{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T23:48:57Z","timestamp":1789775337605,"version":"4.0.1"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T00:00:00Z","timestamp":1733184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Premature rupture of membranes (PROM) before 37 weeks of gestation is a common obstetrical event, whose pathophysiology is still poorly understood. Our objective was to study the mechanical strength of fetal membranes in women with a clinical risk factor for preterm premature rupture of membranes (PPROM).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We included, in a prospective, descriptive, single-center study, patients scheduled for cesarean section at term (\u2265 37 weeks of gestation). For each patient, we performed uniaxial tensile tests on fetal membranes with a universal testing machine equipped with a force sensor (EZ20<jats:sup>\u00ae<\/jats:sup>, Lloyds), allowing the recording of an applied force\/time curve. We collected maximum force (Fmax), maximum stress (\u03c3Max), and Young\u2019s modulus of elasticity. The thickness of each membrane sample was also measured. We compared the values obtained according to certain clinical risk factors for PPROM such as age, body mass index, gravidity, parity, a history of PPROM or preterm birth, smoking, gestational diabetes, geographic origin, and socioeconomic level.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>We analyzed 31 patients and found no association between the studied risk factors and \u03c3Max. Fmax was lower in primiparous patients (p = 0.02) but increased with patient parity (p = 0.005). Gestational diabetes was associated with a higher Fmax (p = 0.033) and sub-Saharan geographical origin with a greater thickness (p = 0.0043). As membrane thickness increased, \u03c3Max (p = 0.009) and Young\u2019s modulus decreased (p = 0.037).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Primiparous patients have lower membrane mechanical strength than patients who have had one or more deliveries. Mechanically, the thicker membranes are less rigid and less resistant.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0312760","type":"journal-article","created":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T18:33:54Z","timestamp":1733250834000},"page":"e0312760","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Influence of clinical risk factors for preterm premature rupture of membranes (PPROM) on the elastic strength of fetal membranes at term: A prospective study"],"prefix":"10.1371","volume":"19","author":[{"given":"Amaury","family":"Robin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Tessier Doyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Ben Rhaiem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Valette","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00e9ronique","family":"Fermeaux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Marie","family":"Preux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Martinez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Luc","family":"Eyraud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chahrazed","family":"El Hamel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Riethmuller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7558-0175","authenticated-orcid":true,"given":"Perrine","family":"Coste Mazeau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,12,3]]},"reference":[{"issue":"2","key":"pone.0312760.ref001","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.jgyn.2012.12.012","article-title":"Rupture of membranes: pathophysiology, diagnosis, consequences and management","volume":"42","author":"L Blanchon","year":"2013","journal-title":"J Gynecol Obstet Biol Reprod (Paris)"},{"issue":"1","key":"pone.0312760.ref002","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/0020-7292(94)90454-5","article-title":"Epidemiological correlates of preterm premature rupture of membranes","volume":"47","author":"A Spinillo","year":"1994","journal-title":"Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet"},{"issue":"4","key":"pone.0312760.ref003","doi-asserted-by":"crossref","first-page":"373.e1","DOI":"10.1016\/j.ajog.2008.05.011","article-title":"A population-based study of race-specific risk for preterm premature rupture of membranes","volume":"199","author":"TT Shen","year":"2008","journal-title":"Am J Obstet Gynecol"},{"issue":"3","key":"pone.0312760.ref004","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1067\/mob.2000.106766","article-title":"The Preterm Prediction Study: prediction of preterm premature rupture of membranes through clinical findings and ancillary testing. 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