Matrix metalloproteinase-induced cervical extracellular matrix remodelling in pregnancy and cervical cancer

The phenomenal extracellular matrix (ECM) remodelling of the cervix that precedes the myometrial contraction of labour at term or preterm appears to share some common mechanisms with the occurrence, growth, invasion and metastasis of cervical carcinoma. Matrix metalloproteinases (MMPs) are zinc-dependent endopeptidases that are pivotal to the complex extracellular tissue modulation that includes degradation, remodelling and exchange of ECM components, which contribute to homeostasis under normal physiological conditions such as cervical remodelling during pregnancy and puerperium. However, in cancer such as that of the uterine cervix, this extensive network of extracellular tissue modulation is altered leading to disrupted cell–cell and cell–basement membrane adhesion, abnormal tissue growth, neovascularization and metastasis that disrupt homeostasis. Cervical ECM remodelling during pregnancy and puerperium could be a physiological albeit benign neoplasm. In this review, we examined the pathophysiologic differences and similarities in the role of MMPs in cervical remodelling and cervical carcinoma

Acute villitis and intravascular microorganisms in fetal vessels : a case report and literature review of an unusual histopathological finding

Optimal management of intrauterine infection to avoid serious adverse perinatal outcomes entails prompt administration of antibiotics and consideration of early delivery of the fetus to remove the focus of infection. We report an unusual case of preterm chorioamnionitis which did not improve with sensitive antibiotics, or delivery of the fetus, and ultimately required an emergency hysterectomy to save the mother’s life. Interestingly, subsequent histopathological analysis of the post-hysterectomy specimen did not reveal myometrial necrosis or infectious microorganisms. The placental pathological examination, on the other hand, showed evidence of necrotising chorioamnionitis accompanied by a rarely reported lesion: acute villitis with abundant intravascular Escherichia coli, a finding which is strongly associated with fetal demise and adverse maternal outcomes

Exploring the antimicrobial properties of vaginal Lactobacillus crispatus against preterm birth-associated bacteria

The need to develop new treatments to prevent unprompted premature delivery before 37 weeks of pregnancy remains pressing and unmet. Bacteria (Lactobacillus species) that promote vaginal health produce biochemical compounds that prevent the growth of microbes such as Gardnerella vaginalis. Overgrowth of G. vaginalis can cause vaginal infection with smelly discharge and increase a woman’s risk of sexually transmitted infections and premature delivery. In this study, we examined how normal health-promoting (L. crispatus) and potentially harmful (G. vaginalis) vaginal bacteria interact in a laboratory setting. This was in order to observe natural and effective agent(s) from L. crispatus that can hinder the growth of G. vaginalis and accompanying immune response. We observed that L. crispatus clears G. vaginalis by itself and with several biochemical compounds that it produces. Such biochemical compounds can be developed into treatment for vaginal infections and premature delivery due to infection and inappropriate immune response

Spectroscopic techniques as potential screening tools for preterm birth: A review and an exploratory study

Preterm birth (PTB) is the single-most important determinant of infant adverse outcome worldwide, accounting for over 1 million neonatal deaths a year. Given its complex pathophysiology, prediction and prevention of PTB remain elusive. Current screening methods lack accuracy and reliability, and have failed to reduce the incidence and consequences of PTB. Hence, there remains a real need to develop noninvasive and more cost-effective screening tests, which can facilitate earlier identification of women at greatest risk, more timely prevention, and better risk stratification and management of PTB. Spectroscopic techniques have shown great promise to meet this demand. Therefore, in this article, the literature is reviewed to assess current evidence regarding the potential application of spectroscopic techniques to predict PTB via in vitro analysis of biofluids as well as in vivo study of cervical remodeling. In addition, preliminary data exploring the use of Raman spectroscopy (RS) to analyze cervicovaginal fluid (CVF) in pregnancy as a predictive tool for PTB is detailed for the first time with the aim to inform future avenues of research