title: Fetal cells in the mother: from genetic diagnosis to diseases associated with fetal cell microchimerism.
abstract: Fetal cells circulate in the blood of pregnant women. When the gestation is normal, fetal cells are low in number. Complications of pregnancy, such as pre-eclampsia, or fetal cytogenetic abnormalities, such as Down's syndrome, increase fetomaternal transfusion. The isolation of fetal cells from maternal blood is currently under active investigation as a non-invasive method for prenatal diagnosis. The fetal cells that are most commonly used for non-invasive genetic diagnosis, the nucleated erythrocyte and the trophoblast, are highly differentiated and do not persist post-partum. In the context of studying fetal cells in maternal blood it was discovered that fetal progenitor cells originating from a prior pregnancy could also be detected. This led to the appreciation that unlike fetal DNA in plasma, which is cleared almost immediately following delivery, fetal cells persist for decades post-partum. Following pregnancy, labor, and delivery, a woman becomes a chimera. Transfused fetal stem and progenitor cells appear to be capable of further differentiation and migration to maternal organs. A further research agenda is needed to explore the newly appreciated phenomenon of bi-directional fetomaternal cell trafficking. Any consideration of the fetus as a patient must also consider the fetus as a potential source of therapeutic stem cells for the mother.
authors.affiliation: Lifespan Fetal Treatment Team, New England Medical Center, and Rhode Island Hospital, Providence, RI, USA. dbianchi@lifespan.org
authors.forename: D W
authors.initials: DW
authors.lastname: Bianchi
mesh_terms: D000818:Animals; D001327:Autoimmune Diseases / Q000235:genetics / Q000276:immunology; D002678:Chimera; D004247:DNA / Q000032:analysis / Q000097:blood; D005260:Female; D005312:Fetal Blood / Q000166:cytology*; D005331:Fetomaternal Transfusion; D005821:Genetic Techniques; D006801:Humans; D008297:Male; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood; D011296:Prenatal Diagnosis / Q000379:methods*; D012595:Scleroderma, Systemic / Q000235:genetics / Q000276:immunology
chemical_list: D004247:DNA