Готові списки джерел за темами / Prelabour rupture of membranes at term

Добірка наукової літератури з теми "Prelabour rupture of membranes at term"

Автор: Grafiati

Опубліковано: 10 грудня 2022

Оновлено: 28 січня 2023

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Статті в журналах з теми "Prelabour rupture of membranes at term"

Malak, TM, and SC Bell. "Fetal membranes structure and prelabour rupture." Fetal and Maternal Medicine Review 8, no. 3 (August 1996): 143–64. http://dx.doi.org/10.1017/s0965539500001583.

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In most pregnancies labour begins at term in the presence of intact fetal membranes. Without intervention the membranes usually spontaneously rupture near the end of the first stage of labour. In 10% of pregnancies that deliver at term the fetal membranes fail to maintain their structural integrity and this results in their “prelabour rupture”, defined as spontaneous rupture of membranes at least one hour before the onset of labour. In 95–98% of these cases at term, labour is precipitated within 48 hours. Although preterm birth, defined as birth prior to 37 completed weeks of pregnancy, occurs in only 7–8% of all pregnancies, 40–60% of these deliveries are preceded by prelabour rupture of the fetal membranes.

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Hannah, Mary E., and Gareth R. Seaward. "Prelabour rupture of membranes at term: the role of induction of labour." Fetal and Maternal Medicine Review 10, no. 2 (May 1998): 61–68. http://dx.doi.org/10.1017/s0965539597000211.

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Prelabour rupture of the membranes(PROM) is generally defined as rupture of the membranes prior to the onset of labour. When this occurs at term (greather than/equal 37 weeks of pregnancy) it is referred to as term PROM (to distinguish it from preterm PROM). The time interval between membrane rupture and the onset of labour is termed the latent period. The duration of this period is known to vary inversely with the gestational age at membrane rupture.

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JAVAID, MISBAH KAUSAR JAVAI, SAMIA HASSAN, and TAYYABA TAHIRA. "MANAGEMENT PRELABOUR RUPTURE OF THE MEMBRANES AT TERM;." Professional Medical Journal 15, no. 02 (March 10, 2008): 216–19. http://dx.doi.org/10.29309/tpmj/2008.15.02.2770.

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To find outmaternal and fetal outcome in induction of labourcompared with expectant management for prelabour rupture of membranes at term. Design: Open randomizedcomparative study. Setting and period: Gynae Unit- II Services Hospital, from 1 April 2007 to 30 September 2007. stPatient and methods: 100 patients at > 37 weeks with ruptures membranes with no contraindication to vaginal deliverywere enrolled in the study. 50 patients were in the expectant group while 50 patients were in the induction group.Results: Both groups had the same general characteristics but the Misoprostol group had a significantly shorter latancyperiod (10-16 hour Vs 20-24 hours), shorter period of hospitalization, lesser LSCS rate (24% Vs 34%) lesser need ofaugmentation (40% Vs 62%), choroamnionitis (3%Vs 7.8%), and postpartumfever (1% Vs 1.8%) when compared withexpectant group. Rate of infected wound after LSCS were compared in induction and expectant groups (2.2% Vs2.6%), also there was no difference between them regarding neonatal morbidity and nursery admission. Conclusion:So it was concluded that there was slightly high maternal complications in expectant group but no long-term maternalmorbidity. Both groups have no effect on neonatal morbidity and mortality however the duration between PROM anddelivery effect the neonatal admission in nursery and antibiotic requirements.

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Beckwith, JE, and MD Read. "Prelabour rupture of membranes at term: home management." British Journal of Midwifery 4, no. 2 (February 1996): 74–76. http://dx.doi.org/10.12968/bjom.1996.4.2.74.

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Seger, Suhad, Hala Al-Moayed, Enas Abdulrasul, and Sahar Mushatat. "PLACENTAL ALPHA-MICROGLOBULIN 1 AS A MARKER OF PRETERM PRELABOUR RUPTURE OF MEMBRANE." Iraqi Journal of Medical Sciences 17, no. 3-4 (December 31, 2019): 183–90. http://dx.doi.org/10.22578/ijms.17.3-4.4.

