Symptoms that precede preterm labor and preterm premature rupture of membranes

Article Abstract:

The signs and symptoms of early labor vary. Symptoms that are common during pregnancy are often dismissed without further exploration. The frequency of common symptoms preceding premature labor were studied in 107 women experiencing premature labor, 102 women with premature rupture of membranes (the membrane surrounding the fetus that contains the amniotic fluid) and 106 women having healthy pregnancies. The eight warning symptoms of early labor, painful contractions, painless contractions, backache, change in vaginal discharge, pelvic pressure, menstrual cramps, abdominal cramps and diarrhea, and thigh pain were assessed in each group. Women in early labor had both more painful and painless contractions than the women with premature rupture of membranes or normal pregnancies. Symptoms commonly found during normal pregnancy, such as menstrual cramps, backache, and increased vaginal discharge were also more common during early labor. Only 26 percent of women in preterm labor denied experiencing painful or painless contractions, even though they were in labor. Although the presence of vaginal discharge is found during a normal pregnancy, a change in character may indicate leakage of amniotic fluid. Since many pregnant women not in premature labor experience these symptoms, the predictive value of any one symptom is low. Pregnant women should be educated regarding all signs and symptoms of premature labor, such as increased vaginal discharge, pelvic pressure, menstrual cramps, backache and painful or painless contractions. All but pelvic pressure are commonly found in women with premature rupture of membranes. Persistent symptoms should be assessed for premature labor. (Consumer Summary produced by Reliance Medical Information, Inc.)

Premature labor

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Prostaglandin F2-alpha output by amnion-chorion-decidua: relationship with labor and prostaglandin E2 concentration at the amniotic surface

Article Abstract:

Prostaglandin F2-alpha (PF2-alpha) in fetal membranes may help induce or sustain maternal labor. PF2-alpha is a compound derived from fatty acids that is thought to stimulate the contraction or smooth uterine muscles. Fetal membranes from 10 cesarean section deliveries and nine vaginal deliveries were used to assess the action of PF2-alpha. PF-2 alpha production was higher on unseparated surfaces of fetal membranes after labor. It was much higher on the maternal side in vaginal deliveries than cesarian deliveries. When the membranes were separated, higher concentrations of PF2-alpha were found in the chorion-decidua than the in the amnion. Metabolites of PF-2 alpha were higher on the fetal side. Prostaglandin metabolism changes in fetal tissues and apparently increases PGF2-alpha production that stimulate uterine muscles and promote labor.

Prostaglandins, Fetal membranes, Labor (Obstetrics)

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Elevated protease activities in human amnion and chorion correlate with preterm premature rupture of membranes

Article Abstract:

Preterm rupture of the membranes in pregnant women may be caused by high levels of an enzyme in the body called protease that breaks down protein. Researchers compared membranes from 14 pregnancies after preterm birth to nine membranes delivered preterm or at term without premature rupture. Preterm ruptured membranes had 10 to 40 times the amount of protease activity than intact membranes. Membranes that did not rupture prematurely, either preterm or term, had low levels of protease activity. The amount of protease activity was not affected by the route of delivery (vaginal vs. cesarean) or by contractions or a lack thereof. Production of protease within the membranes may cease to be regulated by the body in cases of preterm rupture of the membranes.

Proteases

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