6533b832fe1ef96bd129a4d0

RESEARCH PRODUCT

Short-term therapy for recurrent abortion using intravenous immunoglobulins: Results of a double-blind placebo-controlled Italian study

A VassiliadisAugusto E. SempriniNicola ColacurciA. VucetichGuido MenatoM. CignittiAntonio Perino

subject

AdultAbortion Habitualmedicine.medical_specialtyAnti-nuclear antibodyAbortionPlacebolaw.inventionDouble-Blind MethodRandomized controlled trialPregnancylawAntiphospholipid syndromemedicineHumansLupus anticoagulantPregnancyObstetricsbusiness.industryRehabilitationPregnancy OutcomeImmunoglobulins IntravenousObstetrics and Gynecologymedicine.diseaseSurgeryItalyReproductive MedicineGestationFemalebusiness

description

It is still unclear whether i.v. immunoglobulins (Ig) can facilitate the reproductive prognosis of women who have suffered recurrent pregnancy loss. We report the results of a multicentre placebo-controlled study on the effect of Ig administration on pregnancy outcome in 46 women who had suffered at least three recurrent miscarriages. All were screened to exclude chromosomal or Müllerian abnormalities, the presence of antinuclear antibodies, lupus anticoagulant (LA) or elevated titres of anticardiolipin antibodies which may have revealed an underlying autoimmune problem. To avoid a selection bias towards ongoing pregnancies, i.v. Ig or placebo were administered between weeks 5 and 7 of gestation for 2 consecutive days as soon as each woman knew she was pregnant and before embryonic heart activity could be detected. A further infusion was administered at week 8 when ultrasonography confirmed an ongoing embryonic development. In all, 68% of the women who received Ig went to term versus 79% of those who received a placebo (not significant), with no significant differences in the pregnancy course or the perinatal outcome. These results suggest either that women with recurrent miscarriages who have no recognized cause of pregnancy loss have a good reproductive prognosis without any treatment or that the emotional care associated with the administration of a placebo can indirectly facilitate the progression of pregnancy.

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