Maternal Floor Infarction/Massive Perivillous Fibrin Deposition: A Manifestation of Maternal Antifetal Rejection?
Key result
Massive perivillous fibrin deposition in pregnancy was associated with a higher prevalence of plasma cell deciduitis (40% vs 8.6%, P=0.01) and maternal anti-HLA class I positivity (80% vs 36%, P=0.01).
Population
185 pregnant women, including 10 cases with massive perivillous fibrin deposition and 175 controls with…
Design
Case-control
Authors
Discussion
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Implication
Supports maternal antifetal rejection mechanism; hypothesis-generating and should not yet change practice.
Study Design
Type
Case-Control (n=185)
Structured PICO
P
Population
185 pregnant women, including 10 cases with massive perivillous fibrin deposition and 175 controls with uncomplicated term deliveries.
C
Comparator
Women with uncomplicated pregnancies who delivered at term without MPFD
O
Outcome
Markers of maternal antifetal rejection (panel-reactive anti-HLA class I and II antibodies, chronic chorioamnionitis, villitis of unknown etiology, plasma cell deciduitis, C4d deposition, plasma CXCL-10 concentrations)surrogate
Main Result
Absolute Event Rate: 40% vs 8.6%
p-value: p=0.01
Massive perivillous fibrin deposition in pregnancy appears to be a manifestation of maternal antifetal rejection, characterized by increased anti-HLA antibodies and complement activation.
Cite This Study
Romero et al. (2013) conducted a case-control in Massive perivillous fibrin deposition (MPFD) / Maternal floor infarction (MFI) (n=185). Massive perivillous fibrin deposition (MPFD) vs. Uncomplicated term pregnancies without MPFD was evaluated on Prevalence of plasma cell deciduitis (p=0.01). Massive perivillous fibrin deposition in pregnancy was associated with a higher prevalence of plasma cell deciduitis (40% vs 8.6%, P=0.01) and maternal anti-HLA class I positivity (80% vs 36%, P=0.01).