Maternal autoimmune disease and the fetus.

The privileged position of the fetus, containing foreign protein that is not rejected by its mother, has intrigued biologists for many years. More recently, it has been realised that certain maternal autoimmune diseases, particularly immune thrombocytopenia, Graves' disease, pemphigoid gestationis (herpes gestationis), myasthenia gravis, and systemic lupus erythematosus may affect the fetus by immune mechanisms, and, in particular, that the degree of fetal involvement may be out of proportion to the extent of maternal illness. Rhesus isoimmunisation has been specifically excluded from the following discussion sinee, although the fetus is affected by maternal antibody, this antibody is not related to maternal autoimmune disaese.