OBJECTIVE: The aim of our study was to compare the thickness and histopathologic changes in the fetal membrane between premature rupture of membranes (PROM) and intact membrane after delivery. METHODS: In a prospective study involving 31 patients who were divided into 4 groups such as <37 weeks without PROM, <37 weeks with PROM, >or=37 weeks without PROM, and >or=37 weeks with PROM, we measured the thickness of membrane and studied the histopathologic findings in vitro by light microscopy of histological sections. RESULTS: The membrane thickness of <37 weeks with PROM group was thinner (35.9 micrometer) than that (42.3 micrometer) of <37 weeks without PROM group, but there was no statistical significance. The membrane thickness of >or=37 weeks with PROM and >or=37 weeks without PROM were similar (25.6 micrometer, 26.0 micrometer). But the membrane thickness of >or=37 weeks with/without PROM was significantly thinner (25.8 micrometer) compared with that (38.9 micrometer) of <37 weeks with/without PROM. The histopathologic features of PROM positive group was amnionitis with neutrophilic infiltration, focally or diffusely necrotic change of amniotic membrane, separation of amniotic membrane and degeneration of chorionic villi. CONCLUSION: The thickness of fetal membrane between PROM group and intact membrane group was not different but the thickness of fetal membrane between <37 weeks and >or=37 weeks was statistically significant. The histopathologic change of PROM positive group was prominent as amnionitis. Further evaluation will be needed about the relationship between membrane thickness and PROM.
Amnion ; Chorioamnionitis ; Chorionic Villi ; Extraembryonic Membranes ; Female ; Humans ; Membranes* ; Microscopy ; Neutrophils ; Pregnancy ; Prospective Studies ; Rupture*

The amniotic membrane is the innermost layer of fetal membrane and is attached to the chorion in the placenta. This membrane has been used for nearly a century in varied fields such as ophthalmology, reconstructive surgery, and burn treatment. In this case report, we used a human amniotic membrane to repair an iatrogenic oroantral communication that occurred during the extraction of the patient's right upper second molar. A splint was given after the perforation was covered with human amniotic membrane and healing was clinically evaluated at various intervals. The outcome of the study revealed that the human amniotic membrane was an efficient graft material for repairing the defect caused by an iatrogenic oroantral communication following tooth extraction.
Amnion* ; Burns ; Chorion ; Extraembryonic Membranes ; Humans* ; Membranes ; Molar ; Ophthalmology ; Patient Rights ; Placenta ; Splints ; Tooth Extraction ; Transplants

BACKGROUND: Preterm labor accounts for one third of preterm deliveries. However, the causes and the mechanism of preterm labor are still under investigation. The purpose of this study was to investigate the changes of tissue transglutaminase 2 (TGM2) and cyclo-oxigenase I,II in the fetal membrane of patients with preterm birth compared with patients with term delivery. METHODS: Fetal membrane were obtained from women with preterm birth due to preterm labor (n=3) and from the women with term delivery (n=3) after each vaginal birth. The expression of TGM2, COX I & II were assessed by RT-PCR and immunoblotting analysis of the amnion and chorion. Nonparametric statistics were used for analysis. RESULTS: In the amnion in patients with preterm delivery, the expression of TGM2, COX I and COX II mRNA were increased by 2.3-fold, 2.7-fold, 1.3-fold, respectively, compared to term delivery with labor. The protein expression of TGM2 and COX I in these patients was increased in 1.9-fold and 2.1-fold but COX II protein expression showed no significant change, compared to term delivery with labor. In the chorion in patients with preterm delivery, the expression of TGM2, COX I and COX II mRNA showed no significant change, compared to term delivery with labor, but the protein concentration was significantly increased in 14.6-fold, 1.4-fold and 1.3-fold respectively, compared to term delivery with labor. CONCLUSION: This study shows that TMG2 and COX I are expressed more in the fetal membrane at preterm delivery caused by preterm labor, compared to term delivery with labor. These data suggests that the mechanism of preterm labor might be different form term labor.
Amnion ; Chorion ; Extraembryonic Membranes* ; Female ; Humans ; Immunoblotting ; Obstetric Labor, Premature ; Parturition ; Pregnancy ; Premature Birth* ; Prostaglandin-Endoperoxide Synthases* ; RNA, Messenger

