Background: Caspase-3 is involved in the execution of apoptosis and is
widely used as an apoptotic marker. Tumor necrosis factor-
(TNF-) released from activated macrophages has various functions such
as modulation of cell growth and differentiation, immunoregulation, coagulation,
and regulation of endothelial cell function. This study investigated the
immunohistochemical staining of caspase-3 and TNF- expression in the
placentas of pregnant women with preterm premature rupture of membranes (PPROM).
Methods: Placentas of 25 healthy, and 25 women with PPROM were processed
for routine histological tissue processing. Placentas were stained with
hematoxylin-eosin, caspase-3, and TNF- immunostaining.
Results: Normal placental histology was observed in the control group.
Amniotic epithelium, vascular structures, and fibrinoid accumulation were
histologically normal. Leukocyte infiltration, thinned vessel walls with
dilatation and congestion, syncytial nodes, and fibrinoid accumulation were
increased in the PPROM group. The immune activity of caspase-3 expression was
mainly negative in placental components such as syncytial nodes, vascular
endothelium, fibrinoid accumulation, and macrophages in the control group. In the
PPROM group, caspase-3 positive reaction was increased in the amniotic membrane
and epithelium, endothelial cells, fibrinoid accumulation, and areas of
inflammatory cell infiltration. In the control group, negative TNF-
expression was observed in the placental membranes and structures. In the PPROM
group, TNF- expression was increased in inflammatory cells, endothelial
cells, and syncytial nodes. Conclusions: Placentas of patients with
PPROM showed loss and weakened membranes with increased placental pathology, and
increased expression of caspase-3 and TNF-. We suggest that caspase-3
and TNF- signaling pathways can be used as a marker in the progression
of PPROM.