Preeclampsia: Immunologic Alteration of Nitabuch's Membrane? Clinical Sequelae.

Authors

James Balducci MD, Lehigh Valley Health NetworkFollow
Patrice M. Weiss MD, Lehigh Valley Health NetworkFollow
Robert O. Atlas MD, Lehigh Valley Health NetworkFollow
Marc F. Pajarillo, Lehigh Valley Health Network
William B. Dupree MD, Lehigh Valley Health NetworkFollow
Stephen K. Klasko MD, MBA, Lehigh Valley Health NetworkFollow

Publication/Presentation Date

11-1-1997

Abstract

OBJECTIVE: To determine if preeclampsia is an immunologic disease process consistent with a host-vs.-graft reaction by examining differences in immunoglobulin deposition at the maternal fetal interface (Nitabuch's layer) in preeclamptic patients.

STUDY DESIGN: A prospective study of patients at Lehigh Valley Hospital was conducted between July 1993 and April 1994. Group 1 (study) consisted of 11 primigravid women meeting the criteria for the diagnosis of preeclampsia. Group 2 (control) consisted of 11 primigravid women who had an uncomplicated pregnancy. At delivery, basal plate placental specimens were obtained, fixed, and processed for study by a blinded observer utilizing IgG, IgA, IgM, IgE immunofluorescence techniques. The placenta was then sent to a gynecologic pathologist for blinded evaluation and measurement of Nitabuch's membrane by light microscopy.

RESULTS: Taking the average width of 3 measurements of Nitabuch's membrane by light microscopy revealed no significant difference (group 1, .1839 mm vs. group 2, .1555 mm). Immunofluorescence techniques revealed that the thickness of immunofluorescence of Nitabuch's membrane was significantly greater in the study group vs. the control group (157.48 pixels vs. 63.80 pixels, P = .006, respectively).

CONCLUSION: Evaluation of the maternal-fetal interface reveals the deposition of increased immunoglobulins, the physiology of which may be similar to nephropathies as seen in systemic disease processes. The deposition of immunoglobulins may be associated with a common antigen which may point to an immunologic etiology for preeclampsia in some women.

Volume

6

Issue

6

First Page

324

Last Page

328

ISSN

1057-0802

Published In/Presented At

Balducci, J., Weiss, P. M., Atlas, R. O., Pajarillo, M. F., Dupree, W. B., & Klasko, S. K. (1997). Preeclampsia: immunologic alteration of Nitabuch's membrane? Clinical sequelae. The Journal Of Maternal-Fetal Medicine, 6(6), 324-328.

Disciplines

Obstetrics and Gynecology

PubMedID

9438214

Department(s)

Department of Obstetrics and Gynecology, Department of Obstetrics and Gynecology Faculty

Document Type

Article