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Association of placental inflammation with fetomaternal hemorrhage and loss of placental mucin-1

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract:

Background

Fetomaternal hemorrhage (FMH) poses an immediate risk to the fetus and, in case of Rhesus-immunization, to future pregnancies. Given that altered endothelial permeability is part of the pathophysiology of inflammation, in this study we investigated whether placental inflammatory processes like chorioamnionitis (ChoA) or preeclampsia (PE) lead to increased rates of FMH compared to the established risk factor of placenta previa (PP). Putative accompanying markers of trophoblastic damage were also explored.

Methods

40 patients (14 PE; 6 ChoA; 9 PP; 11 normal controls) were evaluated for FMH using a flowcytometric test kit, which is able to quantify FMH of 0.06% fetal cells. Placental tissue samples were immunostained for human placental lactogen (hPL), human chorionic gonadotropin (hCG), and mucin-1 (MUC1). MUC1 was evaluated as a potential serum marker of FMH.

Results

Patients with ChoA had a mean calculated FMH volume of 29 ml, compared to 4 ml in PE and 1 ml in PP and controls. MUC1 staining was reduced in PE and ChoA placenta samples, while elevated MUC1 serum concentration correlated positively with FMH.

Conclusion

Diseases of placental inflammation are associated with FMH. Placental MUC1 staining is reduced and serum concentrations are increased in cases of FMH.

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Acknowledgments

The authors are very grateful to Prof. S. Endres and his team at the Division of Clinical Pharmacology, University of Munich for their generous assistance with flow-cytometric experiments.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Maistrasse, Ludwig-Maximilians University, Munich, Germany

    Christine Hermann, Andrea Kachler, Franz Kainer, Klaus Friese & Udo Jeschke

  2. Department of Obstetrics and Gynecology, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece

    Antonios Makrigiannakis

  3. Department of Obstetrics and Gynecology, Medical Faculty, Heinrich-Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany

    Christoph Scholz

Authors
  1. Christoph Scholz
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  2. Christine Hermann
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  3. Andrea Kachler
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  6. Antonios Makrigiannakis
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Correspondence to Christoph Scholz.

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Scholz, C., Hermann, C., Kachler, A. et al. Association of placental inflammation with fetomaternal hemorrhage and loss of placental mucin-1. Arch Gynecol Obstet 285, 605–612 (2012). https://doi.org/10.1007/s00404-011-2028-1

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  • DOI: https://doi.org/10.1007/s00404-011-2028-1

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