Differences in the Expression of Apoptosis inducing Factoramniotic Cells in Premature Rupture of Membranes and Without Premature Rupture of Membranes in Preterm Labor

Background: Preterm premature rupture of membranes (PROM) is one of the important causes of preterm birth associated with perinatal morbidity and mortality and high maternal morbidity. The pathogenesis of preterm PROM is multifactorial where apoptosis initiated by apoptosis inducing factor (AIF) in mitochondria of amniotic cells is thought to play an important role. This protein is the first protein to initiate the caspase-independent apoptosis mechanism through nicotinamide adenosine dinucleotide hydrogen (NADH) oxidase in the mitochondria. The purpose of this study was to prove the differences in AIF expression of amniotic cells in PROM cases and without PROM in preterm labor. Method: We conducted this cross-sectional study in the ER Maternity Room at Sanglah Hospital Denpasar for 6 months from July 2019 to December 2019. The samples were preterm pregnant women who were willing to participate in the study using simple consecutive random sampling. The material is the amniotic membrane amniotic tissue on the side of the tear after delivery and examination of AIF expression using immunohistochemical techniques at the Integrated Biomedical Laboratory, Faculty of Medicine, Udayana University, Bali. Analysis of the results of the examination and research data for normality-homogeneity was tested with the KS test and the prevalence ratio of AIF expression using the SPSS 20-version for windows independent t test to be presented in the form of tables, narratives, and pictures. Result: 40 samples of preterm pregnancy were divided into two groups, namely 20 PROM and 20 without PROM, where the KS test did not show any significant differences in the variables of maternal age, parity, PROM, and income (pgreater than 0.05), except that the mean number of leukocytes was highein the without PROM group with a previous history of PROM than in the PROM group (p less than0.05). The mean total score of AIF expression in the PROM groups and without PROM groups were 56.60 ? 11.20 and 24.10 ? 5.70, respectively, with a value of t = 11.60; df = 28.20; p = 0.001. Conclusion: Thus, it has been proven that there are differences in the AIF expression of amnionic cells in PROM cases and without PROM cases in preterm delivery.