title: In vitro sealing of iatrogenic fetal membrane defects by a collagen plug imbued with fibrinogen and plasma.
abstract: OBJECTIVE
  We aimed to demonstrate local thrombin generation by fetal membranes, as well as its ability to generate fibrin from fibrinogen concentrate. Furthermore, we aimed to investigate the efficacy of collagen plugs, soaked with plasma and fibrinogen, to seal iatrogenic fetal membrane defects.
  
  
  METHODS
  Thrombin generation by homogenized fetal membranes was measured by calibrated automated thrombography. To identify the coagulation caused by an iatrogenic membrane defect, we analyzed fibrin formation by optical densitometry, upon various concentrations of fibrinogen. The ability of a collagen plug soaked with fibrinogen and plasma was tested in an ex vivo model for its ability to seal an iatrogenic fetal membrane defect.
  
  
  RESULTS
  Fetal membrane homogenates potently induced thrombin generation in amniotic fluid and diluted plasma. Upon the addition of fibrinogen concentrate, potent fibrin formation was triggered. Measured by densiometry, fibrin formation was optimal at 1250 µg/mL fibrinogen in combination with 4% plasma. A collagen plug soaked with fibrinogen and plasma sealed an iatrogenic membrane defect about 35% better than collagen plugs without these additives (P = 0.037).
  
  
  CONCLUSIONS
  These in vitro experiments suggest that the addition of fibrinogen and plasma may enhance the sealing efficacy of collagen plugs in closing iatrogenic fetal membrane defects.
authors.affiliation: Centre for Surgical Technologies, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: A C
authors.initials: AC
authors.lastname: Engels
authors.forename: M F
authors.initials: MF
authors.lastname: Hoylaerts
authors.forename: M
authors.initials: M
authors.lastname: Endo
authors.forename: S
authors.initials: S
authors.lastname: Loyen
authors.forename: G
authors.initials: G
authors.lastname: Verbist
authors.forename: S
authors.initials: S
authors.lastname: Manodoro
authors.forename: P
authors.initials: P
authors.lastname: DeKoninck
authors.forename: J
authors.initials: J
authors.lastname: Richter
authors.forename: J A
authors.initials: JA
authors.lastname: Deprest
mesh_terms: D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000209:etiology / Q000628:therapy*; D046128:Fetal Therapies / Q000009:adverse effects*; D005340:Fibrinogen / Q000627:therapeutic use*; D006801:Humans; D066298:In Vitro Techniques; D010949:Plasma; D011247:Pregnancy; D013917:Thrombin / Q000096:biosynthesis
chemical_list: D005340:Fibrinogen; D003094:Collagen; D013917:Thrombin