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Background:Normal pregnancy requires that the physical integrity of the fetal membranes be maintained until term delivery. Objective:To detect preterm prelabour rupture of membrane in pregnant women with history of watery vaginal discharge by measurement of placental alpha microglobulin 1 in cervicovaginal fluid. Methods:A case-control study done at the department of Obstetrics and Gynecology of Al-Imamein Al-Kadhimein Medical City, included 100 pregnant women attending the Outpatient Clinic with a gestational age ranging between 28-36 weeks +6 days, 50 cases with rupture of membrane (study group) and 50 cases without any complaint (control group). All women underwent sterile speculum vaginal examination then nitrazine paper used, finally placental alpha microglobulin1 level was measured by using enzyme linked immunosorbent assay kit in vaginal washing fluid. Results:A highly significant association was found between mean of placental alpha microglobulin 1 in vaginal fluid of women with premature rupture of membrane compared to the control. The validity results of placental alpha microglobulin 1 findings regarding premature rupture of membrane include: sensitivity (100%), specificity (98.0%), +ve predictive value (98.1%), -ve predictive value (100%) and accuracy (99.0%), while for nitrazine; the sensitivity (94.0%), specificity (90.0%), +ve predictive value (90.4%), -ve predictive value (93.7%) and accuracy (92%) and for vaginal fluid sensitivity (80.0%), specificity (72.0%), +ve predictive value (74.1%), -ve predictive value (78.3%) and accuracy (76.0%). Conclusion:The placental alpha microglobulin-1 immunoassay in vaginal fluid wash found to be accurate and noninvasive test, in identifying preterm prelabour rupture of the membrane. Keywords:Placental alpha-microglobulin1, preterm prelabour rupture of membrane, prelabour rupture of membrane Citation:Seger SH, Al-Moayed HA, Abdulrasul EA, Mushatat SH. Placental alpha-microglobulin 1 as a marker of preterm prelabour rupture of membrane. Iraqi JMS. 2019; 17(3&4): 183-190. doi: 10.22578/IJMS.17.3&4.4

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GRANT, JOHN M., ELISABETH SERLE, TAHIR MAHMOOD, PURNIMA SARMANDAL, and DAVID I. CONWAY. "Management of Prelabour Rupture of the Membranes in Term Primigravidae." Obstetrical & Gynecological Survey 48, no. 2 (February 1993): 88–90. http://dx.doi.org/10.1097/00006254-199302000-00011.

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Patil, Alka, Shweta Shinde, Amol Koranne, and Amod Mahajani. "Comparison of Oral Misoprostol and Oxytocin for Labour Induction in Prelabour Rupture of Membranes at Term." Indian Journal of Obstetrics and Gynecology 6, no. 4 (2018): 347–49. http://dx.doi.org/10.21088/ijog.2321.1636.6418.1.

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Shetty, A., K. Stewart, G. Stewart, P. Rice, P. Danielian, and A. Templeton. "Active management of term prelabour rupture of membranes with oral misoprostol." BJOG: An International Journal of Obstetrics and Gynaecology 109, no. 12 (December 2002): 1354–58. http://dx.doi.org/10.1046/j.1471-0528.2002.02082.x.

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Gupta, Anjali, Sarika Gautam, Om Prakash, and Meenakshi Chauhan. "Early induction versus expectant management in prelabour rupture of membranes." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 11 (October 25, 2018): 4634. http://dx.doi.org/10.18203/2320-1770.ijrcog20184521.

