Maternal floor infarction: relationship to X cells, major basic protein, and adverse perinatal outcome.
OBJECTIVE
Maternal floor infarction of the placenta is characterized by gross placental abnormalities and histologic evidence of X-cell proliferation. Previously, pregnancy-associated major basic protein has been localized to the placental X cell and identified at elevated levels in serum and amniotic fluid in all normal pregnancies. Here we test the hypothesis that pregnancy-associated major basic protein is localized to the X cells in maternal floor infarction and that it contributes to the pathophysiologic features of pregnancies complicated by maternal floor infarction.


METHODS
Seven patients with eight pregnancies complicated by maternal floor infarction were evaluated. We analyzed placental tissue, serum, amniotic fluid, and placental cyst fluid for pregnancy-associated major basic protein.


RESULTS
Placental tissue from pregnancies complicated by maternal floor infarction had increased numbers of X cells and fibrinoid material that occupied or surrounded degenerating villi and that stained intensely for pregnancy-associated major basic protein. Serum pregnancy-associated major basic protein levels were variable and likely cannot be used to predict the occurrence of maternal floor infarction.


CONCLUSIONS
Pregnancy-associated major basic protein, a potent cytotoxin, is localized to X cells and is deposited in close proximity to chorionic villi in maternal floor infarction and may contribute to the pathophysiology of this disorder.
Vernof
K K
KK
Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905.
Benirschke
K
K
Kephart
G M
GM
Wasmoen
T L
TL
Gleich
G J
GJ
D000328:Adult; D000653:Amniotic Fluid / Q000378:metabolism; D001798:Blood Proteins / Q000378:metabolism*; D047091:Eosinophil Granule Proteins; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D015592:Immunoradiometric Assay; D007238:Infarction / Q000097:blood / Q000378:metabolism / Q000473:pathology*; D010920:Placenta / Q000098:blood supply* / Q000378:metabolism; D011247:Pregnancy; D011256:Pregnancy Outcome; D011257:Pregnancy Proteins / Q000378:metabolism*; D012260:Ribonucleases; D014327:Trophoblasts / Q000378:metabolism / Q000473:pathology*
D001798:Blood Proteins; D047091:Eosinophil Granule Proteins; D011257:Pregnancy Proteins; D012260:Ribonucleases