In vitro sealing of punctured fetal membranes: potential treatment for midtrimester premature rupture of membranes.


Journal Article

OBJECTIVE: Midtrimester premature rupture of membranes causes significant perinatal morbidity and death. No effective treatment exists. We investigated (1) whether a needle puncture in the fetal membranes could be sealed in vitro and (2) the optimal composition of the sealant to be used. STUDY DESIGN: Membranes from second trimester pregnancies (16-24 weeks of gestation) were stretched over a modified syringe with a 2.5-cm open diameter. The syringe was filled with 20 mL of second trimester amniotic fluid, and the membrane was punctured with a 20-gauge needle. Sealants were injected into the amniotic fluid. The primary outcome variable was time for leakage of amniotic fluid. Median times for leakage for the formulations were compared by Wilcoxon exact rank sum test. RESULTS: Platelets alone failed to seal the puncture site. All other formulations stopped leakage temporarily. Tisseel (Baxter Corp, Glendale, Calif) and cryoprecipitate/thrombin preparations led to more prolonged sealing of punctured amniotic membranes than platelets (P <.01) and were not significantly different from each other. CONCLUSION: Of the sealants tested in vitro, amniotic membranes are best sealed by a fibrin/thrombin-based sealant.

Full Text

Cited Authors

  • Reddy, UM; Shah, SS; Nemiroff, RL; Ballas, SK; Hyslop, T; Chen, J; Wapner, RJ; Sciscione, AC

Published Date

  • November 2001

Published In

Volume / Issue

  • 185 / 5

Start / End Page

  • 1090 - 1093

PubMed ID

  • 11717639

Pubmed Central ID

  • 11717639

International Standard Serial Number (ISSN)

  • 0002-9378

Digital Object Identifier (DOI)

  • 10.1067/mob.2001.117685


  • eng

Conference Location

  • United States