OBJECTIVE: To investigate the subcellular localization of nuclear factor kappa B (NF-kappa B) in term human fetal membranes and myometrium during labor. METHODS: Fetal membranes and myometrial tissue were collected from term pregnant women undergoing cesarean delivery after labor (n=4) and before labor (n=4). An immunostaining was done with NF-kappa B p65 antibody. The intensity and distribution of nuclear immunostaining of NF-kappa B p65 subunit were evaluated visually using a semiquantitative analysis. RESULTS: NF-kappa B p65 was present in all tissues studied, and it was localized principally in the cytoplasm of cells of amnion and chorion. But, NF-kappa B p65 was localized more abundant in the nucleus than in the cytoplasm in myometrial cells. In amnion, chorion and myometrium, the staining scores of nuclear NF-kappa B did not show any difference between the after-labor group and before-labor group. CONCLUSION: In human term gestational tissues, subcellular localization of NF-kappa B showed cytoplasmic predominance in amnion and chorion, and nuclear predominance in myometrium. But these subcellular localizations did not change during labor.
Amnion ; Animals ; Chorion ; Cytoplasm ; Extraembryonic Membranes* ; Female ; Humans* ; Mice ; Myometrium* ; NF-kappa B* ; Pregnant Women ; Transcription Factor RelA

OBJECTIVE: Cyclooxygenase-2 (Cox-2) is a rate-limiting enzyme in the production of prostaglandins. The purpose of this study was to investigate the expression of Cox-2 in various human conceptional tissues obtained from term pregnant women in labor and those not in labor. METHODS: Myometrium, chorion, and amnion were collected during cesarean section from women in labor and women not in labor. The expression of Cox-2 in each tissue was measured by Western blot analysis and the localization of Cox-2 in these tissues was confirmed by immunohistochemical staining. RESULTS: Western blot analysis showed significantly higher levels of Cox-2 in the tissue from women in labor than that from women not in labor. Immunohistochemical detection showed stronger cytoplasmic staining in the smooth muscle cells and amnion obtained from women in labor than that from women not in labor, but no change was found in chorion. CONCLUSION: In term pregnancy, the expression of Cox-2 increases in the smooth muscle cells and amnion, placenta, but not in chorion after labor.
Amnion ; Animals ; Blotting, Western ; Cesarean Section ; Chorion ; Cyclooxygenase 2* ; Cytoplasm ; Extraembryonic Membranes* ; Female ; Humans ; Membranes ; Mice ; Myocytes, Smooth Muscle ; Myometrium* ; Placenta ; Pregnancy* ; Pregnant Women ; Prostaglandin-Endoperoxide Synthases ; Prostaglandins

OBJECTIVE: Our purpose was to investigate transglutaminase 2 (TGM2) mRNA and protein expressions in term placentas and fetal membranes delivered with labor compared to no labor. METHODS: Samples were obtained from five cases delivered with labor and five cases delivered without labor after 38 weeks of gestation. Each sample was collected from amnion, chorion, central and peripheral portion of the basal plate of placenta. Real time polymerase chain reaction (RT-PCR) was done to analyze mRNA expression of TGM2. Western blot was done and TGM2 protein level was detected. Mann-Whitney U test was used for statistic analysis. RESULTS: In labor group, TGM2 mRNA expressions were decreased compared to no labor group in 3 sampling sites except chorion (0.66+/-0.10 vs 1.29+/-0.12 in peripheral placenta, 0.67+/-0.23 vs 1.02+/-0.02 in central placenta, 0.70+/-0.16 vs 1.04+/-0.05 in amnion in contrast with 1.62+/-0.64 vs 1.56+/-0.21 in chorion). TGM2 protein expressions of four differential portions were decreased in all labor groups (1.05+/-0.35 vs 1.27+/-0.19 in peripheral placenta, 0.69+/-0.84 vs 0.84+/-0.31 in central placenta, 0.33+/-0.15 vs 0.39+/-0.33 in amnion, 0.96+/-0.18 vs 1.77+/-0.61 in chorion). CONCLUSIONS: This result suggests that TGM2 might involve in labor progress of term pregnancy.
Amnion ; Blotting, Western ; Chorion ; Extraembryonic Membranes ; Gene Expression ; GTP-Binding Proteins ; Placenta ; Pregnancy ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Transglutaminases

No abstract available.
Extraembryonic Membranes* ; Placenta*

OBJECTIVETo investigate the expression of aquaporin (AQP)-1, 3, 8, 9 in human fetal membrane and their role in the human amniotic fluid circulation.

METHODSRT-PCR was employed for detection of the expressions of AQP-1, 3, 8, 9 mRNA in human amnion and chorion from 20 women with normal term pregnancy.