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Background: Prelabour rupture of membrane defined as spontaneous rupture of membrane prior to the onset of regular uterine contractions. The incidence of PROM varies from 6-18%. Management of term PROM is not having specific guidelines leading to management dilemma.Methods: This prospective study was conducted on 100 women with singleton pregnancy, cephalic presentation with spontaneous PROM at term. The aim to compare maternal and perinatal outcome of early induction with expectant management in women with PROM. The patients were divided into two group expectant group and early induction group. Induction of labour was done by PGE2 gel and expectant group patient were observed for 24 hours for spontaneous labour since leaking. Augmentation of labour was done with Oxytocin if required. Outcomes were measured as PROM to delivery interval, induction to delivery interval, mode of delivery, maternal and neonatal morbidity.Results: Eighty percent of women of expectant group went into active labour within 24 hours, and all patient of induction group went into active labour in 18 hours (p<0.001). ROM to active labour interval and ROM to delivery interval were significantly less in early induction group, (9.87 and 17.212 hour) compared to expectant group (19.118 and 23.34-hour, p<0.001). Fetal distress and LSCS were comparatively higher in induction group (16%vs 2% p=0.038). Neonatal Sepsis was seen more in expectant group but statistically insignificant (22% versus 16%, p=0.26).Conclusions: Women with term PROM can be given informed choice of expectant management and early induction explaining the merits and demerits of both options.

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Malathi, Jonna, and Venigalla Sunita. "OBSTETRIC OUTCOME IN WOMEN WITH PRELABOUR RUPTURE OF MEMBRANES AT TERM PREGNANCY." Journal of Evolution of Medical and Dental Sciences 4, no. 94 (November 21, 2015): 15960–62. http://dx.doi.org/10.14260/jemds/2015/2325.

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Дисертації з теми "Prelabour rupture of membranes at term"

Joyce, Sarah Julia. "Demographic, clinical and environmental risk factors for prelabour rupture of membranes in Western Australia." University of Western Australia. School of Population Health, 2009. http://theses.library.uwa.edu.au/adt-WU2009.0126.

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[Truncated abstract] This thesis explores the risk factors and perinatal outcomes associated with prelabour rupture of membranes, with a particular focus on the environmental context. Prelabour rupture of membranes is defined as the rupture of fetal membranes before the onset of labour. It is a relatively common obstetric endpoint, occurring in approximately 8-10% of pregnant women at term (PROM) and in up to 40% of all preterm deliveries (pPROM). Despite the high prevalence of the condition, the biological mechanisms and risk factors, and in particular the role of environmental predictors, behind the development of PROM and pPROM remain largely unclear. A record-based prevalence design was used to analyse a population of 16,229 nulliparous, Caucasian women residing in Perth, Western Australia who gave birth to a single newborn during 2002-2004. Maternal age, socioeconomic status and threatened preterm labour during pregnancy were identified as risk factors for prelabour rupture of membranes. Term PROM was significantly associated with fetal distress (OR 1.19; 95%CI 1.00-1.43) and post-partum haemorrhage (OR 1.99; 95%CI 1.60-2.48). A number of perinatal complications were observed to be associated with the presentation of preterm PROM, including prolapsed cord (OR 13.95; 95%CI 4.57-42.61), ante-partum haemorrhage (OR 3.29; 95%CI 2.20-4.91), post-partum haemorrhage (OR 2.12; 95%CI 1.54-2.91), low birth weight (OR 17.79; 95%CI 13.87-22.82), very low birth weight (OR 20.01; 95%CI 14.12-28.35) and stillbirth (OR 5.42; 95%CI 2.87-10.21). However, the outcomes were similar between pPROM patients and other preterm deliveries, indicating that the complications arose due to the timing of the delivery. In contrast though, the risk factors between the two outcomes varied which may suggest that a different aetiological pathway exists between preterm PROM and other preterm deliveries. The frequency of complications decreased with increasing gestational age at delivery until the pregnancy reached full-term, whereupon an increase in gestational age at delivery resulted in an increased risk of fetal distress and post-partum haemorrhage. This finding is novel and may have important implications for the management of prelabour rupture of membranes, specifically with regard to the relative risks and benefits of expectant management (that is, the patient is admitted to an obstetric facility or hospital and closely monitored) versus planned delivery. ... This study represents the first attempt to investigate the potential associations between environmental risk factors and prelabour rupture of membranes. The results of the thesis provide a substantial contribution to our knowledge on prelabour rupture of membranes, including findings of direct relevance to clinical practice as well as a potentially contributing environmental exposure pathway. These original findings suggest a possible preventative approach to reducing the occurrence and associated morbidity of prelabour rupture of membranes may be feasible, and should be pursued if future research confirms the preliminary findings of this thesis.

