title: Elevated expression levels of matrix metalloproteinase-9 in placental villi and tissue inhibitor of metalloproteinase-2 in decidua are associated with prolonged bleeding after mifepristone-misoprostol medical abortion.
abstract: OBJECTIVE
  To determine whether the expression levels of matrix metalloproteinases 2 and 9 (MMP-2 and -9) and tissue inhibitors of metalloproteinases 1 and 2 (TIMP-1 and -2) in the villi and the decidua are associated with prolonged bleeding after medical abortion.
  
  
  METHODS
  Case-controlled study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Mifepristone-misoprostol medical abortion patients were divided into two groups (20 women each) based on the length of time (>14 or ≤14 days) of bleeding after the abortion.
  
  
  METHODS
  Discharged villi and deciduas were collected.
  
  
  METHODS
  The expression levels of MMP-2 and -9 and TIMP-1 and -2 in the villi and deciduas were assessed with semiquantitative immunohistochemistry.
  
  
  RESULTS
  The median semiquantitative immunohistochemistry staining index (SI) scores for MMP-9 expression in the villi were elevated in the bleeding group compared with the control group (median SI scores 0.31 and 0.03, respectively). TIMP-2 expression was elevated in the decidua in the bleeding group compared with the control group (median SI scores 1.00 and 0.20, respectively). No significant differences were observed between the two groups in the expression levels of MMP-2 in the villi or of MMP-2, MMP-9, or TIMP-1 or of the ratios of MMP-9/TIMP-1 or MMP-2/TIMP-2 in the decidua.
  
  
  CONCLUSIONS
  Elevated expression levels of MMP-9 in the villi and of TIMP-2 in the decidua were associated with prolonged bleeding after medical abortion.
authors.affiliation: Department of Family Planning, Women's Hospital, Medical School, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Yaling
authors.initials: Y
authors.lastname: Zhuang
authors.affiliation: Department of Family Planning, Women's Hospital, Medical School, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Zhida
authors.initials: Z
authors.lastname: Qian
authors.affiliation: Department of Family Planning, Women's Hospital, Medical School, Zhejiang University, Hangzhou, People's Republic of China. Electronic address: 29402335@qq.com.
authors.forename: Lili
authors.initials: L
authors.lastname: Huang
mesh_terms: D000021:Abortifacient Agents, Steroidal / Q000008:administration & dosage / Q000009:adverse effects; D000028:Abortion, Induced / Q000009:adverse effects / Q000379:methods*; D000328:Adult; D002824:Chorionic Villi / Q000187:drug effects / Q000201:enzymology; D003656:Decidua / Q000187:drug effects / Q000201:enzymology; D005260:Female; D005500:Follow-Up Studies; D015971:Gene Expression Regulation, Enzymologic; D006801:Humans; D020778:Matrix Metalloproteinase 2 / Q000096:biosynthesis; D020780:Matrix Metalloproteinase 9 / Q000096:biosynthesis*; D015735:Mifepristone / Q000008:administration & dosage* / Q000009:adverse effects; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000201:enzymology*; D011247:Pregnancy; D013997:Time Factors; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000096:biosynthesis; D019716:Tissue Inhibitor of Metalloproteinase-2 / Q000096:biosynthesis*; D055815:Young Adult
chemical_list: D000021:Abortifacient Agents, Steroidal; C560822:TIMP1 protein, human; C560823:TIMP2 protein, human; D019715:Tissue Inhibitor of Metalloproteinase-1; D016595:Misoprostol; D019716:Tissue Inhibitor of Metalloproteinase-2; D015735:Mifepristone; C522361:MMP2 protein, human; D020778:Matrix Metalloproteinase 2; C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9
keywords: Matrix metalloproteinase; abortion; immunohistochemistry; tissue inhibitor of matrix metalloproteinase