Monitoring fetal immune development in human pregnancies: current concepts and future goals

• Association between fetal stress, immune development and autoimmune disease.
• Monitoring of fetal immune organ development possible using ultrasound.
• Prenatal ultrasound of thymus promising method to monitor fetal immune development.
• Need for prospective studies to measure impact of fetal stress on the immune system.

The vast majority of the current knowledge on immune development in the fetal period has been gained from animal studies, particularly from mouse models. This has led to a great improvement in our current understanding of immune ontogeny. However, it has also become clear that in many ways the mouse model of pregnancy differs from the situation in human pregnancy, such as the degree and importance of trophoblast invasion, the kind of MHC class repertoire of the extravillous trophoblast cells, and differences concerning the development and regulation of T-cells. It will be of paramount importance to develop non-invasive screening methods to assess fetal immune development in humans. The focus of this mini-review is to discuss how prenatal ultrasound evaluation can be used as a tool to monitor fetal immune development in human pregnancies. To identify the fetuses at risk of immune disorders could be the first step to developing prevention strategies in the future.