Mussel mimetic tissue adhesive for fetal membrane repair: initial in vivo investigation in rabbits.
OBJECTIVE
Iatrogenic preterm prelabour rupture of fetal membranes (iPPROM) remains the main complication after invasive interventions into the intrauterine cavity. The aim of this study was to evaluate the sealing capability and tissue interaction of mussel-mimetic tissue adhesive (mussel glue) in comparison to fibrin glue on punctured fetal membranes in vivo.


METHODS
A mid-gestational rabbit model was used for testing the materials. The fetal sacs of pregnant rabbits at day 23 were randomly assigned into experimental groups: unoperated (negative control), unclosed puncture (positive control), commercially available fibrin glue (FG) with decellularized amnion scaffold (DAM), mussel glue (MG) with DAM, or mussel glue alone. Evaluation was done at term (30 days' gestation) assessing fetal survival, fetal membrane integrity and histology of the membranes.


RESULTS
Fetal survival was not significantly lower in any of the treatment groups compared to the negative control. All plugging materials could be found at the end of the pregnancy and no adverse effects on the fetus or the pregnant does could be observed. Sac integrity was higher in all treatment groups compared to the positive control group but significant only in the FG+DAM group. Cellular infiltration could be seen in fibrin glue and DAM in contrast to mussel glue which was only tightly adhering to the surrounding tissue. These cells were mostly of mesenchymal phenotype staining positive for vimentin. CD68 positive macrophages were found clustered around all the plugging materials, but their numbers were only significantly increased for the mussel glue alone group compared to negative controls.


CONCLUSIONS
Mussel glues performance in sealing fetal membranes in the rabbit model was comparable to that of fibrin glue. Taking into account its other favorable properties, it is a noteworthy candidate for a clinically applicable fetal membrane sealant.
Department of Obstetrics, University Hospital Zurich, Switzerland.
A
A
Kivelio
P
P
Dekoninck
M
M
Perrini
C E
CE
Brubaker
P B
PB
Messersmith
E
E
Mazza
J
J
Deprest
R
R
Zimmermann
M
M
Ehrbar
N
N
Ochsenbein-Koelble
D000818:Animals; D049872:Bivalvia; D002396:Catechols / Q000627:therapeutic use*; D005321:Extraembryonic Membranes / Q000601:surgery*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000188:drug therapy* / Q000209:etiology; D005332:Fetoscopy / Q000009:adverse effects; D015718:Fibrin Tissue Adhesive; D007049:Iatrogenic Disease; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011247:Pregnancy; D011677:Punctures / Q000009:adverse effects; D011817:Rabbits; D014014:Tissue Adhesives / Q000627:therapeutic use*; D014945:Wound Healing
D002396:Catechols; D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D011092:Polyethylene Glycols
Fetal membrane repair; Fetoscopy; Fibrin sealant; Iatrogenic PPROM; Mussel mimetic sealant; Rabbit model