Human Reproduction Update, Vol.8, No.6 pp.501-508, 2002
© European Society of Human Reproduction and Embryology 2002; all rights reserved
Fetal cells and cell-free fetal DNA in maternal blood: new insights into pre-eclampsia
1 University Women’s Hospital, University of Basel, Switzerland
To whom correspondence should be addressed at: Sinuhe Hahn, University Women’s Hospital, University of Basel, Schanzenstrasse 46, CH-4031 Basel, Switzerland; e-mail: shahn{at}uhbs.ch
Abstract
The examination of fetal cells, specifically erythroblasts, and cell-free fetal DNA from the blood of pregnant women is currently the subject of intense research with the aim of developing new risk-free methods for prenatal diagnosis. An unexpected finding made during these studies was that the traffic of fetal erythroblasts into the maternal peripheral circulation was enhanced in pre-eclampsia. Independent prospective studies examining samples collected in the second trimester indicated that this perturbation in fetal cell trafficking occurs early in pregnancy, well before the onset of pre-eclampsia symptoms. The quantitative analysis of cell-free fetal and maternal DNA levels indicated that these concentrations were elevated in a co-ordinate manner in manifest pre-eclampsia, and that these elevations corresponded to disease severity. On the other hand, analysis of prospectively collected samples indicated that only cell-free fetal but not maternal DNA levels were elevated before onset of symptoms in pregnancies which subsequently developed pre-eclampsia. These data support hypotheses suggesting that pre-eclampsia is a multi-step disorder, initiated by a placental lesion that occurs early in pregnancy and which subsequently leads to a systemic maternal inflammatory response and associated endothelial cell damage.
Key words: cell-free DNA / fetal cells / hypothesis / maternal blood / pre-eclampsia
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