The membranes surrounding the amniotic cavity are composed ofthe amnion and the chorion, which are closely adherent layersconsisting of several cell types, including epithelial cells,mesenchymal cells, and trophoblast cells, embedded in a collagenousmatrix. They retain amniotic fluid, secrete substances bothinto the amniotic fluid and toward the uterus, and guard thefetus against infection ascending the reproductive tract. Themembranes normally rupture during labor. Premature rupture ofthe fetal membranes is defined as rupture of the membranes beforethe onset of labor.1 Premature rupture of the membranes occurringbefore 37 weeks' gestation is usually referred to . . . [Full Text of this Article]
Structure of the Fetal Membranes
Natural History and Management of Fetal-Membrane Rupture
Mechanisms of Fetal-Membrane Rupture Preceding and during Labor
Changes in Collagen Content, Structure, and Catabolism
Connective-Tissue Disorders and Nutritional Deficiencies as Risk Factors
Increased Collagen Degradation
Clinical Factors Associated with Collagen Degradation and Premature Rupture of the Membranes
Infection
Hormones
Programmed Cell Death
Membrane Stretch and Premature Rupture of the Membranes
Predicting Preterm Premature Rupture of the Membranes
Prevention of Preterm Premature Rupture of the Membranes
Conclusions
Source Information
From the Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women's Health and the Division of MaternalFetal Medicine, 2000 Courtyard Bldg., University of Pennsylvania Medical Center, 3400 Spruce St., Philadelphia, PA 19104-4283, where reprint requests should be addressed to Dr. Parry.
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