Study on the mechanism of placental abruption from the viewpoint of uterine microbiota

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K09653
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56040:Obstetrics and gynecology-related
• Research Institution: Showa University
• Principal Investigator: Sekizawa Akihiko 昭和大学, 医学部, 教授 (10245839)
• Co-Investigator(Kenkyū-buntansha): 四元 淳子 昭和大学, 医学部, 特別研究生 (30553648) ; 小出 馨子 昭和大学, 医学部, 講師 (90384437)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 常位胎盤早期剥離 / 妊娠高血圧症候群 / 慢性子宮内感染 / 子宮内フローラ

Outline of Final Research Achievements

Although the incidence of placental abruption is known to be higher in pregnant women with hypertensive disorder of pregnancy and congenital coagulation disorders, the pathogenesis of this condition is unknown. We hypothesized that chronic intrauterine infection may contribute to the pathogenesis of placental abruption, focusing on epidemiological data showing a high rate of recurrence. Immediately after delivery of the placenta during cesarean section, we abraded the maternal surface to collect cells and analyzed the bacterial flora using a next-generation sequencer. No bacteria were detected in 10 normal elective cesarean sections collected as controls. Furthermore, no bacteria were detected in three cases of placental abruption. Thus, the hypothesis that chronic intrauterine infection is involved in the pathogenesis of early abruption could not be proven.

Free Research Field

周産期医学

Academic Significance and Societal Importance of the Research Achievements

妊娠中の児娩出前に胎盤が剥離する常位胎盤早期剥離（早剥）は、出生児の脳性麻痺の原因として最多であるばかりか、早剥に子宮内胎児死亡を併発した病態では、分娩時に血管内凝固症候群（DIC）となることで大量出血の原因にもなり、ときに妊産婦死亡の原因にもなる重篤な疾患である。しかし、妊娠高血圧症候群や先天性の凝固障害のある妊婦に発症率が高いことが知られているものの、その原因となる病態は不明であり、その病態解明は早剥の発症予防を可能にするものであり、周産期医療の安全性向上に重要な課題である。