Reactive oxygen species and preterm premature rupture of membranes-a review.
Preterm premature rupture of membranes (PPROM) results initially from damage to collagen in the chorioamnion leading to a tear in the membrane. Tissue-damaging molecules called reactive oxygen species (ROS) are capable of damaging collagen in the chorioamnion that could lead to PPROM. This hypothesis is supported by epidemiological studies linking clinical conditions known to produce ROS or reduce antioxidant protection to PPROM, by in-vitro studies in which membrane segments exposed to ROS exhibited tissue alterations consistent with PPROM, and by clinical studies showing that chorioamnion and amniotic fluid samples obtained from PPROM patients exhibit excessive collagen degradation. The role of antioxidants to protect the chorioamnion from ROS damage has been demonstrated in one in-vitro study. A prospective, randomized blinded trial of antioxidant therapy during pregnancy is needed to evaluate this approach for the prevention of PPROM.
Woods
J R
JR
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA. james_woods@urmc.rochester.edu
D000328:Adult; D000650:Amnion / Q000166:cytology / Q000187:drug effects; D000975:Antioxidants / Q000378:metabolism / Q000494:pharmacology; D001205:Ascorbic Acid / Q000494:pharmacology; D002821:Chorioamnionitis / Q000378:metabolism; D002823:Chorion / Q000166:cytology / Q000187:drug effects; D003094:Collagen / Q000378:metabolism; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000378:metabolism* / Q000517:prevention & control; D006801:Humans; D066298:In Vitro Techniques; D018384:Oxidative Stress / Q000502:physiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D017382:Reactive Oxygen Species / Q000378:metabolism*; D014810:Vitamin E / Q000494:pharmacology
D000975:Antioxidants; D017382:Reactive Oxygen Species; D014810:Vitamin E; D003094:Collagen; D001205:Ascorbic Acid