A preliminary study on the use of cyanoacrylate glue for the closure of fetal membranes.

Amnion leakage, infection and inflammation are the most important problems of intrauterine fetal surgery. This study aimed to determine the shear strength characteristics of fetal membranes attached with cyanoacrylate glue. Fresh amniochorionic membrane stripes (40x30 mm) were prepared after ten term elective cesarean section patients. Two stripes were attached with 5 mm overlapping and an increasing weight was applied until separation. Shear strength of the attached segment and resultant normal stresses developed in the membrane were calculated. Finally, corresponding intraluminal pressure that shear strength could resist without rupture was estimated by assuming two perfect semi-spherical membranes that are glued together with 5 mm overlapping to form a perfect sphere with a diameter of 200 mm. Mean total weight until rupture was 156 +/- 72 gr. Shear strength of the glued 5 mm segment was calculated as 10199 +/- 4696 Pa (104 +/- 48 cmH(2)0) that resulted in 101989 +/- 46963 Pa (1040 +/- 479 cmH(2)0) mean tensile normal stress within the membrane. Assuming a perfect sphere with a diameter of 200 mm, the maximum intraluminal pressure that attached membrane stripes could resist without rupture was calculated as 1020 +/- 470 Pa (10.4 +/- 4.79 cmH(2)O). This preliminary basic study showed that the shear strength of cyanoacrylate was strong even in small tissue segments. Considering antibacterial properties, immediate action in the presence of tissue fluids, and water impermeability of the attachment sites, this agent should be considered for closure of amniochorionic membranes after fetal surgery.