What does decidual hemorrhage lead to that can promote preterm birth?

Decidual hemorrhage refers to bleeding that occurs in the decidua, which is the uterine lining during pregnancy. This bleeding can trigger specific physiological responses that may lead to preterm birth. One key response is an increase in the expression of Tissue Factor and Thrombin.

Tissue Factor is a protein that plays a crucial role in the initiation of the coagulation cascade. When decidual hemorrhage occurs, the increased expression of Tissue Factor leads to heightened coagulation activity. This activation promotes thrombosis and can cause local inflammation in the decidual tissue. Thrombin, a potent pro-inflammatory and pro-coagulant molecule, further amplifies these effects. The presence of these factors not only disrupts normal placental and uterine function but can also make the uterine environment more conducive to preterm labor.

In contrast, other options present different scenarios. An increase in placental hormones would typically support pregnancy and is less likely to directly correlate with preterm birth initiated by hemorrhagic events. Decreased uterine contractions would suggest a lower risk of preterm birth, as increased contractions are often associated with labor. Enhanced fetal growth usually indicates a healthy pregnancy status and is typically not a direct consequence of decidual hemorrhage. Thus, the relationship