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Preterm premature rupture of membranes (PPROM) likely results from weakening of the constituent connective tissue. It is uncertain if the alterations are limited to the fetal membranes or are also present in other sites such as the skin. The aim of the study was to compare the dermal structure of women suffering from recurrent PPROM with the dermis of both nonpregnant women and women with uneven tful gestation. Skin biopsies were taken from 42 women who recently under went P PROM, 33 women with uneventful gestation and 33 nonpregnant women. Histochemistr y, immunohistochemistry, and electron microscopy were performed on these specime ns and analyzed blindly. Morphologic changes were found in the dermis of most (3 3 of 42 at optical microscopy and 40 of 42 at ultrastructure) of the women suffe ring from PPROM. They were reminiscent of those found in some types of Ehlers-D anlos Syndrome (EDS). However, there was no clinical evidence suggesting a recog nized form of EDS. We conclude that some cases of PPROM are a systemic connectiv e tissue disorder representing a yet unidentified type of EDS.
It is uncertain if the alterations are limited to the fetal membranes or are also present in other sites such as the skin. The aim of the study was to compare the dermal structure of the women suffering from recurrent PPROM with the dermis of both nonpregnant women and women with an uneven tful gestation. Skin biopsies were taken from 42 women who had under went P PROM, 33 women with uneventful gestation and 33 nonpregnant women. Histochemistr y, immunohistochemistry, and electron microscopy were performed on these specime ns and analyzed blindly. Morphologic changes were found in the dermis of most (3 of 42 at optical microscopy and 40 of 42 at ultrastructure) of the women suffe ring from PPROM. They were reminiscent of those found in some types of Ehlers-D anlos Syndrome (EDS). However, there was no clinical evidence suggesting a recog nized form of EDS. We conclude that some cases of PPROM are a systemic connectiv e tissue disorder representing a yet unidentified type of EDS.