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Bioengineering of fetal membrane repair


Zisch, A H; Zimmermann, R (2008). Bioengineering of fetal membrane repair. Swiss Medical Weekly, 138(41):596-601.

Abstract

Preterm premature rupture of the foetal membranes (früher vorzeitiger Blasensprung) has remained a devastating complication of pregnancy with very high risk of pregnancy loss. Several methods of sealing spontaneously ruptured membranes to stop amniotic fluid leakage and prolong pregnancy have been tested, but no one of them has achieved a clinical breakthrough. Also, needle and foetoscopic puncture of membranes for diagnostic or surgical interventions in the amniotic cavity carry a significant risk of persistent membrane leakage and subsequent rupture - thus limiting the developing field of intrauterine foetal surgery. Efforts are concentrated on taking action before rupture rather than reacting after rupture: one avenue of research concerns prophylactic plugging of foetoscopic access sites in foetal membranes at the time of intervention, thus inhibiting leakage and rupture. Foetal membrane injuries, spontaneous or iatrogenic, constitute extreme challenges to repair: thinness of foetal membrane tissue, difficult localisation and accessibility of the rupture site, the need for injectable sealants, wet gluing conditions and poor wound healing in this tissue all complicate repair. The goal is to achieve immediate and at the same time long-lasting closure of the membrane leak. Here we review approaches to closure of foetal membrane defects with liquid sealants or solid biomaterial scaffolds, with the focus on prophylactic plugging of foetoscopic access sites.

Preterm premature rupture of the foetal membranes (früher vorzeitiger Blasensprung) has remained a devastating complication of pregnancy with very high risk of pregnancy loss. Several methods of sealing spontaneously ruptured membranes to stop amniotic fluid leakage and prolong pregnancy have been tested, but no one of them has achieved a clinical breakthrough. Also, needle and foetoscopic puncture of membranes for diagnostic or surgical interventions in the amniotic cavity carry a significant risk of persistent membrane leakage and subsequent rupture - thus limiting the developing field of intrauterine foetal surgery. Efforts are concentrated on taking action before rupture rather than reacting after rupture: one avenue of research concerns prophylactic plugging of foetoscopic access sites in foetal membranes at the time of intervention, thus inhibiting leakage and rupture. Foetal membrane injuries, spontaneous or iatrogenic, constitute extreme challenges to repair: thinness of foetal membrane tissue, difficult localisation and accessibility of the rupture site, the need for injectable sealants, wet gluing conditions and poor wound healing in this tissue all complicate repair. The goal is to achieve immediate and at the same time long-lasting closure of the membrane leak. Here we review approaches to closure of foetal membrane defects with liquid sealants or solid biomaterial scaffolds, with the focus on prophylactic plugging of foetoscopic access sites.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Obstetrics
04 Faculty of Medicine > Center for Integrative Human Physiology
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Language:English
Date:2008
Deposited On:01 Dec 2008 12:37
Last Modified:05 Apr 2016 12:33
Publisher:EMH Swiss Medical Publishers
ISSN:0036-7672
Additional Information:Free full text article
Official URL:http://www.smw.ch/docs/pdf200x/2008/41/smw-11997.pdf
Related URLs:http://www.smw.ch/dfe/set_archiv.asp?target=2008/41/smw-11997 (Publisher)
http://www.smw.ch/dfe/set_archiv.asp (Publisher)
PubMed ID:18941945
Permanent URL: http://doi.org/10.5167/uzh-5256

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