The fetus, not the mother, elicits maternal immunologic rejection: lessons from discordant dizygotic twin placentas
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Kamran Yusuf
Abstract
Aims: Our objective was to elucidate the pathogenesis of twin discordance in four dizygotic pregnancies where only one of the twins had IUGR due to chronic villitis.
Methods: We identified four cases of dizygotic twin placentas over a period of four years with evidence of chronic villitis. There was no clinical or pathologic evidence of TORCH, bacterial infection, preeclampsia or autoimmune disorders. Placentas were weighed, processed for histologic examination and stained with CD45RO (clone UCHL1) mouse monoclonal antibody, which identifies T-cells.
Results: All placentas were dichorionic, with two being fused. Birth weight differences were 29%, 41%, 17% and 10%. Villitis was more marked in the placenta of the twin that weighed less and correlated with the degree of weight discordance. On examining the junction between the fused dichorionic placentas, the chorionic villi from the smaller twin contained numerous T-cells, whereas the villi associated with the less affected twin, showed little to no T-cells.
Conclusion: We describe a series of dizygotic twin placentas where the more severe the chronic villitis, the more affected the placenta and fetus. Since the maternal environment was constant for each of these twins, differences in villitis severity appears to be attributable to differences in the ability of each placenta to induce a maternal immune response.
©2008 by Walter de Gruyter Berlin New York
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- Erratum
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- Congress Calander
- Congress Calendar
- Announcement
- Announcement
Artikel in diesem Heft
- Editorial
- Does globalization and change demand a different kind of perinatal research?
- Recommendations and guidelines for perinatal practice
- Intrauterine restriction (IUGR)
- Review article
- The role of antioxidant vitamins in hypertensive disorders of pregnancy
- Original articles – Obstetrics
- The fetus, not the mother, elicits maternal immunologic rejection: lessons from discordant dizygotic twin placentas
- Do risk factors for elective cesarean section differ from those of cesarean section during labor in low risk pregnancies?
- Obstetric antecedents for preterm delivery
- Post-delivery oxidative stress in women with preeclampsia or IUGR
- Evidence supporting proteolytic cleavage of insulin-like growth factor binding protein-1 (IGFBP-1) protein in amniotic fluid
- Original articles – Fetus
- Value of a single early third trimester fetal biometry for the prediction of birth weight deviations in a low risk population
- Comparison of six sonographic signs in the prenatal diagnosis of spina bifida
- Original articles – Newborn
- Relationships between umbilical cord arterial blood pH levels at delivery and Bayley Psychomotor Development Index scores in early childhood
- Head circumference and long-term outcome in small-for-gestational age infants
- Hypocalcemia is common in the first 48 h of life in ELBW infants
- Total body water in small- and appropriate- for gestational age newborns
- Below median birth weight in appropriate-for-gestational-age preterm infants as a risk factor for bronchopulmonary dysplasia
- Letter to the editor
- Congenital lupus erythematosus affecting both twins
- Obituary Gösta Rooth
- The death of Prof. Gösta Rooth
- Erratum
- Hematological profile of Korean very low birth weight infants
- Congress Calander
- Congress Calendar
- Announcement
- Announcement
