BACKGROUND: Premature Rupture of Membranes (PROM) is significantly linked to the infections-related maternal deaths. In the inflammatory process, the influencing stressor will stimulate the activation of Nuclear Factor Kappa B (NF-κB) and Receptor of Advanced Gyclation End product (RAGE). Yet up to date, the expression of NF-κB and RAGE in pregnant women with PROM are still rarely studied. Therefore, this study aimed to observe the differences of NF-κB and RAGE expression from PROM and non-PROM subjects.METHODS: This was a cross-sectional study involving 20 PROM subjects and 20 non-PROM subjects with infections and complications. Samples from the fetal membrane tissue of subjects were obtained and put into paraffin block preparation for the determination of NF-κB and RAGE expression. The detection of NF-κB and RAGE expression was conducted using immunohistochemical staining and observed under an upright light microscope. The expressions were later calculated using ImageJ software. RESULTS: Both NF-κB and RAGE expression were found to be higher in PROM subjects compare to the non-PROM subjects. The median of NF-κB in PROM and non-PROM subjects were 32.47±1.22 and 5.59±1.09, respectively (p=0.000). While the median of RAGE in PROM subjects was 53.58±3.46, and in non-PROM subjects was 11.64±2.49 (p=0.013).CONCLUSION: There is significant difference between NF-κB and RAGE expression in fetal membranes of PROM and non-PROM subjects. Therefore, the increased of NF-κB and RAGE expression can be used as a potential marker to detect complication of PROM.KEYWORDS: premature ruptures of membrane, non-premature ruptures of membrane, expression of NF-κB

BACKGROUND Premature rupture of membranes (PROM) often occurs in pregnancy. The fetal membrane weakening is caused by inflammation involving receptor activation for advanced glycation end-products (RAGE) and high mobility group box protein 1 (HMGB1). The associations between RAGE and HMGB1 with PROM are rarely studied. Hence, this study aimed to determine those associations in fetal membranes with PROM occurrence. METHODS This case-control study was conducted at Dr. Ramelan Central Naval Hospital, Surabaya, Indonesia, from August to November 2019. The subjects, determined using a non-probability sampling method (a saturated sample), were divided into PROM and normal pregnancy with intact fetal membranes (control) groups. Fetal membrane specimens were collected during vaginal and cesarean section deliveries. The expressions of RAGE and HMGB1 were determined using the immunohistochemical method and further analyzed using the Mann–Whitney U test. RESULTS The expression of RAGE in fetal membranes with PROM was significantly higher than the control (52.74% versus 14.9% expression/mm2, p<0.001), as well as the expression of HMGB1 (45.9% versus 8.5% expression/mm2, p<0.001). CONCLUSIONS The higher expressions of RAGE and HMGB1 in fetal membranes were associated with PROM.