Document Detail

Prospective assessment of fetal-maternal cell transfer in miscarriage and pregnancy termination.
MedLine Citation:
PMID:  22752611     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Fetal cells (microchimerism) are acquired by women during pregnancy. Fetal microchimerism persists decades later and includes cells with pluripotent capacity. Persistent microchimerism has the capacity for both beneficial and detrimental maternal health consequences. Both miscarriage and termination of pregnancy can result in fetal microchimerism. We sought to determine whether cellular fetal microchimerism is acquired during management of pregnancy loss and further explored factors that could influence fetal cell transfer, including viability of fetal tissue, surgical versus medical management and gestational age.
METHODS: Pregnant women (n= 150 samples from 75 women) with singleton pregnancies undergoing a TOP (n= 63) or treatment for embryonic or fetal demise (miscarriage, n= 12) were enrolled. Mononuclear cells were isolated from blood samples drawn before, and 30 min after, treatment. Fetal cellular microchimerism concentrations were determined using quantitative PCR for a Y chromosome-specific sequence, expressed as genome equivalents of fetal DNA per 100 000 maternal cell equivalents (gEq/10(5)). Detection rate ratios were determined according to clinical characteristics.
RESULTS: Cellular fetal microchimerism was found more often in post- compared with pretreatment samples, 24 versus 5% (P= 0.004) and at higher concentrations, 0-36 versus 0-0.7 gEq/10(5) (P< 0.001). Likelihood of microchimerism was higher in surgical than medical management, detection rate ratio 24.7 (P= 0.02). The detection rate ratio for TOP versus miscarriage was 16.7 for known male fetuses (P= 0.02). Microchimerism did not vary with gestational age.
CONCLUSIONS: Significant fetal cell transfer occurs during miscarriage and TOP. Exploratory analyses support relationships between obstetric clinical factors and acquisition of fetal cellular microchimerism; however, our limited sample size precludes definitive analysis of these relationships, and confirmation is needed. In addition, the long-term persistence and potential consequences of fetal microchimerism on maternal health merit further investigation.
S E Peterson; J L Nelson; K A Guthrie; V K Gadi; T M Aydelotte; D J Oyer; S W Prager; H S Gammill
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-06-29
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  27     ISSN:  1460-2350     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-10     Completed Date:  2013-01-11     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  2607-12     Citation Subset:  IM    
Department of Obstetrics & Gynecology, University of Washington, Box 356460, Seattle, WA 98195-6460, USA.
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MeSH Terms
Abortion, Induced*
Abortion, Spontaneous / diagnosis*,  genetics
Chromosomes, Human, Y / ultrastructure
Cohort Studies
Gestational Age
Leukocytes, Mononuclear / cytology,  pathology
Maternal-Fetal Exchange
Polymerase Chain Reaction / methods
Prospective Studies
Grant Support

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