Document Detail

Alterations in maternal-fetal cellular trafficking after fetal surgery.
MedLine Citation:
PMID:  22703775     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/PURPOSE: Bidirectional trafficking of cells between the mother and the fetus is routine in pregnancy and a component of maternal-fetal tolerance. Changes in fetal-to-maternal cellular trafficking have been reported in prenatal complications, but maternal-to-fetal trafficking has never been studied in the context of fetal intervention. We hypothesized that patients undergoing open fetal surgery would have altered maternal-fetal cellular trafficking.
METHODS: Cellular trafficking was analyzed in patients with myelomeningocele (MMC) who underwent open fetal surgical repair (n = 5), patients with MMC who had routine postnatal repair (n = 6), and healthy control healthy patients (n = 9). As an additional control for the fetal operation, trafficking was also analyzed in patients who were delivered by an ex utero intrapartum treatment procedure (n = 6). Microchimerism in maternal and cord blood was determined using quantitative real-time polymerase chain reaction for nonshared alleles.
RESULTS: Maternal-to-fetal trafficking was significantly increased in patients who underwent open fetal surgery for MMC compared with healthy controls, patients who underwent postnatal MMC repair, and patients who underwent ex utero intrapartum treatment. There were no differences in fetal-to-maternal cell trafficking among groups.
CONCLUSION: Patients undergoing open fetal surgery for MMC have elevated levels of maternal microchimerism. These results suggest altered trafficking and/or increased proliferation of maternal cells in fetal blood and may have important implications for preterm labor.
Payam Saadai; Tzong-Hae Lee; Geoanna Bautista; Kelly D Gonzales; Amar Nijagal; Michael P Busch; Chong Jai Kim; Roberto Romero; Hanmin Lee; Shinjiro Hirose; Larry Rand; Douglas Miniati; Diana L Farmer; Tippi C MacKenzie
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  47     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-18     Completed Date:  2012-10-29     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1089-94     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Division of Pediatric Surgery and Fetal Treatment Center, Department of Surgery, University of California, San Francisco, CA 94143-0570, USA.
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MeSH Terms
Airway Obstruction / congenital,  surgery
Cell Movement
Fetal Blood / cytology
Fetal Therapies*
Fetomaternal Transfusion*
Hernia, Diaphragmatic / congenital,  surgery
Infant, Newborn
Meningomyelocele / embryology*,  surgery*
Obstetric Labor, Premature
Real-Time Polymerase Chain Reaction
Reverse Transcriptase Polymerase Chain Reaction
Sacrococcygeal Region
Single-Blind Method
Teratoma / embryology,  surgery
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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