RESULTSAQP-1, 3, 8, 9 mRNA expression was detected in both human amnion and chorion, and no significant difference was found in their expression levels or between the amnion and chorion (P>0.05).

CONCLUSIONAQP-1, 3, 8, 9 can be associated with intramembranous transport and volume regulation of amniotic fluid.

Adult ; Amnion ; embryology ; metabolism ; Aquaporin 1 ; genetics ; Aquaporin 3 ; genetics ; Aquaporins ; genetics ; Chorion ; embryology ; metabolism ; Electrophoresis, Agar Gel ; Extraembryonic Membranes ; embryology ; metabolism ; Female ; Gene Expression Regulation, Developmental ; Humans ; Pregnancy ; Reverse Transcriptase Polymerase Chain Reaction

BACKGROUND: Recent studies have suggested that implantation site intermediate trophoblasts (ISITs) and chorionic type intermediate trophoblasts (CTITs) show different immunohistochemical findings, and that each type has specific location in placentas. However, we observed that both subtypes are intimately admixed in many areas of the placentas and both types are proliferated around the infarcts. METHODS: In order to examine the site specificity in their distribution and the changes of intermediate trophoblasts (ITs), if any, in the pre-eclamptic placentas, quantitative analyses of ISITs and CTITs using p63, CD146, placental alkaline phosphatase, human placental lactogen, and alpha-inhibin were performed in normal and pre-eclamptic placentas containing infarcts. RESULTS: In the fetal membranes of both normal and pre-eclamptic placentas, CTITs and ISITs were equally identified, forming distinct layers. ISITs were predominant in the intervillous septum and basal plate, while CTITs were predominant in the subchorionic area. At the margin of infarcts in pre-eclamptic placentas, both subtypes were increased in number, forming distinct layers. CONCLUSIONS: The subtypes of ITs do not have site specificity in placentas. Increased number of ITs and zonal distribution around infarcts suggest that CTITs and ISITs have differentiation associated relationship, and the differentiation might be related to the microenvironment of placenta, such as intraplacental oxygen concentration.
Alkaline Phosphatase ; Chorion ; Extraembryonic Membranes ; Fluconazole ; Immunohistochemistry ; Inhibins ; Oxygen ; Placenta ; Placental Lactogen ; Pre-Eclampsia ; Sensitivity and Specificity ; Trophoblasts

Premature rupture of membranes(PROM) means the rupture of amniotic membranes at any time prior to labor during the gestational period. The dilemma of correctly diagnosing rupture of the fetal membranes is well known as the consequences of management based on an incorrect diagnosis. This study was undertaken to determine if the measurement of B-hCG levels in the vaginal fluid is useful for the diagnosis of premature rupture of membranes. HCG is synthesized and secreted by the placental syncytiotrophoblast and it is normally found in amniotic fluid, maternal urine and blood. We used B-hCG for diagnosis of PROM to exclude the cross reaction with other hormones. After irrigating the posterior vaginal fornix with 3 ml of sterile saline and obtaining vaginal washings, we measured B-hCG levels. The groups were classified normal group(group I), confirmed PROM group(group II ), and suspicious PROM group(groupIII) during the third trimester. The median and 95% confidence intervals(CIS) of vaginal fluid B-hCG in each group(normal, confirmed PROM, suspicious PROM group) were 30.99mIU/ml(range: 0.32-209.89mIU/ml), 188.61mIU/ml(range: 9.65-2095.00mIU/ml), 69.63mIU/ml(range 4.76-349.56mIU/ml). There was significant difference between normal and confirmed PROM group(p<0.05), sensitivity was 95.00%, specificity 80.00%, positive predictive value 82.60%, negative predictive value 94.12%, and accuracy 87.50%, using threshold value of 60mIU/ml. There was significant difference between normal and suspicious PROM group(p<0.05) but the result of the B-hCG was not used in the obstetric decision. In terms of these results, the B-hCG level in vaginal fluid is a useful marker of PROM during the third trimester. A new technic is proposed to confirm the diagnosis of rupture of the membranes based on the introduction of B-hCG in vaginal fluid.
Amnion ; Amniotic Fluid ; Cross Reactions ; Diagnosis ; Extraembryonic Membranes ; Female ; Humans ; Membranes* ; Pregnancy ; Pregnancy Trimester, Third ; Rupture* ; Sensitivity and Specificity ; Trophoblasts