DISTURBED FETOMATERNAL CELL TRAFFIC IN PREECLAMPSIA

Objective: To investigate whether the transfer of fetal blood cells to the maternal circulation is perturbed in pregnancies affected by pree clampsia. Methods: Fetal erythroblasts were isolated from eight women with clinically diagnosed preeclampsia (blood pressure values of at le ast 140/90 mmHg and associated proteinuria) and an equal number of mat ched corresponding controls. All patients in both groups were pregnant with male singleton fetuses. The presence of fetal cells was evaluate d histologically and by fluorescence in situ hybridization for X and Y chromosomes. Results: The number of fetal cells was higher in preecla mptic patients than in controls, with respect to both nucleated red bl ood cells (median per 200 cells 38 versus 7; P < .001) and the proport ion of these cells that were of fetal origin (median per 2000 cells 9 versus 2; P = .001). Conclusion: These results suggest that the traffi cking of fetal cells into the maternal periphery is disturbed in patie nts with preeclampsia. Because it is unlikely that such an altered flo w of cells is restricted to the erythroblasts examined in this study, these findings also may lead to interesting new concepts regarding the development of preeclampsia and possibly the associated syndrome of h emolysis, elevated liver enzymes, and low platelets. (C) 1998 by The A merican College of Obstetricians and Gynecologists.