. is a beneficiary of a fundamental clinical research grant from the Fonds Wetenschappelijk Onderzoek Vlaanderen (1.8.012.07.N.02). J. R. is a beneficiary of a grant from the KOOR Fonds of the University Hospitals Leuven.

  • Conflicts of interest: None declared

Correspondence to: Jan Deprest. E-mail: jan.deprest@uzleuven.be

ABSTRACT

Objectives

We aimed to demonstrate local thrombin generation by fetal membranes, as well as its ability to generate fibrin from fibrinogen concentrate. Furthermore, we aimed to investigate the efficacy of collagen plugs, soaked with plasma and fibrinogen, to seal iatrogenic fetal membrane defects.

Methods

Thrombin generation by homogenized fetal membranes was measured by calibrated automated thrombography. To identify the coagulation caused by an iatrogenic membrane defect, we analyzed fibrin formation by optical densitometry, upon various concentrations of fibrinogen. The ability of a collagen plug soaked with fibrinogen and plasma was tested in an ex vivo model for its ability to seal an iatrogenic fetal membrane defect.

Results

Fetal membrane homogenates potently induced thrombin generation in amniotic fluid and diluted plasma. Upon the addition of fibrinogen concentrate, potent fibrin formation was triggered. Measured by densiometry, fibrin formation was optimal at 1250 µg/mL fibrinogen in combination with 4% plasma. A collagen plug soaked with fibrinogen and plasma sealed an iatrogenic membrane defect about 35% better than collagen plugs without these additives (P = 0.037).

Conclusions

These in vitro experiments suggest that the addition of fibrinogen and plasma may enhance the sealing efficacy of collagen plugs in closing iatrogenic fetal membrane defects. © 2013 John Wiley & Sons, Ltd.

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