The Histological Finding And The Expression Of Angiopoitin-1,2 In Endometrium Of The Women With Abnormal Bleeding After Medical Abortion

Background: Mifepristone and misoprostol have been used typically for medical abortion in women in early pregnancy since nearly twenty years ago. The abnormal bleeding is a main side effect of it and which affected the health of women by pelvic inflammatory disease, anemia and so on. The reason of abnormal bleeding is unclear. It has been considered to be related to remain of decidua and villus, delay repairs of endometrium and inflammation of endometrium, but it has been short of pathological evidences till now. And then the mechanism by which villus and deciduas remain after medical abortion has yet to be elucidated. Angiopoietin is a kind of angiogenic growth factor which has been known recently. Angiopoietin-1 and angiopoietin-2 are express in the utera and ovary. They act on the Tie-2 receptor assisted by VEGF to regulate vascular integrity and remodeling, and they areconcerned with the development of endometrium, follicle and lutein. Our study is to investigate the pathologic histological changes of the women with abnormal bleeding after medical abortion with mifepristone and misoprostol, and to analyze the main reason of abnormal bleeding. The other objective is to study the localization and expression of angiopoietin-1 (Ang-1) and angiopoietin-2(Ang-2) in endometrium of women with abnormal bleeding after medical abortion.Methods: 1087 women with abnormal bleeding after medical abortion with mifepristone and misoprostol in early pregnancy were involved in our study. Analyze the pathologic histological changes of the endometrium of them. The immunochemical trial enrolled 60 women after medical abortion, according to whether with abnormal bleeding or not they were divided into 2 groups: group 1 (women with abnormal bleeding after medical abortion, n=40) and group 2 (women without abnormal bleeding after medical abortion, n=20). The location and expression of Ang-1 and Ang-2 protein in two groups were detected.Results: (1) The women with the remains of villus were 83.2%; (2)The remains of villus was the main pathologic histological changes in any age and parity; (3) Ang-1 and Ang-2 were expressed in the endometrial glandular epithelium, luminal epithelium mainly, and the immunoprecipitation could be found in stromal cells and the endothelial cells of vessels too; (4) The expression rate of Ang-1 and Ang-2 were 10.32 ± 0.53 and 11.51 ± 0.50 in group 1, and they were8.20±0.64 and 9.80±0.65 in group 2(P<0.05). The rate of Ang-1/Ang-2 was hardly varied between two groups.Conclusion: The remains of villus was the main reason of abnormal bleeding after medical abortion. The hyperexpression of Ang-1 and Ang-2 in endometrium may play an important role in abnormal bleeding after medical abortion.