A favorable outcome of pregnancies in women with primary and secondary recurrent pregnancy loss associated with antiphospholipid syndrome

Diejomaoh, Michael; Al-Azemi, Majedah; Bandar, A.; Egbase, P.E.; Jirous, J; Al-Othman, S.; Bukhadour, N.; Al‐Sweih, Noura

doi:10.1007/s004040100179

Cited by 21 publications

(16 citation statements)

References 17 publications

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“…[21] The fetal outcome of pregnancy in patients with recurrent pregnancy loss associated with APS was virtually identical and quite satisfactory. [22] In some cases, the women with recurrent pregnancy loss did not have positive aCL. The absence of aCL and aPS in patients with recurrent abortion is comparable.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of anticardiolipin antibodies and antiphosphatidylserine antibodies in women with recurrent abortion

Velayuthaprabhu

Archunan

2005

Indian J Med Sci

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BACKGROUND: Antiphospholipid syndrome (APS) is a major reproductive complication in women, which is characterized by recurrent fetal loss, thrombosis, and thrombocytopenia in association with anticardiolipin antibodies (aCL). AIMS: To analyze the prevalence of aCL and antiphosphatidylserine antibodies (aPS) in relation to pregnancy failures in women with the history of recurrent spontaneous abortion. SETTINGS AND DESIGN: A sequential study of 155 patients, who had three or more recurrent spontaneous abortions, was carried out. METHODS AND MATERIALS: Women with unexplained recurrent pregnancy loss in first trimester were selected for this study. Anticardiolipin antibodies IgG and aPS IgG were detected in the serum by the enzyme linked immunosorbent assay method. STATISTICAL ANALYSIS: Percentage calculation was carried out. Two-tailed t-test was performed to know the significance of aCL and aPS total population. RESULT: The levels of aCL IgG and aPS IgG were detected as 40% (62) and 19% (18), respectively in women with history of recurrent abortion. CONCLUSION: Anticardiolipin antibody is found to be the most important factor for recurrent abortion. In addition, women with negative aCL are having positive for another antiphospholipid antibodies like aPS, which may involve in recurrent abortion.

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Section: Discussionmentioning

confidence: 98%

Evaluation of anticardiolipin antibodies and antiphosphatidylserine antibodies in women with recurrent abortion

Velayuthaprabhu

Archunan

2005

Indian J Med Sci

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“…This may serve as a diagnostic tool as part of the routine workup for women with idiopathic RSA, and also has therapeutic implications, evidenced by the utility of combining intravenous immunoglobulin in the standard therapy regimen, which allegedly resulted in excellent fetal and maternal outcome (Branch et al 2000), in particular in cases of APS (Diejomaoh et al 2002). However, the definitive utility of this treatment modality awaits the outcome of international randomized trials, which are currently in progress.…”

Section: Discussionmentioning

confidence: 99%

A case-control study on the association of idiopathic recurrent pregnancy loss with autoantibodies against β2-glycoprotein I and annexin V

Zammiti

Mtiraoui²,

Kallel³

et al. 2006

Reproduction

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Whereas antiphospholipid antibodies (aPL) are associated with thrombotic events and recurrent spontaneous abortion (RSA), the contribution of anti-b2 glycoprotein 1 (b2GP1) and anti-annexin V antibodies as risk factors for RSA remain poorly understood. We investigated anti-b2-GPI and anti-annexin V IgM and IgG antibodies as potential risk factors for RSA in 200 women with more than three consecutive idiopathic RSA, and 200 age-matched, healthy, parous women. Pearson's chi squared test analysis showed that while anti-b2-GPI IgG (P 5 0.416) and IgM (P 5 0.72) were comparable between patients and controls, elevated anti-annexin V IgG (P 5 0.006), but not IgM (P 5 0.084), was more pronounced in patients. Higher frequencies of elevated IgG-only (P 5 0.005), but not IgM-only (P 5 1.000; OR 5 6.66), anti-annexin V antibodies were noted among patients. Multinomial regression analysis showed that body-mass index (overweight and obesity; P 5 0.008), education status (P < 0.001) and anti-b2-GPI IgM (P 5 0.033), but not IgG (P 5 0.723), were associated with early abortion, while anti-b2-GPI IgG (P 5 0.030) and anti-annexin V IgG (P 5 0.004) were associated with late RSA. For combined early-late RSA, the only variable selected was education status (P < 0.001), and neither anti-annexin V nor anti-b2-GPI IgM and IgG was associated with early-late RSA. Accordingly, anti-annexin V and anti-b2-GPI should be regarded as independent risk markers of RSA.

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“…There were limitations in both meta-analyses [113,114]; these arise from the design and quality of the studies and the small number of patients in the trials included in the second meta-analysis [114]. The live birth rate of 82% reported in a Kuwait study [115] in which patients with RSM and APS were treated with LDA, unfractionated heparin or low-molecular-weight heparin (LMWH) is comparable to the above result of 74 and 79% reported in the AOCG Practice Bulletin [116] where LMWH was combined with LDA. Two smaller studies [117,118] have not reported any significant differences in pregnancy outcome with the combination therapy using unfractionated heparin and LDA and LMWH and LDA in patients with RSM associated with APS.…”

Section: Treatment Of Rsmmentioning

confidence: 99%

Recurrent Spontaneous Miscarriage Is Still a Challenging Diagnostic and Therapeutic Quagmire

Diejomaoh¹

2014

Med Princ Pract

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Recurrent spontaneous miscarriage (RSM), affecting 1-2% of women of reproductive age seeking pregnancy, has been a clinical quagmire and a formidable challenge for the treating physician. There are many areas of controversy in the definition, aetiology, investigations and treatment of RSM. This review will address the many factors involved in the aetiology of RSM which is multifactorial in many patients, with antiphospholipid syndrome (APS) being the most recognized aetiological factor. There is no identifiable cause in about 40-60% of these patients, in which case the condition is classified as idiopathic or unexplained RSM. The RSM investigations are extensive and should be undertaken in dedicated, specialized, well-equipped clinics/centres where services are provided by trained specialists. The challenges faced by the treating physician are even more overwhelming regarding the decision of what should be the most appropriate therapy offered to patients with RSM. Our review will cover the diverse modalities of therapy available including the role of preimplantation genetic testing using recent microarray technology, such as single nucleotide polymorphism and comparative genomic hybridization, as well as preimplantation genetic diagnosis; the greatest emphasis will be on the treatment of APS, and there will be important comments on the management of patients presenting with idiopathic RSM. The controversial areas of the role of natural killer cells in RSM, the varied modalities in the management of idiopathic RSM and the need for better-planned studies will be covered as well.

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A favorable outcome of pregnancies in women with primary and secondary recurrent pregnancy loss associated with antiphospholipid syndrome

Cited by 21 publications

References 17 publications

Evaluation of anticardiolipin antibodies and antiphosphatidylserine antibodies in women with recurrent abortion

Evaluation of anticardiolipin antibodies and antiphosphatidylserine antibodies in women with recurrent abortion

A case-control study on the association of idiopathic recurrent pregnancy loss with autoantibodies against β2-glycoprotein I and annexin V

Recurrent Spontaneous Miscarriage Is Still a Challenging Diagnostic and Therapeutic Quagmire

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