| Abnormal expression of MMP-9 and imbalance of MMP-9/TIMP-1 is associated with prolonged uterine bleeding after a medical abortion with mifepristone and misoprostol. | |
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MedLine Citation:
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PMID: 19353331 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate the expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibitory of metalloproteinase-1 (TIMP-1) in women who had undergone a medical abortion and explore their possible role in the mechanism of prolonged uterine bleeding after a mifepristone-misoprostol abortion. DESIGN: Cross-sectional study. SETTING: Tertiary referral university hospital. SAMPLE: Forty women were recruited following a medical abortion with mifepristone and misoprostol, 20 with duration of bleeding >14 days and 20 with duration of bleeding <or= 14 days. METHODS: Endometrial specimens were stained with hematoxylin and eosin for histological examination. The expression of MMP-9 and TIMP-1 was evaluated by immunohistochemistry. MAIN OUTCOME MEASURES: Histology was analyzed by light microscope and expression of MMP-9 and TIMP-1 was semi-quantitatively evaluated. RESULTS: Histological examination showed residual villi and trophoblasts with inflammatory cell infiltration in women with duration of bleeding >14 days after a medical abortion (bleeding group), whereas each sample of women with duration of bleeding <or= 14 days after a medical abortion (control group) showed normal endometrial changes. Immunohistochemistry and semi-quantitative scoring showed a significantly decreased expression level of MMP-9 in the bleeding group, compared with the control group. There was no significant difference of TIMP-1 expression between the bleeding group and the control group. The MMP-9/TIMP-1 ratio value was significantly lower in the bleeding group than in the control group. CONCLUSION: This study documents that prolonged bleeding after a medical abortion with mifepristone and misoprostol is associated with retained products of conception with inflammatory cell infiltration, abnormal expression of MMP-9 and imbalance of MMP-9/TIMP-1. |
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Authors:
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Li Li; Zanhua Zhou; Lili Huang |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Acta obstetricia et gynecologica Scandinavica Volume: 88 ISSN: 1600-0412 ISO Abbreviation: Acta Obstet Gynecol Scand Publication Date: 2009 |
Date Detail:
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Created Date: 2009-05-20 Completed Date: 2009-06-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370343 Medline TA: Acta Obstet Gynecol Scand Country: Denmark |
Other Details:
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Languages: eng Pagination: 673-9 Citation Subset: IM |
Affiliation:
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Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abortifacient Agents
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adverse effects* Abortion, Induced / adverse effects*, methods Adult Cross-Sectional Studies Female Humans Matrix Metalloproteinase 9 / biosynthesis* Mifepristone / adverse effects* Misoprostol / adverse effects* Pregnancy Tissue Inhibitor of Metalloproteinase-1 / biosynthesis* Uterine Hemorrhage / etiology*, metabolism |
| Chemical | |
Reg. No./Substance:
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0/Abortifacient Agents; 0/Tissue Inhibitor of Metalloproteinase-1; 59122-46-2/Misoprostol; 84371-65-3/Mifepristone; EC 3.4.24.35/Matrix Metalloproteinase 9 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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