Repairing Fetal Membranes with a Self-adhesive Ultrathin Polymeric Film: Evaluation in Mid-gestational Rabbit Model

Preterm premature rupture of membranes causes 40% of all preterm births, affecting 150000 women each year in the United States. Prenatal diagnostic procedures and surgical interventions increase incidence of adverse events, leading to iatrogenic membrane rupture after a fetoscopic procedure in 45% o...

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Bibliographic Details
Published in:	Annals of biomedical engineering Vol. 43; no. 8; pp. 1978 - 1988
Main Authors:	Pensabene, Virginia, Patel, Premal P., Williams, Phillip, Cooper, Trisha L., Kirkbride, Kellye C., Giorgio, Todd D., Tulipan, Noel B.
Format:	Journal Article
Language:	English
Published:	New York Springer US 01-08-2015 Springer Nature B.V
Subjects:	Animals Biochemistry Biocompatibility Biological and Medical Physics Biomedical and Life Sciences Biomedical Engineering and Bioengineering Biomedical materials Biomedicine Biophysics Classical Mechanics Defects Female Fetal Membranes, Premature Rupture - surgery Humans In vivo testing Instrumentation Lactic Acid - chemistry Lactic Acid - pharmacology Membranes Membranes, Artificial Nanostructure Polyesters Polymers - chemistry Polymers - pharmacology Pregnancy Premature Birth - prevention & control Rabbits Seals Tissue Adhesives - chemistry Tissue Adhesives - pharmacology lactic acid Ultrathin polymeric film Fetal surgery Amnion IPPROM Poly Chorion
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Summary:	Preterm premature rupture of membranes causes 40% of all preterm births, affecting 150000 women each year in the United States. Prenatal diagnostic procedures and surgical interventions increase incidence of adverse events, leading to iatrogenic membrane rupture after a fetoscopic procedure in 45% of cases. We propose an ultrathin, self-adherent, poly- l -lactic acid patch (“nanofilm”) as a reparative wound closure after endoscopic/fetoscopic procedures. These nanofilms are compatible with application in wet conditions and with minimally invasive instrumentation. Ex vivo studies to evaluate the nanofilm were conducted using human chorion–amnion (CA) membranes. A custom-built inflation device was used for mechanical characterization of CA membranes and for assessment of nanofilm adhesion and sealing of membrane defects up to 3 mm in size. These ex vivo tests demonstrated the ability of the nanofilm to seal human CA defects ranging in size from 1 to 3 mm in diameter. In vivo survival studies were conducted in 25 mid-gestational rabbits, defects were created by perforating the uterus and the CA membranes and subsequently using the nanofilm to seal these wounds. These in vivo studies confirmed the successful sealing of defects smaller than 3 mm observed ex vivo . Histological analysis of whole harvested uteri 7 days after surgery showed intact uterine walls in 59% of the nanofilm repaired fetuses, along with increased uterine size and intrauterine development in 63% of the cases. In summary, we have developed an ultrathin, self-adhesive nanofilm for repair of uterine membrane defects.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0090-6964 1573-9686
DOI:	10.1007/s10439-014-1228-9