Successful sealing of fetoscopic access sites with collagen plugs in the rabbit model

Citation
E. Gratacos et al., Successful sealing of fetoscopic access sites with collagen plugs in the rabbit model, AM J OBST G, 182(1), 2000, pp. 142-146
Citations number
12
Categorie Soggetti
Reproductive Medicine","da verificare
Journal title
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
ISSN journal
00029378 → ACNP
Volume
182
Issue
1
Year of publication
2000
Part
1
Pages
142 - 146
Database
ISI
SICI code
0002-9378(200001)182:1<142:SSOFAS>2.0.ZU;2-O
Abstract
OBJECTIVE: The aim of this study was to evaluate the efficacies of various plugging techniques in sealing the membrane defect created by fetoscopy in the rabbit at midgestation. STUDY DESIGN: Fetoscopy was performed in pregnant rabbits at 23 days' gesta tion (term, 32 days' gestation). In group 1 fetal sacs were left unclosed ( positive control group, n = 24). In group 2 injection with commercially ava ilable extracellular matrix (Matrigel; ED Labware, Bedford, Mass) was perfo rmed and a myometrial suture was inserted (n = 23). In group 3 the entry si te was plugged with collagen (Colgen; Inter-Phar, Paris, France) combined w ith a myometrial suture (n = 22). At 30 days' gestation the membrane integr ity, amniotic fluid presence, and fetal lung/body weight ratios were assess ed. The plugging site was examined histologically. RESULTS: The use of suture and collagen plugs (group 3) resulted in functio nal restoration of membrane integrity with preservation of amniotic fluid a nd normal fetal lung/body weight ratio at term in 82% of cases, compared wi th 42% in the positive control group (group 1; P <.05). Histologic examinat ion revealed entrapment of membranes between the plug and the myometrium bu t no anatomic repair of the membranes. The use of suture and extracellular matrix (group 2) did not achieve better results than those seen in group 1 (positive control group). CONCLUSION: Collagen plugs achieved functional sealing of fetoscopic access sites in a rabbit model and prevented oligohydramnios and pulmonary hypopl asia.