In vitro sealing of iatrogenic fetal membrane defects by a collagen plug imbued with fibrinogen and plasma (pages 162–167)
A. C. Engels, M. F. Hoylaerts, M. Endo, S. Loyen, G. Verbist, S. Manodoro, P. DeKoninck, J. Richter and J. A. Deprest
Version of Record online: 7 JAN 2013 | DOI: 10.1002/pd.4032
What's already known about this topic?
- Iatrogenic preterm premature rupture of membranes remains the main complication after fetal surgery. Over the years, we have witnessed a real Odyssey of sealants being suggested or used to treat or prevent iPPROM; however, none of them has been shown to be clinically very effective. In the case of fetal membranes, the role of thrombin generation is less clear, but amniotic cells produce in vitro potent procoagulant activity consisting of tissue factor.
What does this study add?
- This study provides experimental evidence of thrombin generation in the presence of not-intact fetal membranes. Optimal plasma and fibrinogen concentrations were determined to optimize local formation of a ‘white’ fibrin clot that effectively seals a membrane defect ex vivo. All described methods are technically feasible in a clinical setting so that it seems logic to test this combination in vivo.