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- W2906367777 abstract "Amniotic Fluid Embolism (AFE) is one of the leading causes of maternal deaths in Japan. Our Investigations have revealed Postpartum Acute Myometritis (PAM) with massive infiltration of inflammatory cells into the uterine myometrium affected by AFE, which can induce contractile dysfunction. We focus now on uterine isthmus which lies just adjacent to uterine body. Uterine isthmus undergoes marked structural change throughout normal pregnancy and becomes elongated significantly. It is composed of a mixture of myocytes from body and fibroblasts with extracellular matrix which forms the passive lower uterine segment during labor in vaginal delivery. However, its contribution to uterine contractile dysfunction involving PAM is still unknown. Our aim is to investigate isthmus tissue of PAM cases and find its involvement in the inflammatory changes observed in uterus affected by AFE. Under the AFE Registry Program in Japan, all AFE cases are registered and investigated in our university in the department of OBGY. We investigated isthmus tissue of these cases and performed immunohistochemistry for inflammatory cell markers-Neutrophil elastase, mast cell tryptase, CD68, CD3 and C5a receptor and observed their expression. Control isthmus tissues were obtained from elective cesarean section patients from the site of lower uterine incision. Winroof software (Mitani Corporation) was used for image analysis and Mann Whitney U test for statistical analysis. A significant number of degranulating mast cells were observed in PAM isthmus as compared to controls (P<0.05) indicating an anaphylactoid reaction in AFE. The number of infiltrating neutrophils in PAM was also significantly more than controls (P<0.001) showing an acute inflammatory reaction in the uterus. Marked inflammatory changes were observed both in isthmus and myometrium in the uterus involving AFE which suggests broad development of inflammation, possibly leading to severe uterine atony and postpartum hemorrhage." @default.
- W2906367777 created "2019-01-01" @default.
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- W2906367777 date "2019-01-01" @default.
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- W2906367777 title "842: Role of inflammation in uterine isthmus leading to uterine atony: pathophysiology of Amniotic Fluid Embolism." @default.
- W2906367777 doi "https://doi.org/10.1016/j.ajog.2018.11.865" @default.
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