Title:Laminin and Collagen IV: Two Polypeptides as Marker of Dystocic Labor
Volume: 18
Issue: 2
Author(s): Antonio Malvasi, Carlo Cavallotti, Leonardo Resta, Ospan A. Mynbaev, Silvia Di Tommaso, Daniele Vergara, Sarah Gustapane, Francesco Giacci and Andrea Tinelli
Affiliation:
Keywords:
Dystocia, cesarean section, obstructed labor, Collagen IV, Laminin, lower uterine segment, uterine cervix.
Abstract: Collagen IV and Laminin are localized in cells and tissue of numerous human organs including the
uterus, where these polypeptides control either age changes, or uterus growth in pregnancy, or ripening and
dilatation in labor. Authors examined the polypeptides distribution of collagen IV and Laminin in the human
pregnant uterus, in normal and dystocic labor, to clarify their physiologic role, by distribution and/or their
changes in prolonged dystocic labor. We collected lower uterine segment (LUS) fragments during cesarean
section (CS); these biopsies were treated with basic morphological staining for the observation of microscopic-
anatomic details. Other samples were processed with immunohistochemical staining for collagen IV
and for membrane bound Laminin. All morphological and immunochemical results were analyzed with quantitative
analysis of images and statistical analysis of data. Both Collagen IV and Laminin show changes in the
pregnant uterus before 4 hours of full cervical dilatation in patients after 4 hours. All the three types of the
human uterine cells, mucosal, submucosal and smooth muscular cells, are more reduced in LUS after 4 hours
of cervical dilatation in dystocic labor. The connective tissues (including fibroblast) show the most evident
changes in the dystocic LUS, collagen IV and laminin changes during cervical dilatation in prolonged dystocic
labor, with a decreased elasticity with increased roughness and dryness. The LUS anatomical modifications
during labor can be the cause of pathological changes in protracted dystocic labor. In the dystocic labor
that lasts more than 4 hours from the complete cervical ripening and dilatation, the laminin and collagen IV
concentration reduces in the LUS tissue. In dystocic labor, delivery should be completed before the 3 hours of
full dilation, to avoid a reduction of laminin and collagen IV and a worsening of LUS healing for the next
pregnancy.
