This study obtained visual evidence of novel cellular and extracellular matrix level structural alterations in term and preterm human fetal amniochorionic membrane. Amniochorions were collected from term cesarean (not in labor) or vaginal deliveries (labor), preterm premature rupture of the membranes, and spontaneous preterm birth.
To determine the effect of oxidative stress on membranes at term or preterm labor, term not in labor samples in an organ explant culture in vitro were exposed to cigarette smoke extract. Tissues were imaged using a combination of multiphoton autofluorescence and second harmonic generation microscopy. Images were analyzed using ImageJ and IMARIS software. 3D microscopic analysis of membranes revealed microfractures that are characterized by the amnion cell puckering, basement membrane degradation, tunnels that extend into the collagen matrix with migrating cells.
Number of microfractures were similar at term regardless of labor status; however, their morphometric measures (width and depth) were higher in term labor. Oxidative stress induced higher number of microfractures in term not in labor membranes with increased morphometry resembling that seen at term labor. Preterm premature rupture of the membranes had the highest number of microfractures compared to membranes from term and other preterm births. Microfractures are structural alterations indicative of areas of tissue remodeling during gestation.
Their increase at preterm and in response to oxidative stress may indicate failure to reseal, predisposing membranes to rupture.
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