Abstract

Objective
Iatrogenic preterm premature rupture of membranes (iPPROM), the main complication of
invasive interventions in the prenatal period, seriously limits the benefit of diagnostic or
surgical prenatal procedures. This study aimed to evaluate preventive plugging of punctured
fetal membranes in an ex vivo situation using a new mussel-mimetic tissue adhesive (mussel
glue) to inhibit leakage.
Methods
A novel biomechanical test device that tests the closure of injured membranes under nearphysiological
conditions was used. Mussel glue, a poly(ethylene glycol)-based hydrogel, was
used to seal membrane defects of up to 3mm in mechanically well-defined elastomeric
membranes with three different degrees of stiffness.
Results
Elastomeric test membranes were successfully employed for testing mussel glue under welldefined
conditions. Mussel glue plugs were distended by up to 94%, which translated to an
improved sealing efficiency on elastomeric membranes with high stiffness. For the stiffest
membrane tested, a critical burst pressure of 48mbar (36mmHg) was accomplished in this ex
vivo setting.
Conclusions
Mussel glue appears to efficiently seal membrane defects under well standardized ex vivo
conditions. As repaired membranes resist pressures measured in amniotic cavities, mussel
glue might represent a novel sealing method for iatrogenic membrane defects.