並列タイトル等原因不明の後産期出血症例における子宮体部筋層の組織学的特徴 −局所免疫応答の関与の可能性について−
タイトル(掲載誌)Journal of reproductive immunology
一般注記doctoral
医学系研究科
The aim of this study was to evaluate the histological characteristics of the myometrium obtained on postpartum hemorrhage (PPH) of unknown etiology secondary to uterine atony. They were selected among registered cases of clinically suspected amniotic fluid embolism (AFE) and classified as PPH of unknown etiology because of no obvious cause of PPH at Hamamatsu University School of Medicine, a registration center for clinical AFE in Japan. Immunohistochemical studies were done on myometrium using anti-mast cell tryptase, anti-neutrophil elastase, anti-CD68, anti-CD88, anti-CD3, and anti-ZnCP-1 antibodies. Massive infiltrations of inflammatory cells with mast cell degranulation within the myometrium secondary to complement activation were observed in PPH of unknown etiology (n=34), but not in control pregnant women (n=15) or after delivery women without PPH (n=18). The concomitant immunohistochemical detection of meconium in myometrium suggests that amniotic fluids or fetal materials are one of the candidates to induce maternal local immune activation in the PPH of unknown etiology. Postpartum acute myometritis in the absence of an infective etiology may be a histological characteristic of PPH of unknown etiology.
DOI10.1016/j.jri.2015.04.004
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