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Leelodharry, Vakil Kumar. "Maternal and neonatal outcomes in late preterm prelabour rupture of membranes: a retrospective study." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29333.

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Background: The management of late preterm prelabour rupture of membranes (PPROM) is associated with an increased risk of neonatal prematurity related morbidity due to many obstetric care guidelines which favour delivery at 34 weeks or immediately upon diagnosis of ruptured membranes after 34 weeks gestation. However, expectant management of this group of patients (i.e delayed delivery) between 34+0 and 36+6 weeks of gestation is associated with an increased risk of neonatal and maternal infectious morbidities. Aim of Study: The aim of this study was to evaluate the impact of the latency period on maternal and neonatal outcomes in late preterm prelabour rupture of membranes in a regional perinatal service in Cape Town, South Africa. The latency period was defined as the time from rupture of membranes to the time of delivery. In addition, we sought to investigate whether immediate induction of labour in the absence of overt signs of infection or fetal compromise should be prioritised in women who present with late preterm prelabour rupture of membranes. Methods: This was a retrospective cohort study carried out over a period of two years in two secondary level hospitals of the Metro West area of Cape Town. The subjects were low risk HIV negative women with singleton pregnancies with ruptured membranes in the late preterm period. Maternal and neonatal outcomes were studied between two latency periods, namely short latency (< 48 hours) and long latency period (≥ 48 hours) after ruptured membranes. Results and Conclusion: There were no significant differences in maternal and neonatal outcomes between the two groups of latency periods when latency was defined as the time from ruptured membranes to delivery. The study favoured a delayed induction thereby improving neonatal outcomes by decreasing the complications of prematurity. There were more adverse maternal outcomes, including an increase likelihood of augmentation of labour and more operative delivery along with its major risk, that of obstetric haemorrhage, were noted in the short latency period group. Therefore, a delayed induction policy appeared to be more appropriate. Preterm delivery places the newborn at risk of prematurity. Therefore, the risk of prematurity must be balanced with the risks of intrauterine infection and antepartum haemorrhage, the two major complications of expectant management if delayed induction is to be adopted. Proper monitoring of both the pregnant woman and fetus is essential when expectant management is carried out to avoid these adverse maternal and neonatal outcomes.

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Iloanusi, Nicholas Emeka. "Evaluation of pregnant women admitted with prelabour rupture of membranes (PROM)." Thesis, 2013.

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Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
Background and objectives Prelabour rupture of the membranes (PROM) is a major obstetric problem affecting about 20% of pregnancies. Complications include preterm labour, ascending intrauterine and perinatal infections, and neonatal mortality. Standard guidelines are formulated and continually reviewed to improve the clinical management of PROM and to reduce poor perinatal outcomes associated with this condition. The objectives of this study, conducted using women in Johannesburg as a sample population, were: 1) to audit the implementation of the standard protocol on management of PROM, and 2) to determine the maternal and fetal outcomes of this condition. Methods A cross-sectional descriptive study was done on women admitted to the antenatal wards of Chris Hani Baragwanath Academic Hospital with PROM. Inclusion criteria were that PROM was the main reason for admission, gestation ≥24 weeks, and maternal age 18 years or more. Hospital clinical files were studied for obstetric and clinical characteristics, adherence by doctors to the management protocol, and final outcome including latency period, induction rate, mode of delivery, and neonatal outcome. Results Ninety-seven women participated in the study. Their mean age was 27.0 years, and 37 (38%) were nulliparous. Eighty-five (87%) had attended antenatal clinic. Twenty-nine (30%) were HIV-infected, 23 (79%) of them on highly active antiretroviral treatment. 6 The mean gestational age on admission was 32.8 weeks, with 78 (80%) women having preterm PROM at GA<37 weeks and 52 (54%) at GA <34 weeks. The most frequent methods of diagnosis were visual inspection in 77 (79%), speculum examination in 49 (51%) and ultrasound scan in 81 (84%) of the women. Antibiotics were given to 96 women (99%), and antenatal corticosteroids were used in all women <34 weeks pregnant. No cases of clinical chorioamnionitis were detected. The mean latency from PROM to delivery for women <37 weeks pregnant was 15 days, and for those <34 weeks, it was 19 days. Twenty-nine women (30%) required induction of labour, and 25 (25.8%) had caesarean sections. There were 12 perinatal deaths (with the exclusion of three late neonatal deaths), resulting from prematurity (n=4), congenital anomalies (n=2), neonatal jaundice (n=2), respiratory distress syndrome (n=2) and perinatal asphyxia / hypoxic ischaemic encephalopathy (n=2). There were no recorded cases of either neonatal or puerperal sepsis. Conclusion The study may have under-represented term PROM, so the findings are most applicable to preterm PROM. The condition was mostly managed appropriately within the local protocol, especially in terms of corticosteroid and antibiotic use. Overt or clinically evident chorioamnionitis was not detected. However, the perinatal mortality rate was high, and whatever the causes of perinatal death in this group, it is clear that PROM is a high-risk condition deserving of close clinical attention.

