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Fibrinolytic components in fetal membranes and amniotic fluid
T Watanabe1, M Araki, J Mimuro
1Department of Obstetrics and Gynecology, Jichi Medical School, Tochigi-ken, Japan.
Objective:
We evaluated fibrinolytic components in plasma and amniotic fluid of pregnant women and in postpartum fetal membranes.
Study Design:
Fibrinolytic parameters in amniotic fluid and plasma were measured by means of enzyme-linked immunosorbent assays. Fetal membranes collected after spontaneous labor at term were analyzed by immunohistochemical methods with immunospecific antibodies against fibrinolytic components.
Results:
Amniotic fluid contained high plasminogen activator inhibitor-1 concentrations but had low activity. Strong staining for plasminogen activator inhibitor-1 and vitronectin was observed in chorionic trophoblasts and moderate staining in decidual connective tissue. Strong staining for plasminogen activator inhibitor-2 was seen in decidual cells. Although prominent staining of plasminogen activators and plasminogen were observed in the amniotic epithelium, virtually no plasminogen activator inhibitor-1, plasminogen activator inhibitor-2, or alpha 2-plasmin inhibitor staining was detected.
Conclusion:
The delicate balance of fibrinolytic activators and inhibitors in fetal membranes and amniotic fluid may contribute to the triggering of membrane rupture at term.