McParland Penny C, Taylor David J, Bell Stephen C
Department of Obstetrics and Gynaecology, University of Leicester, Robert Kilpatrick Building, Leicester Royal Infirmary, PO Box 65, Leicester LE2 7LX, United Kingdom.
Am J Obstet Gynecol. 2003 Nov;189(5):1481-8. doi: 10.1067/s0002-9378(03)00585-4.
The purpose of this study was to determine the location, frequency, and extent of altered fetal membrane morphology before term labor and its relation to myofibroblast activation in their connective tissue layers.
Fetal membranes that were obtained from 10 women who underwent prelabor cesarean delivery at 38 to 39 weeks of gestation underwent biopsy examination with respect to the internal os of the cervix. The thickness of their constituent layers was measured, and the numbers of alpha-smooth muscle actin immunoreactive cells (ie, marker of myofibroblast activation) within the reticular layer were counted.
A region that measured 119+/-21cm(2), that exhibited altered morphology of the fetal membranes from the lower uterine pole, and that was characterized by increased connective tissue thickness and decreased thickness of the cellular layers was demonstrated in all patients. In 8 of 10 patients, this region was centered on the location of the Babcock tissue forceps. Within this region was an area of fetal membranes that exhibited alpha-smooth muscle actin immunoreactivity in the cells of the reticular layer and whose number correlated with parameters of altered morphology.
All patients before labor at term possess an area of fetal membranes that are located in the lower uterine pole that exhibit altered morphology that is associated with myofibroblastic activation in the chorionic connective tissue.
本研究旨在确定足月前分娩前胎膜形态改变的位置、频率和范围，及其与结缔组织层中成肌纤维细胞活化的关系。
从10名在妊娠38至39周时接受分娩前剖宫产的妇女获取的胎膜，针对宫颈内口进行活检检查。测量其各组成层的厚度，并计算网状层内α平滑肌肌动蛋白免疫反应性细胞（即成肌纤维细胞活化标记物）的数量。
在所有患者中均发现一个区域，面积为119±21平方厘米，表现为子宫下段胎膜形态改变，其特征为结缔组织厚度增加而细胞层厚度减小。10名患者中有8名，该区域以巴布科克组织钳的位置为中心。在该区域内有一片胎膜区域，其网状层细胞表现出α平滑肌肌动蛋白免疫反应性，且其数量与形态改变参数相关。
所有足月前分娩的患者均有一片位于子宫下段的胎膜区域，其形态改变与绒毛膜结缔组织中的成肌纤维细胞活化有关。
