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September 20-22, 2017 | Toronto, Canada
10
TH
AMERICAN PEDIATRICS HEALTHCARE &
PEDIATRIC INFECTIOUS DISEASES CONGRESS
Pediatric Healthcare & Pediatric Infections 2017
C
omplications of fetoscopic surgery for feto-fetal transfusion syndrome
reverse arterial transfusion syndrome, diaphragmatic hernia, urethral
valve, spinal cord hernia, and sacral coccygeal teratoma may include
iatrogenic rupture of fetal membranes followed by miscarriage or pre-
term birth and fetal death in 5% to 30%. This limits the clinical application
of fetal surgery and requires the development of new methods of sealing
the defects of membranes. This is the main objective of this study. The
membranes are sealed using a new model of the amniotic catheter, which
is made from a flexible elastic material and contains several channels from
the proximal end, two of which are designed to release a sealant. To seal
the trocar holes in membranes, we introduce the tissue sealant through
the canal in the catheter, and slowly withdrawing the catheter, we gradually
add the sealant through the main canal in the distal catheter. The sealant
cumulates in the puncture channel and around it, completely closing the
trocar hole. The platelet reach plasma-sealant, created in Research Center
of Obstetrics, Gynecology and Perinatology in Moscow is used as a tissue
sealant. This sealant is characterized by high adhesive ability and elasticity,
having full biocompatibility with the tissues of the female body, possessing
the convenience of use, allowing significantly reduction in the perioperative
blood loss, reduces allogeneic transfusions and achieves the reliable sealing
of the bladder. The new method of hermetic sealing of the bladder with an
amniotic catheter was initially used on isolated amniotic membranes (38
experiments) and then on uterus of non-pregnant rats (32 experiments)
with hermetic sealing of trocar holes in uterine horns and in the anterior
abdominal wall followed by histological examination of the containment
zones. The results allow us to suggest the reliable sealing of trocar holes
with an extensive network of new blood vessels growing through the
sealing zone. In future, we plan to use the new model of fetal amniotic
catheter during the fetoscopic surgery. The application of the new method
of hermetic sealing of membranes, based on the use of the new model of
an amniotic catheter allows to reduce the risk of miscarriage and preterm
birth and provides the possibility to conduct fetoscopy at earlier terms of
pregnancy, increasing fetal survival in various pathologies requiring the use
of fetal surgery.
Speaker Biography
Schneiderman M is working as a Professor of Medicine. He received his Bachelor’s
degree from the Medical University of Orenburg in 1965. After obtaining PhD degree
from the Medical University of Moscow in 1967, he worked as an Assistant Professor
in Medical University of Moscow, and from 1972 he worked as Gynecological Surgeon
at Moscow Gynecological Hospital No.5. In 1979 he became the Director of the
Gynecological Clinic at Old Arbat Street in Moscow. Between 1997-1982, he also
consulted as an Assistant Professor in the clinic of Dr. Rokhlin in San Francisco (USA).
In 2013, he joined Academician V I Kulakov Research Center of Obstetrics, Gynecology
and Perinatology Ministry of Healthcare of Russia (Moscow) as a Professor. He has
received various awards in the field of infertility treatment, new methods of surgical
treatment of gynecological diseases, in obstetrics.
e:
innamike@lmi.netA new method for preventing the iatrogenic rupture of fetal membrane and amniotic fluid disposal in
fetal surgery and a new amniotic catheter model for its implementation
Mikhail Schneiderman, Kostyukov K, Fatkhudinov T, Shmakov R
and
Sukhikh G
Ministry of Health of Russia, Russia