Protein 53 (P53) Expressions and Apoptotic Index of Amniotic Membrane Cells in the Premature Rupture of Membranes

Ketut Surya Negara; Ni Luh Lany Christina Prajawati; Gede Putu Surya; Suhendro Suhendro; Komang Arijana; Ketut Tunas

doi:10.3889/oamjms.2018.465

Protein 53 (P53) Expressions and Apoptotic Index of Amniotic Membrane Cells in the Premature Rupture of Membranes

Open Access Maced J Med Sci. 2018 Nov 20;6(11):1986-1992. doi: 10.3889/oamjms.2018.465. eCollection 2018 Nov 25.

Authors

Ketut Surya Negara¹, Ni Luh Lany Christina Prajawati¹, Gede Putu Surya¹, Suhendro Suhendro², Komang Arijana³, Ketut Tunas⁴

Affiliations

¹ Department of Obstetrics and Gynecology, Udayana University, Sanglah Hospital, Bali, Indonesia.
² Department of Pathology, Sanglah Hospital, Bali, Indonesia.
³ Integrated Biomedical Laboratory, Medical Faculty of Udayana University, Bali, Indonesia.
⁴ Department of Public Health, Dhyana Pura University, Bali, Indonesia.

Abstract

Background: The premature rupture of membranes (PROM) represents an obstetric issue causing significant maternal and neonatal morbidity and mortality. Although protein 53 (p53), one of the proapoptotic proteins suspected of causing PROM at the molecular level is closely correlated with the occurrence of PROM, the exact mechanism remains still unclear.

Aim: This study aims to investigate the hypothesis that p53 expression and the apoptotic index play a role in the PROM mechanism.

Methods: Placentas from 20 pregnancies (37-42 weeks gestation) and 20 pregnancies complicated by PROM were collected at delivery. The independent variable is represented by pregnant mothers with a single live fetus experiencing PROM (followed by labour and birth) while without PROM mothers represent the control. The research material was taken from the amnion tissue in the placenta. Also, p53 and apoptotic index (TUNEL) immunohistochemical examination were conducted at the Integrated Biomedical Laboratory, Medical Faculty of Udayana University, Bali. The correlation between the apoptotic index and p53 expression of the PROM group was tested using a McNemar Test.

Results: No statistically significant differences were found between the two groups (p > 0.05). There was a significant difference in p53 expression in PROM cases compared to those without PROM (11.15 + 5.59% vs. 0.95 + 2.52%) with χ² = 19.538 and p = 0.001. The apoptotic index in PROM cases was higher than in those without PROM (19.10 + 5.63% vs. 1.15 + 2.46%) with χ² = 32.40 and p = 0.001. There was a strong correlation between p53 expression and PROM with PR = 3.449 (95% CI = 1.801-6.605; p = 0.001). There was a strong correlation between the apoptotic index and PROM with PR = 19 (95% CI = 2.81-128.69; p = 0.001).

Conclusion: p53 expression and the apoptotic index of amniotic membrane cells in cases of PROM was higher than in those without PROM, there was a strong correlation between p53 expression and apoptotic index with the occurrence of PROM.

Keywords: Apoptotic index; Premature rupture of the membrane; p53 expression.