Correlation Of TRL-2,4 And MCP-1 With Premature Rupture Of Membrane And Chorioamnionitis

Objective To analyze the risk factors of premature rupture of membrane,and its impact on mode of delivery and pregnancy outcome.To explore clinical significance of TLR-2,TLR-4 and MCP-1 in the PROM and chorioamnionitis.Methods 98 patients with premature rupture of membrane who had been admitted to obstetrics department of Yanbian University Affiliated Hospital from September 2017 to January 2018 were enrolled as PROM group,52 patients with term premature rupture of membranes(TPROM group)and 46 patients with preterm premature rupture of membranes(PPROM group).The PPROM group was subdivided into chorioamnionitis group(11 cases)and non-chorioamnionitis group(35 cases).At the same time,40 patients with intact fetal membranes were selected as the control group.Analysis of risk factors of premature rupture of membranes,and its impact on mode of delivery mode and pregnancy outcome.After delivery,fetal membrane and placental tissue of all the patients were taken for HE and immunohistochemical staining to observe the pathological changes and the expression of TLR-2,4 in the placenta.ELISA method was used to detect levels of MCP-1 in umbilical cord blood of all newborns in PPROM group and the correlation between MCP-1 and chorioamnionitis was analyzed.Results1.The primary risk factor for PROM was genital tract infection,followed by history of uterine cavity operation.The cesarean section rate of PPROM group was higher than that of TPROM group(P<0.05).2.The incidence of maternal and neonatal complications in the PROM group was higher than that in the control group,and the difference was statistically significant(P<0.01).3.The expressions of TLR-2,4 in placental tissues of PPROM group and TPROM group were higher than those in normal control group(P<0.05),but there was no statistical difference between PPROM group and TPROM group(P>0.05).4.The level of MCP-1 in umbilical cord blood of neonates in the chorioamnionitis group was higher than that in the non-chorioamnionitis group and the difference is statistically significant(P<0.05).Conclusion1.PROM seriously affects the health of mothers and children,PPROM increases cesarean section rate.2.The increased expression of TLR-2,4 in placenta tissue may be related to the occurrence and development of PROM.3.The increase level of MCP-1 in neonatal umbilical cord blood can indicate the occurrence of chorioamnionitis.