Using MRI to detect if the placenta is being rejected by the immune system

If a woman has a rare condition called chronic histiocytic intervillositis, her immune system rejects the placenta, potentially leading to stillbirth. Our researchers are studying whether MRI scans could be used to diagnose this condition early, so that doctors can intervene to reduce the risk of babies being stillborn.
  • Author's list

    Dr Emma Ingram, Professor Ed Johnstone, Professor Alexander Heazell

    Start date: March 2015
    End date: March 2022

  • Research centre

  • Research status

    Ongoing projects

Why do we need this research?

If a baby’s growth in the womb slows or stops, the chance of stillbirth increases 8-fold. Slow growth, known as fetal growth restriction, is often caused by the placenta not working properly.

One cause of an unhealthy placenta is a rare condition called chronic histiocytic intervillositis (CHI). This is when the immune system rejects the placenta as if it was an ‘alien’ object in the body. CHI can increase the risk of stillbirth and is also a cause of recurrent miscarriage. However, there is currently no way to diagnose CHI during pregnancy; it can only be detected after birth.

What’s happening in this project?

Our scientists have developed an exciting new way of looking at the placenta while the baby is growing. They have been using Magnetic Resonance Imaging or MRI – a technique that uses a strong magnetic field to look inside the body – which gives far more detail about how the placenta is working than they would get by looking at an ultrasound scan.

Previously, while using MRI to study a group of women experiencing fetal growth restriction, the team noticed that one mother’s placenta looked different to the others. The mother was later diagnosed with CHI, which led the research team to speculate that it might be possible to use MRI to diagnose CHI during pregnancy.

The researchers are now working to confirm this chance finding. They will conduct a small study of 20 pregnant women with a history of CHI, including some women whose babies are growing normally and other women whose babies are smaller than expected. The team will look at these women’s placentas during pregnancy using MRI. They will then examine the placentas after birth to confirm if the mother had CHI and if this was picked up by the MRI scan.

What difference will this project make?

This research will provide the evidence needed for a larger clinical trial investigating whether MRI can detect problems with the placenta. If the team’s chance finding can be confirmed, it could lead to new ways to diagnose CHI and other placental problems much earlier than is currently possible. This could mean that women are able to receive a more appropriate treatment, and ultimately reduce the risk of their babies being stillborn.