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Occult fetomaternal hemorrhage in women with pathological placenta with respect to permeability
Author(s) -
Umazume T.,
Yamada T.,
Morikawa M.,
Ishikawa S.,
Kojima T.,
Cho K.,
Masauzi N.,
Minakami H.
Publication year - 2016
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12959
Subject(s) - medicine , obstetrics , fetus , population , placenta , hemoglobin , fetal distress , fetal hemoglobin , pregnancy , andrology , gynecology , genetics , environmental health , biology
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.