Summary
We report a case of repeated fetal death at 31 gestational weeks associated with mild non-proteinuric pre-eclampsia and intrauterine growth retardation. After double intradermal immunisation with paternal leukocytes, a third pregnancy proceeded uneventfully until it ended at 38 weeks. Maternal anti-paternal blocking antibody activity was assessed by the erythrocyte antibody inhibition (EAI) test. Serologic testing revealed that the couple did not share HLA class I antigens. The mechanisms underlying the likely benefit from immunotherapy are discussed.
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References
Need JA, Bell B, Meffin E, Jones WR (1983) Pre-eclampsia in pregnancies from donor inseminations. J Reprod Immunol 5:329–338
Feeney JG, Scott JS (1980) Pre-eclampsia and changed paternity. Eur J Obstet Gynecol Reprod Biol 11:35–38
Klonoff-Cohen HS, Savitz DA, Cefalo RC, McCann MF (1989) An epidemiologic study of contraception and pre-eclampsia. JAMA 262:3143–3147
Marti JJ, Herrmann U (1977) Immunogestosis: a new etiologic concept of “essential” gestosis, with special consideration of the primigravid patient. Am J Obstet Gynecol 128:489–493
Beer AE (1989) Immunology, contraception, and pre-eclampsia. JAMA 262:3184
Feeney JG, Tovey LAD, Scott JS (1977) Influence of previous blood-transfusion on incidence of pre-eclampsia. Lancet I:874–875
Campbell DM, MacGillivray I, Carr-Hill R (1985) Pre-eclampsia in second pregnancey. Br J Obstet Gynaecol 92:131–140
Nelson TR (1955) Clinical study of pre-eclampsia. J Obstet Gynecol Br Emp 62:48–66
Power DA, Mason RJ, Stewart GM, Catto GRD, MacLeod AM, Stewart KN (1983) The fetus as an allograft: evidence for protective antibodies to HLA-linked paternal antigens. Lancet II:701–703
Hinney B, Neumeyer H (1991) Immunotherapy for prophylaxis of abortion. Geburtshilfe Frauenheilkd 51:15–22
Mowbray JF, Liddell H, Underwood JL, Gibbings C, Reginald PW, Beard RW (1985) Controlled trial of treatment of recurrent spontaneous abortion by immunisation with paternal cells. Lancet I:941–943
Sargent IL, Wilkins T, Redman CWG (1988) Maternal immune responses to the fetus in early pregnancy and recurrent miscarriage. Lancet II: 1099–1104
Hinney B, Günther E, Kuhn W (1989) Detection of blocking factors during pregnancy. Arch Gynecol Obstet 245:165–166
Cooper DW, Hill JA, Chesley LC, Bryans CI (1988) Genetic control of susceptibility to eclampsia and miscarriage. Br J Obstet Gynaecol 95:644–653
Chesley LC, Cooper DW (1986) Genetics of hypertension in pregnancy: possible single gene control of pre-eclampsia — eclampsia in the descendents of eclamptic women. Br J Obstet Gynaecol 93:898–908
Kilpatrick CD, Gibson F, Livingston J, Liston WA (1990) Pre-eclampsia is associated with HLA-DR4 sharing between mother and fetus. Tissue Antigens 35:178–181
Christiansen OB, Mathiesen O, Grunnet N, Jersild C, Lauritsen JG (1990) Is there a common genetic background for pre-eclampsia and recurrent spontaneous abortions? Lancet I:361–362
Labarrere CA, Althabe OH (1986) Primary chronic abortion, pre-eclampsia, idiopathic intrauterine growth retardation, hydatiform mole, and choriocarcinoma: a unifying concept. Am J Reprod Immunol Microbiol 10:156–157
Reginald PW, Beard RW, Chapple J, Forbes PB, Liddell HS, Mowbray JF, Underwood JL (1987) Outcome of pregnancies progressing beyond 28 weeks gestation in women with a history of recurrent abortion. Br J Obstet Gynaecol 94:643–648
Saling E, Malchus R, Hoppe I (1983) Prevention of fetal growth retardation by buffy-coat transfusions — a case report. J Perinat Med 11:255–257
Sargent IL, Redman CWG, Stirrat GM (1982) Maternal cell-mediated immunity in normal and pre-eclamptic pregnancy. Clin Exp Immunol 50:601–609
Labarrere CA, Althabe OH, Caletti D, Muscolo E (1986) Deficiency of blocking factors in intrauterine growth retardation and its relationship with chronic villitis. Am J Reprod Immunol Microbiol 10:14–19
Mowbray JF, Underwood JL, Michel M, Forbes PB, Beard RW (1987) Immunisation with paternal lymphocytes in women with recurrent miscarriage. Lancet II:679–680
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Steck, T., Westphal, E. & Würfel, W. Maternal immunization by husband's leukocytes for repeated fetal death associated with mild pre-eclampsia — case report with successful outcome. Arch Gynecol Obstet 252, 103–107 (1992). https://doi.org/10.1007/BF02389636
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DOI: https://doi.org/10.1007/BF02389636