Associations Between Periodontal Status Of Pregnant Women And Premature Rupture Of Membranes

The concept of premature rupture of membranes is the rupture of membranes before labor.premature rupture of membranes seriously affect the safety of mother and child. There are many reasons for premature rupture of membranes, Such as mechanical injury and the twins, abnormal fetal position, the infection and so on.However, the exact pathogenesis has not yet entirely found. So to find the cause of PROM, to prevent the occurrence of PROM, thereby reducing the incidence of maternal and child is becoming the one of the hot issues in the current research field of obstetrics.Infection is a major cause of PROM, and its subsequent infection of host inflammatory response can lead to an increase in vivo biological medium, the formation of immune micro-environment play an important role in the premature rupture of membranes.The major components of membrane include theⅠ,Ⅲ,Ⅳ,Ⅴcollagen, proteoglycan and glycosaminoglycan, such as elastic fibers.MMPs can degrade almost all extracellular matrix (ECM). In the infection, as a result of inflammatory cytokines IL-1β, IL-8, GM-CSF and metabolites of arachidonic acid to stimulate the cells to release matrix metalloproteinases, activation of MMPs can lead to degradation of collagen membrane rupture.In our country, Periodontitis is one of common oral diseases in childbearing-age women. At present, periodontal disease is infectious disease that cause by plaque micro-organisms, the main source of infection is for the accumulation of the dental plaque in the neck and subgingival .first of all,it leads to gingival inflammation, when the inflammation extended to the deep periodontal organizations, caused by gingival and periodontal ligament collagen fibers dissolved destruction, and alveolar bone absorption, resulting in the formation of periodontal pocket. Periodontitis is a violation of gingival and periodontal supporting tissues destructive ,it is chronic inflammatory disease characterized by lesions of the support structure, including teeth - in the extracellular matrix of collagen fibers of periodontal destruction. Gingival inflammation, gingival crevicular fluid, saliva can check that the activity of MMP-9 increase.Periodontitis in the mother may be the risk factors leading to premature rupture of membranes that has not been fully aware of and its mechanism may be due to periodontal disease caused by the original microbial activation and its elevated levelof MMP-9, through the degradation of fetal membrane cells extracellular matrix lead to the occurrence of premature rupture of membranes. In this study, to analysis the periodontal status of normal pregnant women and pregnant women with premature rupture of membranes to find the relationship between them, To provide a theoretical basis for preventing the occurrence of premature rupture of membranes. Objective: To compare the periodontal status of premature rupture of membranes in pregnant women with normal pregnant women to analysis the relationship between the periodontal status and premature rupture of membranes. For the prevention of clinical cause for the occurrence of premature rupture of membranes and provide a theoretical basis.Methods: Preterm Premature Rupture of Membranes (PPROM) in pregnant women in 18 cases, full-term premature rupture of membranes (PROM) as a study of 20 cases of pregnant women group, 28 cases of normal full-term pregnant women (Non-PROM) as a control group, check the record of plaque index (PLI), probing depth (PD) and gingival sulcus bleeding index (SBI), the use of immunohistochemical detection the distribution and expression of matrix metalloproteinase Department -9 (MMP-9) in cervical fetal membrane .Results:1. the plaque index and gingival sulcus bleeding index in premature rupture of membranes is higher than the normal control group, Among the three groups probing depth was no significant difference.2.PPROM Group, PROM group and Non-PROM group PLI and SBI were statistically significant differences (P <0.05), PD was no significant difference. The PROM had the bad periodontal status.3.MMP-9 positive signal located in the amniotic epithelial cells and chorionic cells in the PPROM, preterm PROM, we can see different levels of expression, non-membrane in the early break group has no expression or weakly positive expression. The study group and chorionic membrane in the expression of MMP-9 were significant differences (P <0.05).4. The PD is not associated with expression of MMP-9 in chorionic, r = 0.053, P = 0.075; SBI is positive associated with expression of MMP-9 in chorionic, r = 0.433, P <0.05; PLI is positive associated with expression of MMP-9 in chorionic, r = 0.310, P <0.05. the PD is not associated with expression of MMP-9 in membrane, r = 0.077, P = 0.597; and BI are related, r = 0.430, P <0.05; with PLI positive correlation, r = 0.324, P <0.05.Conclusion:1. Premature rupture of membranes had worse periodontal status than the normal pregnant women, suggesting that periodontal disease may be one of the reasons that lead to premature rupture of membranes.2. Membrane in the expression of MMP-9 higher than the PROM group PPROM group, PROM group than the Non-PROM group and the difference was statistically significant, suggesting that MMP-9 involved in the premature rupture of membranes and the pathogenesis of periodontal disease. Blood or urine testing of pregnant women in the level of MMP-9 can help to predict the occurrence of premature rupture of membranes for further study.3. Oral health care and treatment of periodontal diseases should be carried out in pre-pregnancy to prevent the occurrence of adverse pregnancy outcomes.