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Doezema, Mary B. "A comparison of expectant vs. active management of premature rupture of membranes at term in a nurse midwifery service a report submitted in partial fulfillment ... for the degree of Master of Science, Nurse-Midwifery Track, Parent-Child Nursing ... /." 1995. http://catalog.hathitrust.org/api/volumes/oclc/68798798.html.

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Книги з теми "Prelabour rupture of membranes at term"

1968-, Sebire N. J., and Nicolaides K. H, eds. Preterm prelabour amniorrhexis. New York: Parthenon Pub. Group, 1996.

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Fox, Grenville, Nicholas Hoque, and Timothy Watts. Antenatal care, obstetrics, and fetal medicine. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198703952.003.0001.

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This chapter contains details of methods used for screening and diagnosis of fetal anomalies using antenatal blood tests, ultrasound scanning, chorionic villous sampling, amniocentesis, and fetal blood sampling. There are sections on pre-existing maternal diseases presenting risks to the fetus including maternal diabetes, systemic lupus erythematosus, thrombocytopenia, and neuromuscular disease, as well as those specific to pregnancy—pre-eclampsia, HELLP syndrome, and eclampsia. Intrauterine growth restriction and monitoring is covered in detail. The increased fetal risks of multiple birth due to twin-to-twin transfusion syndrome and other pregnancy complications are described, with detail on oligohydramnios, polyhydramnios, antepartum haemorrhage, preterm prelabour rupture of membranes, cord prolapse, preterm labour, and breech presentation. Intrapartum fetal assessment using electronic fetal monitoring and fetal blood sampling to diagnose fetal distress is covered to enable health professionals involved in care of the newborn to understand events which may have resulted in a baby born in poor condition.

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Частини книг з теми "Prelabour rupture of membranes at term"

Kolarova, Teodora, and Kimberly Ma. "Prelabor Rupture Of Membranes At Or Near Term." In Obstetric Evidence Based Guidelines, 262–67. 4th ed. Boca Raton: CRC Press, 2022. http://dx.doi.org/10.1201/9781003102342-21.

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Ma, Kimberly, and Sally Segel. "20. Premature rupture of membranes at or near term." In Obstetric Evidence Based Guidelines, 243–48. Taylor & Francis Group, 6000 Broken Sound Parkway NW, Suite 300, Boca Raton, FL 33487-2742: CRC Press, 2016. http://dx.doi.org/10.1201/9781315200903-21.

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Wani, Reena, and Madhuri Dwivedi. "Term Prelabor Rupture of Membranes." In Handbook of Obstetrics and Gynecology for Asia and Oceania, 353. Jaypee Brothers Medical Publishers (P) Ltd., 2016. http://dx.doi.org/10.5005/jp/books/12747_54.

