ABSTRACT
To examine the degree of apoptosis [programmed cell death] and to evaluate Fas [a cell surface receptor] receptor expressmon in human fetal membranes associated with premature rupture of membrane [PROM] as compared with normal pregnancies. Fetal membranes from 60 pregnancies were included in the study. Forty of 60 pregnancies had PROM. Twenty pregnancies with intact membranes served as controls. Chorioamniotic membrane biopsies were taken from the rupture site and periphery of the rupture site. In the control group, membrane biopsies were taken from the artificial rupture site, cervical pole of the membranes close1to the edge of the placenta. Samples were fixed in neutral buffered formalin and processed for paraffin embedded tissue. Sections were prepared for morphometric measurement and immunohistochemistry evaluation using Fas receptor expression. Patients with PROM showed reduction of the chorionic thickness [P<0.001] while decidual thickness showed non-significant difference versus control group [p>0.13]. Apoptotic cells were detected predominantly in the chorioaznniotic membrane, including the trophoblastic layer, and decidua. There was a statistically significant difference between the apoptotis [represented by Fas expression] of the PROM and control groups in both the rupture and peripheral sites [P<0.05]. Of the 40 cases that could be evaluated after immunohistochemical staining, Fas expression of the amniotic epithelial cells was observed in 40% of control cases and in 60% of cases with PROM. Fas expression was noticed to be increased in association with PROM group [p=0.0001] as well as with reduction of the chorionic thickness [p=0.001]. Negative Fas expression was noticed to be associated with increased thickness of the. chorionic layer. Fas receptor mediated apoptosis-has a role.in premature rupture of fetal membranes