(2)癒着胎盤のリスクを推定する分子診断法の確立を目指して : 母体血漿中cell-free Placental mRNAを用いた検討(<特集>第61回学術講演会シンポジウム1「産科出血と胎盤異常」)

概要

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Placenta accreta may cause serious obstetric complications, the accuracy of prenatal diagnosis is still unsatisfactory. Circulating cell-free placental mRNA (cff-mRNA) can be isolated and quantified in maternal plasma. Recent reports showed that quantitative aberrations of cff-mRNA in various pregnancy associated disorders. We investigated whether the quantitation of cff-mRNA levels have the potential to predict a placenta previa resulting in hysterectomy. The maternal plasma concentrations of the cff-hPL mRNA measured by real-time reverse-transcription polymerase chain reaction. The concentration of cff-hPL mRNA was significantly higher in women with placenta previa that need hysterectomy and histologically diagnosed placenta accreta than those with placenta previa of other groups. And, to improve the accuracy of diagnosis of placenta accreta, we investigated the usefulness of intraoperative ultrasonography. In some cases of placenta percreta, we could diagnose it precisely by using intraoperative ultrasonography. By intraoperative ultrasonography, the relationship between decidua and myometrium was represented more clearly. In conclusion, the cff-mRNA concentration in maternal plasma has the potential to predict a subgroup of placenta accreta resulting in hysterectomy. And, use of intraoperative ultrasonography may improve the accuracy of diagnosis of placenta accreta.
2009-09-01