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Edozien, Leroy C. "Prelabour rupture of membranes at term (37–42 weeks)." In The Labour Ward Handbook, 23–25. CRC Press, 2010. http://dx.doi.org/10.1201/b13419-12.

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Kern-Goldberger, Adina, and Dena Goffman. "Induction of Labor Versus Expectant Management for Prelabor Rupture of Membranes." In 50 Studies Every Obstetrician-Gynecologist Should Know, 74–80. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780190947088.003.0014.

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The article highlights a landmark paper from 1992 addressing the management of women with prelabor rupture of membranes at term. The article reviews the paper in detail, highlights similar and relevant subsequent studies, and addresses up-to-date guidelines. The study compared the outcomes of 5041 with prelabor rupture of membranes at term. Women were either induced with oxytocin or vaginal prostaglandin or expectant management with subsequent induction as indicated. In women with prelabor rupture of the membranes at term, induction of labor with oxytocin or prostaglandin E₂ and expectant management result in similar rates of neonatal infection and cesarean section. Induction of labor with intravenous oxytocin results in a lower risk of maternal infection than does expectant management. Women view induction of labor more positively than expectant management.

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"Labour and delivery." In Oxford Handbook of Obstetrics and Gynaecology, edited by Sally Collins, Sabaratnam Arulkumaran, Kevin Hayes, Kirana Arambage, and Lawrence Impey, 297–360. 4th ed. Oxford University PressOxford, 2023. http://dx.doi.org/10.1093/med/9780198838678.003.0006.

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Abstract This chapter begins with providing an overview of labour, going into details on the first, second, and third stages. It covers the indications for the induction of labour, cervical ripening, and the methods and special circumstances involved with the induction of labour. Fetal surveillance is included, with topics on cardiotocography, abnormalities, and classification. Operative vaginal delivery, episiotomy, perineal tears, and delivery in the patient with female genital mutilation are all explained. Caesarean sections are covered in depth, alongside prelabour rupture of membranes at term, abnormal lie of the fetus, malpresentations, and the management of the retained placenta and postpartum haemorrhage. The chapter concludes with home birth, the risks, and general practitioner involvement.

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Marowitz, Amy. "Evidence-Based Management of Prelabor Rupture of the Membranes at Term." In Best Practices in Midwifery. New York, NY: Springer Publishing Company, 2016. http://dx.doi.org/10.1891/9780826131799.0021.

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Baldwin, Andrew, Nina Hjelde, Charlotte Goumalatsou, and Gil Myers. "Obstetrics." In Oxford Handbook of Clinical Specialties, 1–97. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198719021.003.0001.

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This chapter explores obstetrics, including obstetric histories, abdominal examination, physiological changes in pregnancy, pre-pregnancy counselling, the placenta, plasma chemistry in pregnancy, antenatal care, structural abnormalities and ultrasound, screening and diagnosis of aneuploidy, minor symptoms of pregnancy, hyperemesis gravidarum, sickle cell disease in pregnancy, cardiac disease in pregnancy, drugs used in psychiatry and epilepsy, anaemia, HIV in pregnancy and labour, diabetes mellitus in pregnancy, thyroid disease in pregnancy, jaundice in pregnancy, malaria, renal disease in pregnancy, epilepsy, respiratory disease in pregnancy, connective tissue diseases in pregnancy, hypertension in pregnancy, thromboprophylaxis, thrombophilia in pregnancy, venous thromboembolism, infection, group B streptococcus (GBS), abdominal pain in pregnancy, sepsis in pregnancy and the puerperium, fetal monitoring in labour, pre-eclampsia, prematurity, small for gestational age (SGA), postmaturity (prolonged pregnancy), maternal collapse, antepartum haemorrhage, prelabour rupture of membranes at term, normal labour, induction of labour, management of delay in labour, home birth, pain relief in labour, multiple pregnancy, breech presentation and other malpresentations/malpositions, cord prolapse, shoulder dystocia, meconium-stained liquor, operative vaginal delivery, caesarean section (CS), uterine rupture, mendelson’s syndrome, stillbirth (intrauterine fetal death, IUD), postpartum haemorrhage (PPH), retained placenta, uterine inversion, placenta praevia, accreta and increta, DIC and coagulation defects, amniotic fluid embolism, birth injuries, episiotomy and tears, the puerperium, maternal and perinatal mortality.

