This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (1) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Leong, A. S.-Y. Articles by Smith, R. Search for Related Content PubMed PubMed Citation Articles by Leong, A. S.-Y. Articles by Norman, J. E. Articles by Smith, R. Social Bookmarking                         What's this?

Vascular and Myometrial Changes in the Human Uterus at Term

Hunter Area Pathology Service, University of Newcastle, Newcastle, Australia

Jane E. Norman, MD

University of Glasgow, Division of Developmental Medicine, Glasgow Royal Infirmary, Glasgow, United Kingdom

Roger Smith, MD, PhD

Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, Faculty of Health, School of Medicine & Public Health, University of Newcastle, Newcastle, Australia, roger.smith@newcastle .edu.au

At term, amniotic fluid contents may mediate the onset of labor through the activation of amniotic fluid macrophages and their migration into the myometrium. To test this concept, the authors examine the histological changes that occur in myometrial biopsies at term prior to (n = 53) and during (n = 15) labor. Biopsies were stained with an antimacrophage antibody, anti-CD34 (endothelial cells), and anti—caspase 3 (apoptotic cells). The samples showed a variable inflammatory infiltrate of neutrophils and macrophages, with a greater infiltrate in the samples obtained during labor (P < .001, Fisher exact test). Prior to labor, there were prominent changes in the myometrial fibers that reflected shearing, shrinkage, edema, and particularly apoptosis; endothelial cells of thin-walled vessels prominent in the biopsies displayed marked nuclear biotinylation, and the vascular lumen contained fibrin and platelet thrombi, microparticles, desquamated endothelial cells, amniotic squamous cells, and mucoid material. These changes were also present in samples obtained during labor. In an additional 10 patients in labor with male fetuses, myometrial samples were examined for the presence of macrophages carrying a Y chromosome indicative of a fetal origin, but none were observed. These findings suggest that endothelial cell damage and amniotic fluid embolism are very common at term prior to clinical labor and provide a mechanism by which surfactant protein A and phospholipids present in the amniotic fluid may access myometrial cells and provoke the inflammatory response that occurs during parturition. The authors' studies give no support to the suggestion that fetal macrophages might invade the human myometrium at term.

Key Words: Labor • myometrium • histology • inflammation • macrophages.

Reproductive Sciences, Vol. 15, No. 1, 59-65 (2008)
DOI: 10.1177/1933719107309646


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				R. E. Youssef, M. A. Ledingham, S. S. Bollapragada, N. O'Gorman, F. Jordan, A. Young, and J. E. Norman The Role of Toll-Like Receptors (TLR-2 and -4) and Triggering Receptor Expressed on Myeloid Cells 1 (TREM-1) in Human Term and Preterm Labor Reproductive Sciences, September 1, 2009; 16(9): 843 - 856. [Abstract] [PDF]

				I. Garcia-Verdugo, Z. Tanfin, E. Dallot, M.-J. Leroy, and M. Breuiller-Fouche Surfactant Protein A Signaling Pathways in Human Uterine Smooth Muscle Cells Biol Reprod, August 1, 2008; 79(2): 348 - 355. [Abstract] [Full Text] [PDF]