Habitual abortions in 678 healthy patients: investigation and prevention

Abstract

The objective of this study of patients with habitual abortion (HA), was to determine their autoimmune profile and to try to prevent new abortions using low-dose aspirin for 7 months with prednisone in the first trimester only, or with low-dose aspirin alone. A total of 678 healthy patients with three or more HA were investigated for antiphospholipid antibodies, antinuclear and antithyroid antibodies. Among these patients, 277 pregnant women were treated, 214 were given prednisone and aspirin (161 autoantibody-negative and 53 autoantibody-positive women), and 63 autoantibody-negative women received aspirin alone. Autoantibodies were present in 33.9% of the patients, in 82.6% of them anticardiolipin antibodies were found to be isolated or associated with antiprothrombin, antithyroid, circulating anticoagulant, antinuclear or anti-beta2 glycoprotein 1 antibodies. In autoantibody-negative pregnant women treated by prednisone and aspirin or aspirin alone, the success rate of live births was 90.7% (146 out of 161) and 74.6% (47 out of 63) respectively (P < 0.01). In autoantibody-positive patients treated with prednisone and aspirin the success rate was 84.9% (45 out of 53) (not significant). Prednisone and aspirin seemed to be as efficient in autoantibody-negative or positive women but better than aspirin alone in autoantibody-negative women. A double-blind trial is in progress to confirm these results.

Factor V Leiden and G20210A prothrombin mutations are risk factors for very early recurrent miscarriage

“…Pregnancies were embryonic, blighted ovum or biochemically identified. Women were normal as described previously 1 1 were measured by ELISA tests. Women with levels higher than 25uGPL or MPL, antib2GP1 above 5uGP at two distant samples were excluded.…”

“…A high percentage of early recurrent miscarriage before 10 weeks of pregnancy remains unexplained, and specific prevention cannot be adequately recommended 1 . During normal pregnancy the concentration of proteins involved in the protein C pathway and fibrinolytic system change in a way that promotes coagulation and inhibits fibrinolysis.…”

Thyroid autoimmunity and miscarriage

“…These syndromes carry a miscarriage rate of 7-8 and 22 % respectively but, unlike thyroid antibodies, these syndromes also carry a higher risk for fetal death after the first trimester. Indeed, antithyroid antibodies are sometimes present together with anticardiolipin antibodies (27). However, in the above-mentioned studies women with other than thyroid antibodies were excluded or were analyzed separately (8, 10, 13, 16, 19, 21, 23, 24) and it appears that the observed association is not due to the co-presence of any of these antibodies.…”

Therapeutic effects of Wharton jelly‐derived mesenchymal stem cells on rat abortion models

“…This was shown by the evidence that a combination of prednisone and low-dose aspirin was significantly helpful in 214 women with RPL compared with 63 women with RPL receiving aspirin alone. 5 The current treatment for RPL mainly includes active immunotherapy (whole blood infusion, lymphocyte immunotherapy, 6 and seminal plasma immune), immunosuppressive therapy and Chinese medicine. However, active immunization might cause allergies, enter an existing source of infection (such as hepatitis, syphilis, HIV, etc.)…”