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Amniotic Membrane in Health and Disease: An Obstetrical Perspective

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Amniotic Membrane

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Abstract

Amnion, chorion and decidua form a complex unit, both anatomically and functionally. In normal pregnancy they constitute a border that simultaneously separates and relates the foetal and maternal environments. The balance between formation and degradation of membrane components is a physiological phenomenon that can be found throughout pregnancy. Moreover, during pregnancy there is an equilibrated balance between membrane degradation and formation; under some circumstances, an imbalance may ensue, resulting in membrane rupture. Immunological interactions between mother and foetus occur not only at the placental level, but also where the membranes (amnion and chorion) contact the deciduas. The amniotic membrane appears to be an immune privileged tissue and to contain some immunoregulatory factors. Therefore, a successful pregnancy seems to be the consequence of numerous interactions between the receptive uterus and the mature blastocyst, under immunohumoral control. Implantation and parturition are specifically characterized by mechanisms of local inflammatory activity. Sequential processes lead to a common pathway of parturition involving increased uterine contractility, cervical ripening and decidual/foetal membrane activation. In human amnion and decidua there is increased production of prostaglandins during parturition; in fact, labour may result from changes in prostaglandin availability within the uterus. Therefore, the process of giving birth may be abnormally initiated out of time by any interference, as membrane mechanical rupture or the action of infectious agents. Chorioamnionitis is the microbial invasion of the amniotic cavity through amnion, which induces a systemic inflammatory reaction. Foetal exposure to infection may lead to perinatal death, neonatal sepsis and other postnatal complications.

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Authors and Affiliations

  1. Faculty of Medicine, University of Coimbra, Coimbra, Portugal

    Ana Luísa Areia & Paulo Moura

  2. Obstetric Unit A, Coimbra Hospital and Universitary Center, Coimbra, Portugal

    Ana Luísa Areia & Paulo Moura

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  1. Ana Luísa Areia
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  2. Paulo Moura
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Correspondence to Ana Luísa Areia .

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Editors and Affiliations

  1. Health Sciences Research Center, CICS-UBI, Covilhã, Portugal

    Ana Catarina Mamede

  2. Biophysics Unit, Faculty of Medicine, University of Coimbra, Coimbra, Portugal

    Maria Filomena Botelho

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Areia, A.L., Moura, P. (2015). Amniotic Membrane in Health and Disease: An Obstetrical Perspective. In: Mamede, A., Botelho, M. (eds) Amniotic Membrane. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-9975-1_5

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