title: Association of placental inflammation with fetomaternal hemorrhage and loss of placental mucin-1.
abstract: BACKGROUND
  Fetomaternal hemorrhage (FMH) poses an immediate risk to the fetus and, in case of Rhesus-immunization, to future pregnancies. Given that altered endothelial permeability is part of the pathophysiology of inflammation, in this study we investigated whether placental inflammatory processes like chorioamnionitis (ChoA) or preeclampsia (PE) lead to increased rates of FMH compared to the established risk factor of placenta previa (PP). Putative accompanying markers of trophoblastic damage were also explored.
  
  
  METHODS
  40 patients (14 PE; 6 ChoA; 9 PP; 11 normal controls) were evaluated for FMH using a flowcytometric test kit, which is able to quantify FMH of 0.06% fetal cells. Placental tissue samples were immunostained for human placental lactogen (hPL), human chorionic gonadotropin (hCG), and mucin-1 (MUC1). MUC1 was evaluated as a potential serum marker of FMH.
  
  
  RESULTS
  Patients with ChoA had a mean calculated FMH volume of 29 ml, compared to 4 ml in PE and 1 ml in PP and controls. MUC1 staining was reduced in PE and ChoA placenta samples, while elevated MUC1 serum concentration correlated positively with FMH.
  
  
  CONCLUSIONS
  Diseases of placental inflammation are associated with FMH. Placental MUC1 staining is reduced and serum concentrations are increased in cases of FMH.
authors.affiliation: Department of Obstetrics and Gynecology, Medical Faculty, Heinrich-Heine University, Moorenstr. 5, 40225 Düsseldorf, Germany. christoph.scholz@med.uni-duesseldorf.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Scholz
authors.forename: Christine
authors.initials: C
authors.lastname: Hermann
authors.forename: Andrea
authors.initials: A
authors.lastname: Kachler
authors.forename: Franz
authors.initials: F
authors.lastname: Kainer
authors.forename: Klaus
authors.initials: K
authors.lastname: Friese
authors.forename: Antonios
authors.initials: A
authors.lastname: Makrigiannakis
authors.forename: Udo
authors.initials: U
authors.lastname: Jeschke
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002821:Chorioamnionitis / Q000097:blood*; D006063:Chorionic Gonadotropin / Q000032:analysis; D005260:Female; D005331:Fetomaternal Transfusion / Q000097:blood*; D006801:Humans; D018396:Mucin-1 / Q000097:blood*; D010928:Placental Lactogen / Q000032:analysis; D011225:Pre-Eclampsia / Q000097:blood; D011247:Pregnancy
chemical_list: D015415:Biomarkers; D006063:Chorionic Gonadotropin; C060192:MUC1 protein, human; D018396:Mucin-1; D010928:Placental Lactogen