Absorbable gelatin plug does not prevent iatrogenic preterm premature rupture of membranes after fetoscopic laser surgery for twin–twin transfusion syndrome

Despite fetoscopic laser ablation (FLA) having emerged as an effective treatment for twin–twin transfusion syndrome (TTTS), major postintervention challenges, such as iatrogenic preterm premature rupture of membranes (iPPROM), remain. A chorioamniotic plug (CAP) made of absorbable gelatin sponge has been used to seal the trocar entry site in the chorioamniotic layers to promote healing and prevent iPPROM, yet the results have been equivocal. Our objective was to test the hypothesis that, following FLA for TTTS, iPPROM may be prevented by placement of an absorbable gelatin CAP.

[1]  R. Papanna,et al.  Novel findings of iatrogenic fetal membrane defect after previous fetoscopy for twin–twin transfusion syndrome , 2013, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[2]  E. Mazza,et al.  Mussel-mimetic tissue adhesive for fetal membrane repair: an ex vivo evaluation. , 2012, Acta biomaterialia.

[3]  R. Stewart,et al.  Fetal membrane patch and biomimetic adhesive coacervates as a sealant for fetoscopic defects. , 2012, Acta biomaterialia.

[4]  Roland Devlieger,et al.  Preterm Prelabor Rupture of Membranes and Fetal Survival after Minimally Invasive Fetal Surgery: A Systematic Review of the Literature , 2011, Fetal Diagnosis and Therapy.

[5]  R. Papanna,et al.  Chorioamnion plugging and the risk of preterm premature rupture of membranes after laser surgery in twin–twin transfusion syndrome , 2010, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[6]  J. Deprest,et al.  Enrichment of collagen plugs with platelets and amniotic fluid cells increases cell proliferation in sealed iatrogenic membrane defects in the fetal rabbit model , 2008 .

[7]  J. Deprest,et al.  Enrichment of collagen plugs with platelets and amniotic fluid cells increases cell proliferation in sealed iatrogenic membrane defects in the foetal rabbit model , 2008, Prenatal diagnosis.

[8]  J. Henke,et al.  Fetoscopic Closure of Punctured Fetal Membranes With Acellular Human Amnion Plugs in a Rabbit Model , 2007, Obstetrics and gynecology.

[9]  J. Deprest,et al.  Fetal membrane healing after spontaneous and iatrogenic membrane rupture: a review of current evidence. , 2006, American journal of obstetrics and gynecology.

[10]  J. Deprest,et al.  OC38: Preventive collagen plugging of fetal membrane defects following fetoscopic endoluminal tracheal occlusion (FETO) , 2006 .

[11]  S. Carr,et al.  Port insertion and removal techniques to minimize premature rupture of the membranes in endoscopic fetal surgery. , 2006, Journal of pediatric surgery.

[12]  J. Deprest,et al.  A histological study of fetoscopic membrane defects to document membrane healing. , 2006, Placenta.

[13]  J. Stockman,et al.  Endoscopic Laser Surgery Versus Serial Amnioreduction for Severe Twin-to-Twin Transfusion Syndrome , 2006 .

[14]  I. Timor-Tritsch,et al.  The Closure of Iatrogenic Membrane Defects after Amniocentesis and Endoscopic Intrauterine Procedures , 2004, Fetal Diagnosis and Therapy.

[15]  J. Deprest,et al.  Matrix Metalloproteinases-2 and -9 and Their Endogenous Tissue Inhibitors in Tissue Remodeling After Sealing of the Fetal Membranes in a Sheep Model of Fetoscopic Surgery , 2002, The Journal of the Society for Gynecologic Investigation: JSGI.

[16]  J. Deprest,et al.  Matrix metalloproteinases -2 and -9 and their endogenous tissue inhibitors in fetal membrane repair following fetoscopy in a rabbit model. , 2000, Molecular human reproduction.

[17]  J. Deprest,et al.  Successful sealing of fetoscopic access sites with collagen plugs in the rabbit model. , 2000, American journal of obstetrics and gynecology.

[18]  R. Quintero,et al.  Staging of Twin-Twin Transfusion Syndrome , 1999, Journal of Perinatology.

[19]  F. Luks,et al.  Gelatin sponge plug to seal fetoscopy port sites: technique in ovine and primate models. , 1999, American journal of obstetrics and gynecology.

[20]  G. Leparc,et al.  Treatment of iatrogenic previable premature rupture of membranes with intra-amniotic injection of platelets and cryoprecipitate (amniopatch): preliminary experience. , 1999, American journal of obstetrics and gynecology.

[21]  S. Özalp,et al.  Maternal blood clot patch therapy: a model for postamniocentesis amniorrhea. , 1997, American journal of obstetrics and gynecology.