Association between Foeto-maternal Bleeding and Hypertension in Pregnancy

Jones, Peter W.; McNay, Angus; Walker, William O.

doi:10.1136/bmj.3.5673.738

Cited by 19 publications

(4 citation statements)

References 22 publications

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“…A ®rst step in the direction of being able to quantify the extent of feto-maternal bleeding was the development of a staining technique which permitted a distinction to be made between fetal and maternal erythrocytes (Kleihauer et al, 1957). Using this technique, it could be shown that the occurrence of fetal erythrocytes was indeed more frequent in pregnancies affected by pre-eclampsia than in healthy controls (61 versus 51%) (Jones et al, 1969). However, this effect was most dramatic in samples taken before 36 weeks pregnancy, where signi®cant differences in the numbers of fetal erythrocytes were noted in those pregnancies subsequently affected by pre-eclampsia, in contrast to those with normal deliveries.…”

Section: Fetal Cell Traf®c In Pre-eclampsiamentioning

confidence: 99%

Fetal cells and cell-free fetal DNA in maternal blood: new insights into pre-eclampsia

Hahn¹

2002

Human Reproduction Update

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The examination of fetal cells, specifically erythroblasts, and cell-free fetal DNA from the blood of pregnant women is currently the subject of intense research with the aim of developing new risk-free methods for prenatal diagnosis. An unexpected finding made during these studies was that the traffic of fetal erythroblasts into the maternal peripheral circulation was enhanced in pre-eclampsia. Independent prospective studies examining samples collected in the second trimester indicated that this perturbation in fetal cell trafficking occurs early in pregnancy, well before the onset of pre-eclampsia symptoms. The quantitative analysis of cell-free fetal and maternal DNA levels indicated that these concentrations were elevated in a co-ordinate manner in manifest pre-eclampsia, and that these elevations corresponded to disease severity. On the other hand, analysis of prospectively collected samples indicated that only cell-free fetal but not maternal DNA levels were elevated before onset of symptoms in pregnancies which subsequently developed pre-eclampsia. These data support hypotheses suggesting that pre-eclampsia is a multi-step disorder, initiated by a placental lesion that occurs early in pregnancy and which subsequently leads to a systemic maternal inflammatory response and associated endothelial cell damage.

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Section: Fetal Cell Traf®c In Pre-eclampsiamentioning

confidence: 99%

Fetal cells and cell-free fetal DNA in maternal blood: new insights into pre-eclampsia

Hahn¹

2002

Human Reproduction Update

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“…The subjects were 110 primigravidae who, as part of another investigation (Jones, 1969), were being carefully supervised during pregnancy. As a group they had the advantage that their folate stores could not have been affected by a previous pregnancy.…”

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confidence: 99%

Relation Between Maternal and Infant Blood Folate Activities

Landon¹,

Oxley²

1971

Archives of Disease in Childhood

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Landon, M. J., and Oxley, A. (1971). Archives of Disease in Childhood, 46, 810. Relation between maternal and infant blood folate activities. The relation between maternal and cord blood folate activity was investigated in a group of 110 primigravidae and their infants. Approximately half of these mothers had received folic acid supplements during their pregnancy, and the effects of this on infant blood folate levels at birth and at 6 weeks were also studied.In unsupplemented pregnancies there was a significant relation between infant and maternal blood folate levels at delivery.The results of folic acid supplementation during pregnancy were reflected by higher cord blood values, but 6 weeks after delivery infant plasma folate levels were essentially the same in both groups and independent of maternal supplies before delivery.The increasing use of microbiological assays for the estimation of blood folate levels during pregnancy has established that at term both plasma and erythrocyte folate activities are frequently below the normal levels found in nonpregnant women (Hansen, 1964;Ball and Giles, 1964;Chanarin, Rothman, and Berry, 1965).Despite these low levels, folic acid deficiency does not appear to be a feature of the fetus because cord blood values are invariably higher than maternal levels (Baker et al., 1958(Baker et al., , 1960Grossowicz et al., 1960).Grossowicz and his co-workers (1960) noted the possibility of an association between low blood folate activity in the mother and a comparatively low blood folate activity in the cord blood. Roberts et al. (1969) in a series of 20 premature infants found a similar relation with regard to erythrocyte folate activity, though in this series the mothers had been receiving prophylactic folic acid since their first antenatal attendance.This present study investigates the relation between matemnal and cord blood folate activities and the effect of the latter on infant folate status six weeks after delivery. MaterialThe subjects were 110 primigravidae who, as part of another investigation , were being carefully supervised during pregnancy. As a group they had the advantage that their folate stores could not have been affected by a previous pregnancy.

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“…This vital aspect was subsequently confirmed by the use of the then novel Kleihauer-Betke stain, which permitted the detection of fetal erythrocytes in maternal blood samples (11). This indicated that their proportion was indeed greater in pregnancies affected by pre-eclampsia (12). These data thereby provided further insight into the placental lesion in pre-eclampsia, indicating that it involved both increased trophoblast shedding, as well as leakage of fetal blood cells across the villous barrier (2, 3).…”

Section: Fmm and Pre-eclampsia: Historical Observationsmentioning

confidence: 91%

Feto-Maternal Microchimerism: The Pre-eclampsia Conundrum

et al. 2019

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Feto-maternal microchimerism (FMM) involves bidirectional cross-placental trafficking during pregnancy, leading to a micro-chimeric state that can persist for decades. In this manner a pregnant woman will harbor cells from her mother, as well as, cells from her child. Historically, eclampsia, a severe disorder of pregnancy provided the basis for FMM following the detection of trophoblast cells in the lungs of deceased women. Bi-directional cell trafficking between mother and fetus is also altered in pre-eclampsia and has been suggested to contribute to the underlying etiology. FMM has been implicated in tolerance promotion, remission of auto-inflammatory disorders during pregnancy, or the development of autoimmune conditions post-partum. The underlying mechanism whereby the host immune system is modulated is unclear but appears to involve HLA class II molecules, in that incompatibility between mother and fetus promotes remission of rheumatoid arthritis, whereas feto-maternal HLA compatibility may assist in the post-partum initiation of scleroderma. Couples having a high degree of HLA class II compatibility have an increased risk for pre-eclampsia, while the occurrence of scleroderma and rheumatoid arthritis is greater in pre-eclamptic cases than in women with normal pregnancies, suggesting a long term autoimmune predisposition. Since pregnant women with pre-eclampsia exhibit significantly lower levels of maternally-derived micro-chimerism, the question arises whether pre-eclampsia and post-partum development of autoimmune conditions occur due to the failure of the grandmothers cells to adequately regulate an inappropriate micro-chimeric constellation.

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Association between Foeto-maternal Bleeding and Hypertension in Pregnancy

Cited by 19 publications

References 22 publications

Fetal cells and cell-free fetal DNA in maternal blood: new insights into pre-eclampsia

Fetal cells and cell-free fetal DNA in maternal blood: new insights into pre-eclampsia

Relation Between Maternal and Infant Blood Folate Activities

Feto-Maternal Microchimerism: The Pre-eclampsia Conundrum

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