Archives of Gynecology and Obstetrics

, Volume 272, Issue 2, pp 95–108

An update in recurrent spontaneous abortion

  • Manoj Kumar Pandey
  • Reena Rani
  • Suraksha Agrawal
Review

DOI: 10.1007/s00404-004-0706-y

Cite this article as:
Pandey, M.K., Rani, R. & Agrawal, S. Arch Gynecol Obstet (2005) 272: 95. doi:10.1007/s00404-004-0706-y

Abstract

Recurrent spontaneous abortion (RSA) is defined as three or more consecutive pregnancy losses prior to the 20th week of gestation. The etiology of recurrent spontaneous abortion is often unclear and may be multifactorial, with much controversy regarding diagnosis and treatment. Reasonably accepted etiologic causes include, genetics, anatomical, endocrine, placental anomalies, hormonal problems, infection, smoking and alcohol consumption, exposure to environmental factors, psychological trauma and stressful life event, certain coagulation and immunoregulatory protein defects. Detection of an abnormality in any of these areas may result into specific therapeutic measures, with varying degrees of success. However, the majority of cases of RSA remains unexplained and is found to be associated with certain autoimmune (APA, ANA, ACA, ATA, AECA) and alloimmune (APCA, Ab2, MLR-Bf) antibodies that may play major role in the immunologic failure of pregnancy and may lead to abortion. Alteration in the expression of HLA-G molecules, T-helper-1 (Th-1) pattern of cytokines and natural killer (NK) cells activity may also induce abortion. Various forms of treatment like antithrombotic therapies such as aspirin and heparin, intravenous immunoglobulin (IVIg) therapy, immunotherapy with paternal lymphocytes and vitamin D3 therapy are effective mode of treatment for unexplained cause of fetal loss in women with RSA.

Keywords

RSA (Recurrent spontaneous abortion) Lymphocyte immunotherapy Immunoglobulin (IVIg) therapy Aspirin/Heparin therapy 1α 25 -dihydroxy-vitamin-D3 (VD3) therapy APA (anti-phospho lipid antibody) ANA (anti-nuclear antibody) ACA (anti-cardiolipin antibody) ATA (anti-thyroidantibody) AECA (anti-endothelial cell antibody) APCA (anti-paternal cytotoxic antibody) Ab2 (anti-idiotypic antibody) MLR-Bf (mixed lymphocyte reaction blocking antibodies) Natural Killer (NK) cells HLA-G T-helper −1(TH-1) and T-helper −2(TH-2) cytokines 

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Manoj Kumar Pandey
    • 1
  • Reena Rani
    • 2
  • Suraksha Agrawal
    • 3
  1. 1.Division of Molecular ImmunologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  2. 2.Department of BiologyUniversity of TexasSan AntonioUSA
  3. 3.Department of Medical GeneticsSGPGIMSLucknowIndia

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