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Nasser, Justin. "Preterm prelabour rupture of membranes." In Examination Obstetrics & Gynaecology, 195–99. Elsevier, 2011. http://dx.doi.org/10.1016/b978-0-7295-3937-1.00036-7.

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Edozien, Leroy C. "Preterm prelabour rupture of membranes." In The Labour Ward Handbook, 105–6. CRC Press, 2010. http://dx.doi.org/10.1201/b13419-39.

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Тези доповідей конференцій з теми "Prelabour rupture of membranes at term"

Ameye, L., J. De Brabanter, J. A. K. Suykens, I. Cadron, R. Devlieger, D. Timmerman, B. Spitz, and S. Van Huffel. "Predictive Models for Long Term Survival after Premature Rupture of Membranes." In 2005 IEEE Engineering in Medicine and Biology 27th Annual Conference. IEEE, 2005. http://dx.doi.org/10.1109/iembs.2005.1615500.

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Oyen, Michelle L., Virginia L. Ferguson, and Steven E. Calvin. "Fracture Resistance of Human Amnion." In ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-174552.

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While normal delivery requires disruption of the placental membranes (the “breaking of waters”), in one third of premature births delivery results from with mechanical rupture of the placental membranes prior to full-term gestation [1]. The biomechanical investigation of membrane rupture has thus been a subject of recent study [2–5]. In particular, mechanical investigations aimed specifically at understanding the membrane rupture process have concluded that the chorioamnion membrane bilayer breaks in two separate events, such that the chorion and amnion component layers fail independently, and that the delamination of the chorioamnion may represent a significant fraction of the total mechanical work done in membrane rupture [5]. The amnion is the stiffer and stronger of the two membrane layers, consisting primarily of a dense type I collagen network.

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Moore, John J., Robert M. Moore, Deepak Kumar, Joseph M. Mansour, Brian M. Mercer, Elizabeth Yohannes, Jillian Novak, and Mark Chance. "Differential Expression of Fibulin Family Proteins in Mechanically Strong vs. Weak Fetal Membrane Fragments." In ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-175332.

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Untimely rupture of the fetal membranes (FM), the amnion and choriodecidua, which normally surround and protect the fetus prior to delivery, is a major cause of preterm birth and results in significant infant mortality and morbidity. The physiological mechanism which normally leads the FM to weaken and fail prior to birth is not known. Conventional thinking that FM rupture is precipitated by the stress of uterine contractions during labor fails to explain the 10% of term deliveries and 40% of preterm deliveries in which FM rupture is the sentinel event, preceding any uterine contractions. Recent studies from several laboratories indicate that the FM undergo a genetically-programmed, biochemically-mediated, maturation process, near term, which is characterized by collagen remodeling and apoptosis. In human FM, in contrast to rat membranes, these changes are limited to the region of the FM overlying the cervix [1]. In a series of publications, our group has demonstrated that human FM have a zone of physical weakness (decreased force to rupture and work to rupture relative to the other areas of the same FM) overlying the cervical opening of the uterus. We further demonstrate that this same zone is characterized by specific markers of increased collagen remodeling and apoptosis [1–3]. These regional characteristics develop prior to the onset of contractions of labor and persist until delivery. Furthermore, the rupture tear line of the FM intersects this weak zone and thus the rupture process is hypothesized to initiate in this weak zone [3]. In order to investigate how differences in the biochemical composition of the extra-cellular matrix of the weak and the strong zones of FM reflect their different biomechanical properties, we utilized a proteomics approach to identify differences in the abundance of specific proteins in weak and strong FM fragments. Initial 2-DIGE screening resolved differences in Fibulin 5 protein expression. This prompted further analysis of additional members of the Fibulin protein family.

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