The Effects Of Different Time Of Mifepristone On The Ultrastructural Change And The Expression Of VEGF,Ang-1 In Human Decidua And Chorion Tissue In Early Pregnancy

Objective: The objective of this study is by light microscope, electron microscope and immunohistochemistry technique, to observe the ultrastructural change and the expression of VEGF,Ang-1 in decidua and chorion tissue, analyze the effects of different time of mifepristone on the decidua and chorion tissue in early pregnancy and the concrete preventable action of mifepristone on early pregnancy, and provide the theory basis for rational use of medicine in clinical treatment to improve rate of abortion and reduce side reaction.Method:1 All the specimens were collected from the women who desire to terminate the early pregnancy in the department of gynecology and obstetrics of Hebei people hospital from September 2008 to November 2008. The fourty ones (trimester of pregnancy less than or equal to 39days)of the whole sixty women were divided into control group and group No.1 at random, and the other ones (trimester of pregnancy less than or equal to 49 days and more than or equal to 39 days) were arranged in group No.2. Control group was treated with 400 microgram misoprostol while the two groups No.1 and No.2 with 150 microgram mifepristone and then with 400 microgram misoprostol after 48 hours. The decidua and chorion tissue after uterine aspiration in the three groups have been collected. Observe the morphological change of decidua and chorion tissue by light microscope and electron microscope.2 Detect the expression of VEGF,Ang-1 in decidua and chorion tissue by immunohistochemistry S-P technique and computer image analysis system.3 Analyze the data with SPSS13.0.Results:1 Light microscope showed:The structure of chorion trophoblastic cell of control group is clear, which the outer layer is syneytiotrophoblast and the inner layer is langhans cell. The decidua tissue contain decidual cell and granular cell. The structure is complete and the rank is compact. group showed: the cell degenerate, necrosis, even amotic, the inflammatory cell infiltrate, the chorion interstitial edema, the blood siltation and the fibrin deposition. The decidual cell turn to degenerate and necrosis, interstitial edema, blood capillary expand and engorge, inflammatory cell infiltrate and the cell bleed.2 Electron microscope showed:Chorion tissue: The surface of syneytiotrophoblast of control group has many microvilli,the cytoplasm is full of many saccular dilatation RER, mitochondrium, free ribosome and a little fat is visible. The administer group showed: the quantity of microvilli decreased, the cell-substance dropsy, the decidual cell is full of many saccular dilatation RER, the bulk cristae of mitochondrium is mixed with membrane which turned to unclear or deletion, the amount of free ribosome reduce, lipid droplet increase, the cell organ degenerate, the langhans cell flatten and shrink, the outline of cell is unclear, the conjunction between syneytiotrophoblast and langhans cell turn to chalasis, the cell spaces widen. There are basically no differences in morphological changes between two administer groups.Decidual tissue: The volume of decidual cell of control group is large and the cell organ is abundant, while the volume of granular cell is relative small which contained affluent electron-dense granum. The collagen fibers among cells is abundant, and they line up in order. The administer group showed: the decidual cell is full of many saccular dilatation RER, the bulk cristae of mitochondrium is mixed with membrane which turned to unclear or deletion, the amount of electron-dense granum reduce or disappear, the collagen fibers disorder, break, even disintegrate.There are basically no differences in morphological changes between two administer groups(P>0.05).3 The expression of VEGF in decidua and chorion tissue In chorion tissue of control group, the expression of VEGF is in the nucleus and intracytoplasm of the chorion cell. The expression of VEGF in administer groups is significant lower than control group(P<0.05), and there is no difference between the administer groups.(P>0.05).In decidua tissue of control group, the expression of VEGF locate in the majority of decidual cell. The masculine grana is expressed in the nucleus and cytoplasm. The expression of VEGF in administer groups is significant lower than control group(P<0.05), and there is no difference between the two administer groups(P>0.05).4 The expression of Ang-1 in decidua and chorion tissueThe expression of Ang-1 which located in the langhans cell, syneytiotrophoblast, and cytoplasm of interstitial cells, is positive in the chorion cell of control group. The Ang-1 expression of administer groups is significant lower than control group(P<0.05), and there is no difference between the two groups(P>0.05).In decidua tissue of control group, the expression of Ang-1 is in the nucleus and intracytoplasm of decidual cell and the minority of glandular epithelium cell. The Ang-1 expression of administer groups is significant lower than control group(P<0.05), and there is no difference between the two groups(P>0.05).The expression of PR is positive in the nucleus and intracytoplasm of the chorion cell of control group. The PR expression of other groups is significant lower than control group(P<0.05), and there is no difference among the there group(P>0.05).Conclusions: 1 Mifepristone rivalry the progestational action by direct inhibition to chorion trophoblast and making the decidua and chorion tissue degenerate and necrosis, then inducing abortion. Through these mifepristone can achieve the purpose of terminating pregnancy.2 The normal decidua and chorion tissue of early pregnancy have complete structure. It will change till 48 hours after oral mifepristone. The decidua and chorion cell turned to dropsy, degenerate and necrosis.3 VEGF,Ang-1 express in the normal decidua and chorion tissue of early pregnancy. The expression has already been inhibited 48 hours after oral mifepristone. The blood vessel of embryo has been destroyed and the pregnancy is hard to maintain.4 The effects of different time of mifepristone on the ultrastructural change and the expression of VEGF,Ang-1 in decidua and chorion tissue in early pregnancy make no difference obviously. It can be considered in theory that the mifepristone has the same effect with medical abortion on the women (trimester of pregnancy less than or equal to 49 days). According to personal situation, the abortion time can be choosen.