PubMed · 5832565
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K Jantzen. 1965-06-10. [Experiences with amnioscopy].. https://pubmed.ncbi.nlm.nih.gov/5832565/
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OBJECTIVE: Our purpose was to compare the level of expression of both type 1 and type 2 cyclooxygenase genes before and after labor and to localize their expression within the fetal membranes. STUDY DESIGN: The sites of type 2 and type 1 cyclooxygenase messenger ribonucleic acid synthesis were identified with in situ hybridization. Expression of both types 1 and 2 cyclooxygenase was studied by reverse transcriptase polymerase chain reaction. RESULTS: Cyclooxygenase type 2 and type 1 expression was localized within the amniotic epithelium and amniotic mesoderm. Type 1 but not type 2 enzyme was also expressed in the chorionic mesoderm. Expression of the type 2 enzyme was significantly increased with the onset of labor. Type 1 enzyme expression did not significantly change with labor. CONCLUSION: It is most likely that it is the inducible type 2 cyclooxygenase enzyme that mediates the increase in prostaglandin synthesis in amnion with the onset of labor.
OBJECTIVE: Our purpose was to determine the predictive accuracy of a composite ultrasonographic evaluation for chorionicity, amnionicity, and zygosity in a consecutive series of twins. STUDY DESIGN: One hundred ten consecutive twins were seen for ultrasonography beginning January 1992. Chorionicity, amnionicity, and, zygosity were prospectively assessed with a composite of ultrasonographic findings (placental number, fetal sex, membrane thickness, and "twin peak" sign). Clinical and pathologic confirmation of chorionicity, amnionicity, and zygosity was available on 100 of these twins. RESULTS: The 100 twins had 3.6 +/- 1.6 ultrasonographic scans each (mean +/- SD) with the first performed at 22.6 +/- 6.9 weeks. Chorionicity, amnionicity, and zygosity were each predicted with > or = 91% sensitivity and specificity. In 35 (35%) cases zygosity could not be determined by either ultrasonographic or clinical or pathologic assessment at delivery. CONCLUSION: Chorionicity, amnionicity, and zygosity have important implications for antepartum management and prognosis of twins. By use of a composite of ultrasonographic findings, chorionicity, amnionicity, and zygosity were predicted with excellent reliability when they were prospectively tested in a heterogeneous consecutive series of twins.
OBJECTIVES: The mechanism(s) of preterm premature rupture of fetal membranes resulting in preterm birth remains unknown. Studies suggest that fetal membranes are susceptible to weakening by protease attack and that collagenases may be active at the site of rupture. In this study fetal membranes from women delivered after preterm premature rupture of membranes were compared with control membranes and analyzed qualitatively and quantitatively for protease activities. STUDY DESIGN: Fourteen membranes from women with preterm premature rupture of membranes and nine membranes from women delivered preterm without premature rupture of membranes or otherwise normal women delivered at term vaginally or by cesarean section were studied. Zymogram gel electrophoresis with gelatin incorporation was used to assess the number and apparent molecular weights of protease activities. Functional and quantitative studies of protease activity were measured by fluorescent substrate cleavage. RESULTS: Zymogram gel electrophoresis studies demonstrated the presence of five to seven different protease bands in preterm premature rupture of membranes samples, whereas control membranes demonstrated only one to three protease bands. Fluorescent studies of protease activity demonstrated a 10- to 40-fold increase in activity in membranes from women with preterm premature rupture of membranes compared with normal control membranes. Studies with protease inhibitors suggest that most of the activity is due to metalloproteinases. CONCLUSION: In membranes from women with preterm premature rupture of membranes there appears to be a general increase in the amount of protease activity and increased numbers of putatively different proteases. Increased activity or deregulated protease control may mediate preterm premature rupture of membranes and be a potentially remediable cause of preterm birth.