{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T01:58:38Z","timestamp":1773021518657,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2010,12,31]],"date-time":"2010-12-31T00:00:00Z","timestamp":1293753600000},"content-version":"vor","delay-in-days":578,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2009,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Objective.<\/jats:italic> To investigate the expression of matrix metalloproteinase\u20109 (MMP\u20109) and tissue inhibitory of metalloproteinase\u20101 (TIMP\u20101) in women who had undergone a medical abortion and explore their possible role in the mechanism of prolonged uterine bleeding after a mifepristone\u2010misoprostol abortion. <jats:italic>Design<\/jats:italic>. Cross\u2010sectional study. <jats:italic>Setting<\/jats:italic>. Tertiary referral university hospital. <jats:italic>Sample<\/jats:italic>. Forty women were recruited following a medical abortion with mifepristone and misoprostol, 20 with duration of bleeding &gt;14 days and 20 with duration of bleeding \u2264 14 days. <jats:italic>Methods.<\/jats:italic> Endometrial specimens were stained with hematoxylin and eosin for histological examination. The expression of MMP\u20109 and TIMP\u20101 was evaluated by immunohistochemistry. <jats:italic>Main outcome measures<\/jats:italic>. Histology was analyzed by light microscope and expression of MMP\u20109 and TIMP\u20101 was semi\u2010quantitatively evaluated. <jats:italic>Results<\/jats:italic>. Histological examination showed residual villi and trophoblasts with inflammatory cell infiltration in women with duration of bleeding &gt;14 days after a medical abortion (bleeding group), whereas each sample of women with duration of bleeding \u2264 14 days after a medical abortion (control group) showed normal endometrial changes. Immunohistochemistry and semi\u2010quantitative scoring showed a significantly decreased expression level of MMP\u20109 in the bleeding group, compared with the control group. There was no significant difference of TIMP\u20101 expression between the bleeding group and the control group. The MMP\u20109\/TIMP\u20101 ratio value was significantly lower in the bleeding group than in the control group. <jats:italic>Conclusion<\/jats:italic>. This study documents that prolonged bleeding after a medical abortion with mifepristone and misoprostol is associated with retained products of conception with inflammatory cell infiltration, abnormal expression of MMP\u20109 and imbalance of MMP\u20109\/TIMP\u20101.<\/jats:p>","DOI":"10.1080\/00016340902898024","type":"journal-article","created":{"date-parts":[[2009,4,7]],"date-time":"2009-04-07T11:32:57Z","timestamp":1239103977000},"page":"673-679","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Abnormal expression of MMP\u20109 and imbalance of MMP\u20109\/TIMP\u20101 is associated with prolonged uterine bleeding after a medical abortion with mifepristone and 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