Significant fetal-maternal hemorrhage after termination of pregnancy: implications for development of fetal cell microchimerism.
OBJECTIVE
Recent reports that an association exists between fetal cell microchimerism and autoimmune disease has increased interest in the postpartum persistence of fetal cells. The purpose of this study was to determine, by means of quantitative polymerase chain reaction amplification, whether a significant fetalmaternal hemorrhage occurs after elective termination of pregnancy.


METHODS
Blood samples were obtained from 23 women who underwent termination of pregnancy immediately before venipuncture; these samples were subjected to analysis by quantitative polymerase chain reaction amplification with the use of Y-chromosome primers. There were 21 male and 2 female fetuses. Results were equilibrated to 16 mL and analyzed by a weighted linear regression analysis to evaluate the correlation between detected fetal nucleated cell equivalents and gestational weeks.


RESULTS
Among the 21 known male fetuses, the median number of detected fetal nucleated cell equivalents was 1552 (range, 50-37,618). The female fetuses had no fetal nucleated cell equivalents detected. A positive dependence of male fetal nucleated cell equivalents on gestational age was shown (P <.001).


CONCLUSIONS
Analysis by quantitative polymerase chain reaction amplification demonstrated a large fetal-maternal transfusion after elective abortion. Consideration of the biologic consequences of pregnancy and the potential for future development of fetal cell microchimerism must now extend to a larger population of women.
Division of Genetics and the Department of Pediatrics, Tufts University School of Medicine, Genzyme Genetics, Framingham, Massachusetts, USA.
D W
DW
Bianchi
A
A
Farina
W
W
Weber
L C
LC
Delli-Bovi
M
M
Deriso
J M
JM
Williams
K W
KW
Klinger
D000028:Abortion, Induced; D002469:Cell Separation; D002678:Chimera; D004247:DNA / Q000097:blood; D017931:DNA Primers; D005260:Female; D005312:Fetal Blood / Q000166:cytology*; D005331:Fetomaternal Transfusion / Q000097:blood*; D005865:Gestational Age; D006801:Humans; D016014:Linear Models; D008297:Male; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D014998:Y Chromosome
D017931:DNA Primers; D004247:DNA