PMID- 19497946
OWN - NLM
STAT- MEDLINE
DCOM- 20091110
LR  - 20211020
IS  - 1460-2350 (Electronic)
IS  - 0268-1161 (Print)
IS  - 0268-1161 (Linking)
VI  - 24
IP  - 9
DP  - 2009 Sep
TI  - Retrieval of trophoblast cells from the cervical canal for prediction of abnormal 
      pregnancy: a pilot study.
PG  - 2086-92
LID - 10.1093/humrep/dep206 [doi]
AB  - BACKGROUND: Fetal cells are shed from the regressing chorionic villi and it is 
      possible to retrieve extravillous cytotrophoblast cells by transcervical 
      sampling. The abundance of trophoblast cells in transcervical samples suggests 
      that this non-invasive approach could distinguish between normal and abnormal 
      pregnancies, such as an ectopic pregnancy (EP) and blighted ovum (BO). We aim to 
      identify and quantify fetal trophoblast cells in the cervical canal during the 
      first trimester to assess their usefulness to predict an abnormal pregnancy. 
      METHODS: Patients, age 18-45, presenting with a normal intrauterine pregnancy 
      (IUP; n = 37), diagnosis of EP (n = 10) or BO (n = 5) were enrolled for 
      collection of transcervical specimens using a cytobrush and fixative rinse. 
      Non-pregnant, nulliparous women (n = 7) were included as negative controls. Cells 
      were cleared of mucus by acidification, prepared on microscope slides and labeled 
      with a monoclonal antibody recognizing the trophoblast marker, human leukocyte 
      antigen (HLA)-G. HLA-G positive and negative cells were counted to calculate the 
      ratio of trophoblast cells to total cervical cells. RESULTS: Trophoblast cells 
      were observed in 35/37 normal IUP, 6/10 EP and 4/5 BO specimens. The average 
      frequency of HLA-G positive cells in the normal IUP cervical samples was 
      approximately 1 in 2000, which was 4-fold higher than samples from patients with 
      EP or BO (P < 0.001). Receiver operating characteristic analysis showed that EP 
      and BO pregnancies were distinguishable from normal pregnancies with 93% 
      sensitivity, 95% specificity, 97% positive predictive value and 87% negative 
      predictive value. CONCLUSIONS: This pilot study presents evidence that 
      trophoblast cells can be reliably obtained and identified among cervical cells in 
      the first trimester by immunohistochemical staining for HLA-G, and suggests for 
      the first time that abnormal pregnancies may be predictable based on the 
      abundance of trophoblast cells in the cervical canal.
FAU - Imudia, Anthony N
AU  - Imudia AN
AD  - Department of Obstetrics & Gynecology, Wayne State University School of Medicine, 
      Detroit, MI, USA.
FAU - Suzuki, Yoko
AU  - Suzuki Y
FAU - Kilburn, Brian A
AU  - Kilburn BA
FAU - Yelian, Frank D
AU  - Yelian FD
FAU - Diamond, Michael P
AU  - Diamond MP
FAU - Romero, Roberto
AU  - Romero R
FAU - Armant, D Randall
AU  - Armant DR
LA  - eng
GR  - Intramural NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Intramural
DEP - 20090604
PL  - England
TA  - Hum Reprod
JT  - Human reproduction (Oxford, England)
JID - 8701199
RN  - 0 (HLA Antigens)
RN  - 0 (HLA-G Antigens)
RN  - 0 (Histocompatibility Antigens Class I)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cervix Uteri/*cytology
MH  - Female
MH  - HLA Antigens/analysis
MH  - HLA-G Antigens
MH  - Histocompatibility Antigens Class I/analysis
MH  - Humans
MH  - Middle Aged
MH  - Pregnancy
MH  - Pregnancy Complications/*diagnosis/immunology
MH  - Pregnancy Trimester, First/immunology
MH  - Pregnancy, Ectopic/diagnosis/immunology
MH  - Trophoblasts/*cytology/immunology
PMC - PMC2727404
EDAT- 2009/06/06 09:00
MHDA- 2009/11/11 06:00
PMCR- 2010/09/01
CRDT- 2009/06/06 09:00
PHST- 2009/06/06 09:00 [entrez]
PHST- 2009/06/06 09:00 [pubmed]
PHST- 2009/11/11 06:00 [medline]
PHST- 2010/09/01 00:00 [pmc-release]
AID - dep206 [pii]
AID - 10.1093/humrep/dep206 [doi]
PST - ppublish
SO  - Hum Reprod. 2009 Sep;24(9):2086-92. doi: 10.1093/humrep/dep206. Epub 2009 Jun 4.