Chowdhury, Bipasha;
(2021)
How do factors known to cause preterm premature rupture of the membranes affect the ultrastructure and integrity of the amnion?
Doctoral thesis (M.D(Res)), UCL (University College London).
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Abstract
Introduction: Preterm premature rupture of the fetal amniotic membrane (PPROM) is a cause of preterm birth and affects 2% of women worldwide. Causative factors such as uterine contractions and inflammatory mediators such as PGE2 weaken the fetal membrane due to a loss in biomechanical properties. This study investigated the influence of fibre orientation on the mechanical properties of the amniotic membrane (AM) and the effect of cyclical tensile strain (CTS) regimens on the fibre network within the AM as well as on PGE2 production. Methods: AM were collected from women undergoing term elective Caesarean Section at University College Hospital. AM from the cervix and placental regions were stained to identify fibre orientation. Specimens of AM were then subjected to a strain to failure regimen (Bionix 100, MTS). AM were also subjected to CTS using the Bose bioreactor (Bose Enduratec, UK). Assays for GAG, DNA, collagen, elastin and PGE2 were performed and compared to unstrained membrane. Results: The mechanical properties of the AM were dependent on fibre orientation with samples where fibres were strained in parallel being stronger than those strained perpendicular (p=0.0002 comparing the placental region using Student t test). Histological examination of the fibres revealed an abundance of elastin rather than collagen fibres within the AM. CTS reduced collagen and elastin synthesis within the AM, which was most marked in the cervical region (p=0.002, for elastin and p=0.02 for collagen, both in the cervical region). PGE2 production increased in strained specimens, again, most marked in the cervical region (p=0.00001). Conclusion: This study shows that fibre orientation is an important factor which influences the mechanical properties of the AM. Furthermore, elastin may have a larger contribution to membrane integrity than previously thought. CTS influenced the AM to cause weakening by decreasing the collagen and elastin content and increasing PGE2 production.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | M.D(Res) |
| Title: | How do factors known to cause preterm premature rupture of the membranes affect the ultrastructure and integrity of the amnion? |
| Event: | UCL (University College London) |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. - Some third party copyright material has been removed from this e-thesis. |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10127568 |
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