2017
DOI: 10.1053/j.semperi.2017.07.012
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Abstract: Preterm prelabor rupture of the membranes (pPROM) remains a significant obstetric problem that affects 3-4% of all pregnancies and precedes 40% to 50% of all preterm births. pPROM arises from complex, multifaceted pathways. In this review, we summarize some old concepts and introduce some novel theories related to pPROM pathophysiology. Specifically, we introduce the concept that pPROM is a disease of the fetal membranes where inflammation-oxidative stress axis plays a major role in producing pathways that can… Show more

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Cited by 198 publications
(190 citation statements)
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“…14 As previously reported by us, microfractures develop during membrane growth in gestation because of shedding of senescent or apoptotic cells, characterized by degradation of basement membranes and ECM collagen. 14,25 However, these microfractures do not threaten pregnancy status or membrane integrity because they are healed by tissue and collagen remodeling. This process is aided by reactive oxygen radicalemediated signaling and localized inflammation similar to what is documented in wound healing.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…14 As previously reported by us, microfractures develop during membrane growth in gestation because of shedding of senescent or apoptotic cells, characterized by degradation of basement membranes and ECM collagen. 14,25 However, these microfractures do not threaten pregnancy status or membrane integrity because they are healed by tissue and collagen remodeling. This process is aided by reactive oxygen radicalemediated signaling and localized inflammation similar to what is documented in wound healing.…”
Section: Discussionmentioning
confidence: 99%
“…14 Similarly, microfractures were more frequent in pPROM and PTB with intact membranes than gestational ageematched membranes from preeclampsia. 25 We postulate that microfractures are areas of membrane remodeling and are increased in response to OS at term or preterm. At term, this could be considered as a normal physiologic response, ensuring fetal and membrane/ placental delivery.…”
mentioning
confidence: 98%
“…However, the cause of PROM remains largely unknown . Although obstetricians have traditionally attributed PROM to physical stress, it is also believed that biochemical processes play a pivotal role in PROM, especially inflammation, which may predispose women to PROM through inducing degradation of the extracellular matrix …”
Section: Introductionmentioning
confidence: 99%
“…PPROM may be complicated by the presence of bacteria and/or elevation of inflammatory mediators in the amniotic fluid, known as microbial invasion of the amniotic cavity (MIAC) and intra‐amniotic inflammation (IAI), respectively . Regardless of whether these conditions are causes or consequences of PPROM, their presence is related to poor neonatal outcomes …”
Section: Introductionmentioning
confidence: 99%
“…PPROM may be complicated by the presence of bacteria and/or elevation of inflammatory mediators in the amniotic fluid, known as microbial invasion of the amniotic cavity (MIAC) and intra-amniotic inflammation (IAI), respectively. [3][4][5][6] Regardless of whether these conditions are causes or consequences of PPROM, their presence is related to poor neonatal outcomes. 4,7,8 To identify these infection-related and inflammatory intra-amniotic conditions, evaluation of an amniotic fluid sample is considered a gold standard approach.…”
Section: Introductionmentioning
confidence: 99%