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Journal of the Society for Gynecologic Investigation
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Reviews

The Role of Matrix Degrading Enzymes and Apoptosis in Repture of Membranes

Ramkumar Menon, MS

Perinatal Research Center of the Women's Health Research and Education Foundation and The University of Phoenix, Nashville Campus; The Women's Hospital at Centennial Medical Carter, Nashville, Tennessee; fortunat{at}edge.net

Stephen J. Fortunato, MD

Perinatal Research Center of the Women's Health Research and Education Foundation and The University of Phoenix, Nashville Campus; The Women's Hospital at Centennial Medical Carter, Nashville, Tennessee

Prematurity is the third leading cause of perinatal death, and pretem premature rupture of the membranes (pPROM) is associated with approximately 20-50% of all preterm births. The etiologic factors described for pPROM and pretem labor (PTL) are the same, although the clinical presentation (pPROM vs PTL) differs among patients. The reason for this disparity is unknown and poses a therapeutic dilemma. Several etiologic factors have been described for PTL and pPROM. PTL and pPROM are associated with overwhelming host inflammatory response. Many of these pro-inflammatory factors (inflammatory cytokine release) are common in both conditions; however, the clinical presentation differs. The objective of this review is to explain the differential expression pattern of matrix metalloproteinases (MMPs) and pro-apoptotic elements in human fetal membranes in pPROM and PTL and how they interact to present different clinical outcomes during pregnancy.

Key Words: PROM • fetal membranes • apoptosis • MMPs • preterm labor

Journal of the Society for Gynecologic Investigation, Vol. 11, No. 7, 427-437 (2004)
DOI: 10.1016/j.jsgi.2004.04.001
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