High Expression of Caspase-9 and Low BcL-2 on Amnion Cells as the Risk Factor for Premature Rupture of Membranes

Premature rupture of membranes (PROM) is an important problem in obstetrics that can increase perinatal morbidity and mortality as well as infection in pregnant women. The occurrence of PROM is caused by various risk factors and not yet fully known. The pathophysiology is said to be related to apoptosis process in amniotic cells. It is known that there are different pathways in the mechanism of the PROM which was related to the expression of caspase-9 and BcL-2. The aim of this study was to determine the role of caspase-9 and BcL-2 expression as the risk factors for PROM.A case control study was conducted with primary data collection in the form of amniotic membrane layer of amnion taken from the placenta after delivery in the emergency room of Sanglah Hospital Denpasar, Bali as many as 40 samples. The expression of caspase-9 and BcL-2 was examined at the Anatomical Pathology Laboratory of Sanglah Hospital Denpasar. The result of this study found there was a statistically significant difference (p = 0.000) where patients with high Caspase-9 expression had a 51 times chance of experiencing PROM compared with patients with low Caspase-9 expression. The group of patients with low Bcl-2 expression had 171 times the likelihood of developing PROM compared to the group of patients with high Bcl-2 expression (p = 0.000). As the conclusion, a high Caspase-9 expression and low BcL-2 expression are the risk factors for PROM in term pregnancy.