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PubMedDate not supplied

Immunotherapy of habitual abortion.

Many cases of habitual abortion have been assumed to be due to hyporesponsiveness to the spouse's antigens encountered in pregnancy. Immunization by paternal leukocytes has been used to potentiate the immune response and prevent further miscarriages. This treatment has been highly controversial in terms of efficacy, mode of action, and side effects. More recently immunoglobulin has been used as passive immunization for similar indications. In our experience immunotherapy is effective; 80% of patients have subsequent live births. The most significant results are seen in patients with five or more abortions, in whom 66% of subsequent pregnancies develop normally compared to 20% in a control group. We have used antipaternal complement-dependent antibody (APCA) production after immunization as a marker of immune response. APCA correlates with beneficial outcome in the next pregnancy. APCA may also be associated with cytokines, which may enhance embryonic and trophoblast development. Immunoglobulin may similarly provide the relevant antibodies or cytokines. At present a large scale meta-analysis is being performed to confirm or refute the efficacy of this treatment. This meta-analysis may resolve the controversy.

Abortion, Habitual↗
PubMed2002

[Expression of leukemia inhibitory factor gene in decidua from women with habitual abortion].

To evaluate the relationship between habitual abortion of unknown etiology and expression of leukemia inhibitory factor (LIF) gene in the decidua,the expression of LIF gene in the decidua were detected in 32 cases of habitual abortion of unknown etiology (abortion group) and 36 cases of normal pregnancy (control group) by reverse transcription-polymerase chain reaction (RT-PCR). The results showed that the level of LIF mRNA expression of the decidua in abortion group was 0.512+/-0.219, significantly lower than those in the control group (1.314+/-0.457, P<0.01). The findings indicated that the low expression of LIF gene in abortion group might be one of the causes of habitual abortion. Analysis on the LIF gene expression of decidua can be used as a index for diagnosis of the habitual abortion.

English Abstract↗
PubMed1990

Immunization by paternal leukocytes for prevention of primary habitual abortion: results of a matched controlled trial.

Habitual abortion is a difficult clinical problem, as no cause can be found for abortion in over 50% of patients. At the habitual abortion clinic of the Sheba Medical Center, immunological activity is tested and patients who are considered suitable are offered immunopotentiation with paternal leukocytes. Patients are only treated if they have no other cause for habitual abortion, no lupus anticoagulant and no antipaternal complement-dependent antibodies (APCA). Immunization is thought to potentiate the maternal immune response to paternal antigens encountered on the trophoblast. The production of APCA antibody indicates that an immune response has occurred. Of the 156 patients so far immunized, 109 have developed these antibodies. To date, 79 of these 156 patients have become pregnant. Sixty-seven patients (with 3-12 miscarriages each) belong to the antibody-positive group. Sixty-four of the 89 subsequent pregnancies have been carried past their previous dates of abortion. Forty-seven live births have occurred. By contrast, 12 patients have been pregnant in the antibody-negative group, of the 16 subsequent pregnancies only 6 were successful. A control group is available for comparison. This consists of patients suitable for immunization, but not immunized. Of these patients, only 11 of 30 pregnancies have been carried to term.

Abortion, Habitual↗
PubMed1964

[TREATMENT OF THREATENED AND HABITUAL ABORTION WITH MEDROXYPROGESTERONE].

A clinical study was made of an oral form of medroxyprogesterone in a group of pregnant patients with signs of a threatened abortion or with a history of habitual abortions, under conditions very similar to those obtaining in general practice. The aim was to assess the agent's effectiveness, its harmlessness, and its effect on the pregnancy in respect of both the mother and the infant.During a 31-month period, 43 pregnant women were administered this drug. The overall result in terms of live and healthy babies was 70%. This result was somewhat lower than that expected on the basis of previous studies; both public and private patients were included and no selection of patients was attempted. There were no apparent harmful side effects to mother or infant or evidence of virilization of female infants; postmaturity was not a problem.

Abortion, Habitual↗
PubMedDate not supplied

Superovulation of habitual aborters with subtle luteal phase deficiency.

Five habitual aborters without a known organic cause of their pregnancy losses were studied in detail by serial blood sampling for immunoreactive estrogen, progesterone, follicle-stimulating hormone, luteinizing hormone, and the ratio of the two. All patients had premenstrual spotting regularly. Luteal phase progesterone levels on the 6th postovulatory day were significantly lower (11.8 +/- 1.2 ng/mL, mean +/- SEM) than in control patients (20.8 +/- 3.5 ng/mL, mean +/- SEM). Results of immunoreactive estrogen, FSH, and LH assays and the FSH/LH ratio did not reveal a discernible pattern of deviation from normal. Indirect immunofluorescence of blood samples from all habitual aborters showed evidence of autoimmunity in three of five patients without clinical symptoms of autoimmune disease. Treatment by superovulation produced at least one living child in each couple. The balance of pregnancy outcome changed from 100% abortion (N = 31) before treatment to 31% (N = 13) after treatment. These results suggest that treatment with superovulation may be the treatment of choice for habitual aborters with a subtle luteal phase deficiency.

Abortion, Habitual↗
PubMed1982

Easily suppressed lymphocytes and absence of cytotoxic antibody in three women with habitual abortion.

This investigation involves 3 women with habitual abortion and 2 women with multiple normal pregnancies. Extensive clinical investigations failed to reveal any cause for the abortions. All husbands were ABO-compatible with their respective wives. The women shared three, two, and zero of five identified HLA-A antigens with their respective husbands. None of the women had any cytotoxic antibody. Lymphocytes from all three women reacted normally in one-way mixed lymphocyte cultures to their husbands' alloantigens. Cell-mediated lympholysis was similar in couples with habitual abortion and in those with repeated normal pregnancies. The women's lymphocytes' proliferation was significantly suppressed by lymphocytes from their husbands and by those from most male controls in two-way mixed lymphocyte culture and double chamber experiments. Two women with 6 and 5 live-born children, respectively, served as controls. Their lymphocytes were not suppressed by lymphocytes from their respective husbands or by those from most male controls in two-way mixed lymphocyte cultures. Their reactions in one-way mixed lymphocyte cultures and in cell-mediated lympholysis, however, did not differ from those of the women with habitual abortion.

Abortion, Habitual↗
PubMed1988

[Immunologic aspects of habitual abortion and intrauterine fetal death].

Habitual abortions and intrauterine death represent diagnostic and therapeutic problems in spite of application of near all diagnostic possibilities. The appearance of autoantibodies to nuclear and extractable nuclear antigens as well as occurrence of phospholipid-antibodies may be associated with negative course of pregnancy. Furthermore problems of autoantibodies to DNA, the role of HLA-system trophoblast antigens and other reasons will be explained. Treatment facilities are referred, too.

Abortion, Habitual↗