PDF(Pubmed)
Abstract：
There is still no curative treatment for the spontaneous preterm prelabor rupture of membranes (sPPROM), the main cause of premature birth. Here, we summarize the most recent methods and materials used for sealing membranes after sPPROM. A literature search was conducted between 2013 and 2023 on reported newborns after membranes were sealed or on animal or tissue culture models. Fourteen studies describing the outcomes after using an amniopatch, an immunologic sealant, or a mechanical cervical adapter were included. According to these studies, an increase in the volume of amniotic fluid and the lack of chorioamnionitis demonstrate a favorable neonatal outcome, with a lower incidence of respiratory distress syndrome and early neonatal sepsis, even if sealing is not complete and stable. In vivo and in vitro models demonstrated that amniotic stem cells, in combination with amniocytes, can spontaneously repair small defects; because of the heterogenicity of the data, it is too early to draw a thoughtful conclusion. Future therapies should focus on materials and methods for sealing fetal membranes that are biocompatible, absorbable, available, easy to apply, and easily adherent to the fetal membrane.
摘要：
对于自发性早产胎膜早破(sPPROM),目前尚无治愈性治疗,早产的主要原因。这里,我们总结了sPPROM后用于密封膜的最新方法和材料。在2013年至2023年之间对报道的新生儿进行了文献检索，这些新生儿在膜密封后或动物或组织培养模型上。14项研究描述了使用羊膜后的结果，一种免疫密封剂，或包括机械宫颈适配器。根据这些研究,羊水量的增加和绒毛膜羊膜炎的缺乏证明了良好的新生儿结局，呼吸窘迫综合征和早期新生儿败血症的发病率较低，即使密封不完整和稳定。体内和体外模型表明，羊膜干细胞，与羊膜细胞结合，可以自发修复小缺陷；由于数据的异质性，得出一个深思熟虑的结论还为时过早。未来的治疗方法应该集中在生物相容性的胎膜密封材料和方法上，可吸收,可用,易于应用，容易粘附在胎膜上。
