Collagenolysis in the lower uterine segment during parturition at term: Correlations with stage of cervical dilatation and duration of labor

Winkler M, Oberpichler A, Tschesche H, Ruck P, Fischer DC, Rath W (1999)
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 181(1): 153-158.

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Abstract
OBJECTIVE: The objective of this study was to quantify the extent of neutrophil infiltration and the concentrations of enzymes involved in collagenolysis in the lower uterine segment in relation to the degree of cervical dilatation and the duration of labor. STUDY DESIGN: Biopsy specimens of the lower uterine segment were obtained from 62 women undergoing cesarean section at term. The number of extravascular neutrophils was assessed with enzyme histochemical evaluation, and the concentrations of matrix metalloproteinase-8, matrix metalloproteinase-9, and tissue inhibitor of metalloproteinases-1 by were assessed by enzyme-linked immunosorbent assay. RESULTS: The neutrophil count and the concentrations of matrix metalloproteinase-8, matrix metalloproteinase-9, and tissue inhibitor of metalloproieinases-1 increased with increasing cervical dilatation. At >6 cm the neutrophil count and the concentrations of matrix metalloproteinase-8, matrix metalloproteinase-9, and tissue inhibitor of metalloproteinases-1 were significantly higher than at <2 cm. An association with the duration of labor was found for the neutrophil count and the concentrations of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinases-1. Multiple linear regression analysis showed that the degree of cervical dilatation is more closely related to the 4 laboratory parameters investigated than to the duration of labor. CONCLUSION: The findings support the hypothesis that local changes (ie, collagenolysis) in the lower uterine segment unrelated to uterine activity play a crucial role in cervical dilatation at term.
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Winkler M, Oberpichler A, Tschesche H, Ruck P, Fischer DC, Rath W. Collagenolysis in the lower uterine segment during parturition at term: Correlations with stage of cervical dilatation and duration of labor. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY. 1999;181(1):153-158.
Winkler, M., Oberpichler, A., Tschesche, H., Ruck, P., Fischer, D. C., & Rath, W. (1999). Collagenolysis in the lower uterine segment during parturition at term: Correlations with stage of cervical dilatation and duration of labor. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 181(1), 153-158.
Winkler, M., Oberpichler, A., Tschesche, H., Ruck, P., Fischer, D. C., and Rath, W. (1999). Collagenolysis in the lower uterine segment during parturition at term: Correlations with stage of cervical dilatation and duration of labor. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 181, 153-158.
Winkler, M., et al., 1999. Collagenolysis in the lower uterine segment during parturition at term: Correlations with stage of cervical dilatation and duration of labor. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 181(1), p 153-158.
M. Winkler, et al., “Collagenolysis in the lower uterine segment during parturition at term: Correlations with stage of cervical dilatation and duration of labor”, AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, vol. 181, 1999, pp. 153-158.
Winkler, M., Oberpichler, A., Tschesche, H., Ruck, P., Fischer, D.C., Rath, W.: Collagenolysis in the lower uterine segment during parturition at term: Correlations with stage of cervical dilatation and duration of labor. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY. 181, 153-158 (1999).
Winkler, M, Oberpichler, A, Tschesche, Harald, Ruck, P, Fischer, DC, and Rath, W. “Collagenolysis in the lower uterine segment during parturition at term: Correlations with stage of cervical dilatation and duration of labor”. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 181.1 (1999): 153-158.
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