| Premature rupture of the fetal membranes (PROM) is defined as rupture of the membranes before the onset of labor. The incidence of PROM is 3.03-21.9%[1]. The rupture of fetal membrane will cause serious results, such as intra-amniotic infection (chorioamnionitis in pathology) , premature delivery , perinatal infection, asphyxia et al. But up to present, the underlying pathogenic mechanism is still unknown. Obstetricians have paid considerable attentions on PROM, but so far, the reasons of PROM have not been identified. So, it is important to find the pathogenesis of PROM. The membranes surrounding the amniotic cavity are composed of the amnioN, the chorion and deciduas. the amnion and the chorion are closely adherent layers consisting of several cell types, including epithelial cells, mesenchymal cells, and trophoblast cells, embedded in a collagenous matrix. Matrix metalloproteinases(MMPs) are a family of Zn2+ dependent endopeptidases that specifically degrade the collagen rich ECM regions in tissues. MMP-9 has been demonstrated to break down collagen type IV, a major component of fetal membranes. Increased levels of amniotic fluid(AF) MMPs expression and activity have been demonstrated in labor. After using MMP-9 monoclonal antibody, the expression and activity of MMPs have decreased. This suggests that MMP-9 is the dominant component in AF MMPs and the activity of MMP-9 is associated with degradation of the collagen. But the relationship between MMP-9 and PROM has not been reported. It had been demonstrated that tissueinhibitor of metalloproteinase-1 (TIMP-1) is MMP-9 inhibitor, and it may inhibit the activity of MMP-9. TIMP-1 and MMP-9 zymogen combined in order to inhibit the activation and the function of MMP-9. Interleukin 8(IL-8) is one of the family of inflammatory cell factors. It plays an important role in series of pathophysiologic process. It has been regarded as an important mediator in the host response to intra-amniotic infection. IL-8 may stimulate polymorphic nucleus leucocyte to produce MMPs. But the relationship between MMP-9 , TIMP-1 , IL-8 and premature rupture of membranes has not been well defined yet.Objectives: This investigation was designed to evaluate the relationshipbetween maternal serum and amniotic fluid MMP-9 , TIMP-1 , IL-8 and premature rupture of membranes so as to help us find new way to prevent and treat with PROM. At the same time placental tissue and membrane of normal pregnancy and PROM were immediately obtained after the delivery of placenta and determined whether there be existed chorioamnionitis to evaluate the relationship between maternal serum and amniotic fluid MMP-9 , TIMP-1 , IL-8 and chorioamnionitis to find new approaches and evidences to predict the sub-clinical chorioamnionitis.Materials and Methods: 1. Materials The study population consisted ofpatients from the Third Affiliated Hospital of ZhengZhou University from August 2002 to June 2003(gestational age is from 37 to 41 week). Subjects were divided into two groups: (1)The normal group (n=40, average age was 27.83 1.91 years old, average gestational age was 37.99 0.72 weeks). (2) The PROM group (n=40, average age was 28.00 2.24 years old, average gestational age was 37.72 0.58 weeks). All PROM patients were divided into three groups: the time after rupture of membranes <16 hours, 16-24 hours and >4 hours. All cases did not using antibiotic before take amniotic fluid, body temperature was below 37.5 C, the pulse rate of pregnant women was below 100 per minute. White blood cell count was below 1.5 109/L. All cases had no regular uterus contraction no other complications of pregnancy. After diagnosing chorioamnionitis, all cases were divided into two groups: chorioamnionitis group and non-chorioamnionitis group. 2. Methods (1)We used an enzyme-linked immunosorbentassay(ELISA) to quantitate matrix metalloproteinase -9 levels , TIMP-1 levels and IL-8 levels in the serum and amniotic fluid samples, (2)a piece of membrane (2cmx2cm) was immediately collected after labor, formalin-fixed...
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