Occult fetomaternal hemorrhage in women with pathological placenta with respect to permeability. Issue 6 (2nd March 2016)

• Record Type: Journal Article
• Authors: Umazume, T.; Yamada, T.; Morikawa, M.; Ishikawa, S.; Kojima, T.; Cho, K.; Masauzi, N.; Minakami, H.
• Is Part Of: Journal of obstetrics and gynaecology research. Volume 42:Issue 6(2016)
• Page Start: 632
• Page End: 639
• Publication Date: 2016-03-02
• Subjects: alpha‐fetoprotein -- fetomaternal hemorrhage -- placenta previa -- placental mesenchymal dysplasia -- pre‐eclampsia; Gynecology -- Periodicals; Obstetrics -- Periodicals; 618.1005
• DOI: 10.1111/jog.12959
• Languages: English
• ISSNs: 1341-8076

Abstract

Abstract: Aim: Women with pre‐eclampsia (PE), placenta previa (PP), placental abruption (PA), and placental mesenchymal dysplasia (PMD) have been described as having placental permeability dysfunction. This study was performed to determine whether occult fetomaternal hemorrhage (FMH) is common in women with such complications and in women with non‐reassuring fetal status. Methods: Forty‐one antenatal and 39 postnatal blood samples were obtained from 46 women, including 11 with placental permeability dysfunction (5, 3, 2, and 1 with PE, PP, PA, and PMD, respectively) and 35 controls without such complications. To estimate the amount of fetal red blood cells, flow cytometry was performed using the fetal cell count system with two antibodies against fetal hemoglobin and carbonic anhydrase and the β‐γ system with two monoclonal antibodies against hemoglobin β‐chain and hemoglobin γ‐chain. A diagnosis of FMH was made when the fraction size of the isolated cell population on scatter plots expressing fetal hemoglobin alone or hemoglobin γ‐chain alone accounted for ≥0.02% of the total cell population on scatter plots. Results: FMH was identified in five women, including one each with PE, PA, PP, PMD, and no complications. Thus, the prevalence rate of FMH was significantly higher in women with complications than in controls (36% [4/11] vs 2.9% [1/35], respectively, P = 0.009). The FMH occurrence rate did not differ between women with and without non‐reassuring fetal status (7.7% [1/13] vs 12% [4/33], respectively, P = 1.000). Conclusion: The risk of fetal red blood cells trafficking into the maternal circulation may be increased in women complicated with PE, PA, PP, and PMD.