Using Specialized Cells of the Placenta as Predictors of Preeclampsia

Donna M. Neale, M.D.,Assistant Professor of Obstetrics and Gynecology

Preeclampsia, described as high blood pressure that occurs after the 20th week of pregnancy, is the second leading cause of maternal mortality. However, no definitive causes or predictors of this disease have been identified. The purpose of this investigation was to enhance understanding of how changes in the normal function of specialized cells of the placenta, called trophoblast cells, lead to preeclampsia.

Highlighted Study Findings

In normal placental development, trophoblast cells invade the blood vessels of the uterus, and these blood vessels dilate or become wider to carry increased blood and oxygen to the fetus. In preeclampsia, these vessels remain narrow and when tissues do not get enough oxygen, toxins are released into the blood. Dr. Neale proposed that abnormal trophoblast invasion occurs in those who develop preeclampsia, due to self-destruction of the trophoblasts. She and her team developed a trophoblast viability screen to highlight differing responses when the trophoblasts were exposed to the blood of pregnant women with normal blood pressure versus blood of pregnant women who developed preeclampsia. The results of the study showed that when trophoblasts were exposed to the serum of women who were either overtly preeclamptic or were destined to develop preeclampsia, the trophoblasts underwent accelerated self-destruction. Moreover, the results of the study suggested the existence of a blood protein profile unique to each trimester of pregnancy, changing as early as the first trimester in women destined to develop preeclampsia. Combining the trophoblast viability screen and the unique protein profile represented steps toward developing a test to identify women at risk for preeclampsia. Development of such a screening test is continuing.