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.