THE CORRELATION OF ELASTIN

EXPRESSION, COLLAGEN 1, COLLAGEN 3

AND RATIO OF COLLAGEN 1/COLLAGEN 3
ON THE EVENT OF UTERINE PROLAPS

Reza Arta Bagaskoro1,

Tatit Nurseta1, Rahajeng1
1Department Obstetrics and Gynecology

Faculty of Medicine Brawijaya University,

dr. Saiful Anwar Hospital Malang
 Introduction

Prevalence of pelvic prolapse western country is 7-23%.

Other data states that in women aged 45-85 years the prevalence
of pelvic organ prolapse is around 40%, but most are
asymptomatic, around 12% are symptomatic.
(Hunskaar et al, 2005; Slieker et al., 2009))
Introduction

Pelvic organ prolapse, also known as

urogenital prolapse, is a decrease in
the pelvic organ from its original
position
urinary difficulties,
discomfort,
stress incontinence

The most common pelvic organ

prolapse is uterine organ prolapse

(Jelovsek et al., 2007)

Introduction

Little is known
About pathophysiology

Connective tissue

Elastin and Colagen

is an important component
in uterine loosening process

(De Lancey & Delmas, 2004)

Objective

Elastin

Collagen Uterine Collagen

1 2
Prolaps

Collagen
Ratio
Method

Type of Research Cross Sectional

Research Site Dr. Saiful Anwar Malang Hospital
Period of Time June – August
Sample Sacrouterine ligament
 Method
Inclusion Criterias
• First pregnancy,
• Aterm pregnancy, and
• Who had caesarean section
because of stuck labor
process in either phase 1 or
2 of labor
Exclusion Criterias
• Patients with pelvic organ
prolapse and or have family
history of pelvic organ
prolapse,
• Obese,
• Chronic cough,
• Chronic constipation, and
• Routine heavy lifting
Results
Sample Characteristics

Average ± SD
Variable p-value
Control (n = 10) Inpartu (n = 10)

Age 25.7 ± 5.08 22 ± 3.92 0.085

BMI 22.06 ± 1.69 21.44 ± 1.69 0.423

Outcome Baby Weight 2875 ± 331.87 3195 ± 306.82 0.088

Results
Expression of Elastin*
p = 0.000
120.5
Expression of Elastin (%)

100.5
[CELLRANGE]

80.5
[CELLRANGE]
60.5

40.5

20.5

0.5
Kontrol Inpartu
Results
Expression of Collagen I
p = 0.178
Expression of Colagen I(%) 120.5

100.5
[CELLRANGE]
[CELLRANGE]

80.5

60.5

40.5

20.5

0.5
Kontrol Inpartu
Results
Expression of Collagen III
p = 0.148
120.5
Expression of Colagen III (%)

100.5 [CELLRANGE]
[CELLRANGE]

80.5

60.5

40.5

20.5

0.5
Kontrol Inpartu
Results
Collagen I/ Collagen III
Expression Ratio*
p = 0.009
Colagen I/Colagen III Ratio 1.4
1.3
1.2
[CELLRANGE]
1.1
1 [CELLRANGE]
0.9
0.8
0.7
0.6
0.5
Kontrol Inpartu
Results
Path Analysis
Direct - Indirect
Results
Direct Influence Test

Direct Influence Pathway Coeff. p-value

Colagen I -> Prolaps -0.602 ns 0.758
Colagen I -> Rasio Col I/Col III -0.858* 0.012
Colagen III -> Prolaps 0.588 ns 0.787
Colagen III -> Rasio Col I/Col III 0.778* 0.023
Elastin -> Prolaps -0.809* 0.000
Rasio Col I/Col III -> Prolaps -0.863 ns 0.672
Keterangan :

ns : not significant
Conclusion

The expression of Collagen I, Collagen III and the

ratio of Collagen I / collagen III
did not have a significant direct effect on the
incidence of uterine prolapse

but a significant direct effect was shown

by Elastin on prolapse.
THANK YOU
 Results
Indirect Influence Test

Indirect influence pathway Coeff, p-value

Colagen I -> Rasio Col I/Col III -> Prolaps 0.741 0.690

Colagen III -> Rasio Col I/Col III -> Prolaps -0.672 0.753

Keterangan :

ns : not significant

* : has a significant impact on the 5% error rate

Introduction

Labor process also induces

Change of

collagen and elastin

Important components in extracellular

matrix that suspected to play role in
uterine prolapse

(De Lancey & Delmas, 2004)