Pre-eclampsia is a medical condition that affects one in twenty pregnancies and can lead to various complications for the mother and child, including stroke, seizures, or even death. Pre-eclampsia can be diagnosed during the second trimester and occurs when the mother develops hypertension, i.e. high blood pressure, or unusually high concentrations of protein in her urine. While there is currently no treatment for pre-eclampsia, a recent study published in Reproductive Sciences could help identify those women at risk for developing pre-eclampsia.
The article, titled “Placental Protein 13 and Decidual Zones of Necrosis: An Immunologic Diversion That May be Linked to Preeclampsia,” was published by Harvey J. Kliman, MD, PhD, a research scientist operating out of Yale University, and several other scientists. The article focused on recent findings Kilman and his colleagues had unearthed about the role of Placental Protein 13 (PP13) and what this could mean for pre-eclampsia patients.
PP13 is a protein made by the placenta during pregnancy. Prior research had found PP13 levels to be very low among women who develop pre-eclampsia; however, the role of PP13 in pregnancy had previously been unknown. In the present study, the doctors studied placentas from normal pregnancies that had been terminated prior to the 14th week of gestation. They not only found the PP13 to be concentrated in maternal tissue surrounding the veins running under the placenta, but also found a high degree of necrotic maternal tissue in the same area.
The researchers were surprised to find necrotic, or dead, tissues present during the course of a healthy pregnancy. To explain the potential reason behind this necrotic tissue, Dr. Kilman first explained the battle for nutrients that occurs between the mother and growing embryo during the course of a typical pregnancy. He explains that the placenta is controlled by the father’s genes, whose goal is “to make the biggest placenta and the biggest baby possible.” Conversely, the mother’s goal is to not die during childbirth.
The placenta tissues seek to draw the maximum amount of nutrients to the placenta, even going so far as to find ways to increase the blood flow to the placenta. However, by doing so, it could harm the mother by increasing her blood pressure until she develops pre-eclampsia. The study suggests that PP13 holds the answer to why the mother allows the placenta to endanger her body and increase her blood pressure to potentially harmful levels.
Kilman and his team believe that PP13 acts as a decoy, distracting the mother’s immune system from the real attack that is taking place on her arteries. PP13 attacks the mother’s veins, causing the immune cells to swarm the veins and repel the PP13. However, doing so means that the immune cells are not present when the placenta begins to attack the mother’s arteries to increase the blood flow to the placenta. Therefore, the mother is unable to counter the attack and develops pre-eclampsia.
This research is in its beginning stages and needs to be tested and collaborated through additional research. And while these findings won’t necessarily help treat mothers with pre-eclampsia, tests of PP13 levels during the earlier stages of pregnancies could potentially help physicians identify those patients who are at risk for developing pre-eclampsia so that physicians can monitor the course of their pregnancies more closely.
Resource:
Roni Caryn Rabin. “Turncoat of Placenta Is Watched for Trouble.” The New York Times, October 17, 2011.
Chicago’s Kreisman Law Offices has been handling Illinois medical negligence matters for more than 35 years for individuals and families in and around Chicago, Cook County, and surrounding areas, including Tinley Park, Park Ridge, Winnetka, Oak Forest, and Alsip.
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