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Antiphospholipid syndrome and other autoimmune diseases associated with chronic intervillositis

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objectives

Chronic intervillositis of unknown etiology (CIUE) is characterized by an intervillous infiltrate of mononuclear cells and a high recurrence rate of adverse obstetrical outcomes. The aim was to describe obstetrical history in patients with at least one event characterized by CIUE, and the possible impact of systematic investigation of an underlying autoimmune disease on the obstetrical outcome of subsequent pregnancies.

Methods

We retrospectively reviewed all pregnancies in patients having experienced at least one adverse obstetric outcome associated with chronic intervillositis of unknown etiology diagnosed by placental histological analysis between 2004 and 2011 in our university hospital. For each patient, data pertaining to obstetrical history, treatments during pregnancies, the results of systematic investigation of an underlying autoimmune disease, and treatments as well as obstetrical outcome in subsequent pregnancies, were collected.

Results

Twelve patients with 38 pregnancies were included [median age 30 (22; 40 years)]. Autoimmune disease or autoimmune antibodies (AID group) were found in 7/12 patients: primary antiphospholipid syndrome (APS) (n = 4), Sjögren’s syndrome (n = 1), pernicious anemia (n = 1) and celiac disease (n = 1). When comparing pregnancies of patients with and without AID, there was no difference with regard to the type of obstetrical events or live-born babies, in spite of appropriate treatment. Corticosteroids (prednisone 10 mg/day) were used in only 2 cases with AID (Sjögren’s syndrome and APS; n = 1 each), and these 2 pregnancies resulted in live-born babies.

Conclusion

This study shows that the immunological assessment in patients with CIUE raises the possibility of a specific severity when AID or obstetrical APS is associated with CIUE, since conventional treatment did not improve obstetrical outcome in these patients as compared to those without autoimmune diseases. The benefit of immunosuppressant agents in this subset of patients needs further evaluation.

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Acknowledgments

We thank Pierre Pothier for English review of the manuscript.

Conflict of interest

None.

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Authors and Affiliations

  1. Service de gynécologie-obstétrique, Université Paris 13, Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris, Hôpital Jean Verdier, 93140, Bondy, France

    Aurélie Revaux & Lionel Carbillon

  2. Service de médecine interne, Université Paris 13, Assistance Publique-Hôpitaux de Paris, Hôpital Jean Verdier, 93140, Bondy, France

    Arsène Mekinian & Olivier Fain

  3. Unité Fonctionnelle d’Immunologie « Auto-immunité et Hypersensibilités », Université Paris 7, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Paris, France

    Pascale Nicaise & Sylvie Chollet-Martin

  4. Laboratoire d’Anatomopathologie, Université Paris 13, Assistance Publique-Hôpitaux de Paris, Hôpital Jean Verdier, 93140, Bondy, France

    Martine Bucourt & Françoise Cornelis

  5. Service de néonatologie et pédiatrie, Université Paris 13, Assistance Publique-Hôpitaux de Paris, Hôpital Jean Verdier, 93140, Bondy, France

    Eric Lachassinne

  6. Université Paris 13, Sorbonne Paris Cité, AP-HP, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Bondy, France

    Lionel Carbillon

Authors
  1. Aurélie Revaux
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  2. Arsène Mekinian
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  3. Pascale Nicaise
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  4. Martine Bucourt
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  5. Françoise Cornelis
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  6. Eric Lachassinne
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  7. Sylvie Chollet-Martin
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  8. Olivier Fain
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  9. Lionel Carbillon
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Corresponding author

Correspondence to Lionel Carbillon.

Additional information

A. Revaux and A. Mekinian contributed equally to this work.

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Revaux, A., Mekinian, A., Nicaise, P. et al. Antiphospholipid syndrome and other autoimmune diseases associated with chronic intervillositis. Arch Gynecol Obstet 291, 1229–1236 (2015). https://doi.org/10.1007/s00404-014-3536-6

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  • DOI: https://doi.org/10.1007/s00404-014-3536-6

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