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Virchows Archiv
Published in: Virchows Archiv 6/2015

01-06-2015 | Original Article

Placental C4d deposition is a feature of defective placentation: observations in cases of preeclampsia and miscarriage

Authors: Eun Na Kim, Bo Hyun Yoon, Joong Yeup Lee, Doyeong Hwang, Ki Chul Kim, JoonHo Lee, Jae-Yoon Shim, Chong Jai Kim

Published in: Virchows Archiv | Issue 6/2015

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Abstract

Placental C4d deposition is frequent in preeclampsia, and shallow placentation is a characteristic of both preeclampsia and miscarriage. This study was conducted to determine the relationship among placental C4d, maternal human leukocyte antigen (HLA) antibodies, and placental pathology in preeclampsia and miscarriage cases. The patient population (N = 104) included those with (1) preterm preeclampsia with fetal growth restriction (PE-FGR; n = 21), (2) preterm preeclampsia (PE; n = 20), (3) spontaneous preterm delivery (sPTD; n = 39), and (4) miscarriage (n = 24). C4d immunohistochemistry was performed, and the presence of maternal plasma HLA antibodies was examined. C4d staining of the syncytiotrophoblast was more frequent in PE-FGR patients (76.2 %) than in PE (10.0 %; p < 0.001) and sPTD (2.6 %; p < 0.001) patients. Maternal HLA antibody-positive rate was not different among the study groups. There was a significant correlation between C4d immunoreactivity and placental pathology consistent with maternal vascular underperfusion (p < 0.001) but not with maternal HLA antibody status. In miscarriages, the positive rates of C4d, HLA class I, and HLA class II antibodies were 58.3, 25.0, and 12.5 %, respectively. There was no correlation between the presence of maternal HLA class I or II antibodies and placental C4d immunoreactivity. This study confirms frequent placental C4d deposition in preeclampsia with fetal growth restriction and miscarriage. The association between placental C4d deposition and pathological findings of maternal vascular underperfusion suggests that C4d staining of the syncytiotrophoblast is a consequence of defective placentation rather than of a specific maternal immune response against fetal HLA. The study also demonstrates the usefulness of C4d as a biomarker of placentas at risk.
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Metadata
Title
Placental C4d deposition is a feature of defective placentation: observations in cases of preeclampsia and miscarriage
Authors
Eun Na Kim
Bo Hyun Yoon
Joong Yeup Lee
Doyeong Hwang
Ki Chul Kim
JoonHo Lee
Jae-Yoon Shim
Chong Jai Kim
Publication date
01-06-2015
Publisher
Springer Berlin Heidelberg
Published in
Virchows Archiv / Issue 6/2015
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI
https://doi.org/10.1007/s00428-015-1759-y

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