Abstract
Background Uterus wall scarring is one of the key factors of placenta praevia (PP) development. Objective To study matrix metalloproteinase (MMP-2 and MMP-9) and its tissue inhibitors (TIMP-2 and TIMP-3) placental expression in placenta praevia cases in pregnancy with uterus scars. Materials and method Forty-four term placentas from cesarean section delivery were divided into 3 groups: PP without uterus scar (12 cases), PP with uterus scar (14 cases) and control group (14 cases). MMPs and TIMPs placental expression was studied immunohistochemically. Results All PP cases were characterized by significantly decreased MMP-2, TIMP-2, TIMP-3 and significantly elevated MMP-9 terminal villi syncytial and endothelial expression compared to control (p 0.05). PP cases with uterus scar were characterized by significantly lower MMPs and TIMPs decidual and extravillous trophoblastic expression compared to PP without scar (p Discussion This study has revealed that different patterns of MMPs and TIMPs placental expression could be a reflection of different pathogenic events in scarred uterus PP development.
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