INITIAL RESULTS OF CLINICAL APPLICATION OF MESENCHYMAL STROMAL STEM CELL-DERIVED EXTRACELLULAR MICROVESICLES AFTER ABDOMINAL DELIVERY


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Abstract

Aim. To investigate the tolerability to the injection of extracellular microvesicles (EMV) of placenta-derived mesenchymal stromal cells (MSC) during abdominal delivery and assess the postoperative course. Materials and methods. The study included two groups of puerperal women after cesarean delivery. The study group consisted of 23 patients who received 500ßl EMV MSC during abdominal delivery and continuous closure of the low transverse uterine incision with vicryl suture. The comparison group (controlgroup) included 30 patients with traditional continuous single-layer closure of uterine incision with vicryl suture. Results. All puerperal women in the study group had an uneventful postoperative course and were discharged home earlier (postoperative stay 4.26+0.09 vs. 5.33+0.38, p <0.05) than patients in the control group. All patients of the study group planned to become pregnant in the next 2-3 years and were included in the registry for subsequent vaginal delivery in the presence of a post-cesarean uterine scar. The patients of the study group did not have septic complications, while two (6.7%) and one (3.3%) patients in the control group had postpartum metroendometritis and lochiometra, respectively Conclusion. The study findings suggest a good tolerability profile and higher effectiveness of intraoperative EMV administration than traditional postpartum management. Initial results of the clinical application of exosomes open up new horizons for their use. It may help improve myometrium repair and predict future spontaneous delivery for patients with post-cesarean uterine scars.

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About the authors

Gennady T. SUKHIKH

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: g_sukhikh@oparina4.ru
Dr. Med. Sci., Professor, Academician of the RAS, Director Moscow, Russia

Oleg G. PEKAREV

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: o_pekarev@oparina4.ru
Dr. Med. Sci., Professor, Deputy Director of the Institute of Obstetrics Moscow, Russia

Evgenia O. PEKAREVA

Novosibirsk City Clinical Perinatal Center

Email: pekareva_e@mail.ru
Ph.D., Obstetrician-Gynecologist Novosibirsk, Russia

Igor V. MAIBORODIN

Institute of Chemical Biology and Fundamental Medicine, SB of the RAS

Email: imai@mail.ru
Dr. Med. Sci., Professor, Head Researcher of the Stem Cell Laboratory Novosibirsk, Russia

Denis N. SILACHEV

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: silachevdn@genebee.msu.ru
Ph.D., Head of the Cell Technologies Laboratory Moscow, Russia

Igor I. BARANOV

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: i_baranov@oparina4.ru
Dr. Med. Sci., Professor, Head of the Department of Scientific and Educational Programs Moscow, Russia

Ivan M. POZDNYAKOV

Novosibirsk City Clinical Perinatal Center

Dr. Med. Sci., Professor, Chief Physician Novosibirsk, Russia

Natalya S. BUSHUEVA

Novosibirsk City Clinical Perinatal Center

M.D., Head of the Maternity Department Novosibirsk, Russia

Aleksey M. NOVIKOV

Institute of Chemical Biology and Fundamental Medicine, SB of the RAS

M.D., Junior Researcher at the Stem Cell Laboratory Novosibirsk, Russia

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