Abstract
Objective
Interleukins (ILs) and matrix metalloproteinases actually target collagen IV in the amniochorion in premature rupture of membranes (PROM), IL-10 acts as a membrane protector. In order to counteract the immunological system involved in the pathogenesis, we have used a combination of proapoptotic bax gene P-53 inhibitor, myristoleate, with antimicrobial peptides, neutrophil defensins, and cytokine IL-10 enhancer.
Methods
A comparative prospective randomized study was conducted from July 2006 to January 2007 in patients (46 cases and 60 controls) attending the Gynecology and Obstetrics Emergency Department, Eden Medical College, Kolkata, complaining of leakage per vagina in their antenatal period between 24 and 36 weeks of gestation. Combination of bax gene inhibitor, antimicrobial peptides, neutrophil defensins, and IL-10 enhancer in scheduled protocol was prescribed and cases followed up as per fixed protocols.
Results
In the 24–30 weeks group, mean prolongation of gestational age was 6.16±3.21 as against 2.66±1.05 (significant), while in 31–36 weeks mean prolongation was 4.69±0.84 as against 4.6±0.632 (significant). In the first group mean birth weight in cases was 1.77±0.66 kg as against 1.2±0.43 kg (significant), while in the second it was 2.18±0.56 kg as against 1.76±0.45 kg (significant). Associated complications were less in cases.
Conclusion
Combination of bax gene inhibitor, antimicrobial peptides, neutrophil defensins, and IL-10 enhancer as per scheduled protocol can be advocated routinely in PROM barring a few situations with excellent fetal and maternal prognosis.
Keywords: proapoptotic bax gene P53, PROM, matrix metalloproteinase inhibitor, interleukins, amnioseal
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