The results of investigations for blocking antibody and autoantibodies help to choose between different immunological treatments for recurrent abortion.
Immunologic investigations were performed on 337 healthy women with unexplained habitual abortion. Their sera were investigated for antinuclear antibodies (ANA), antibodies against DNA, and anti-cardiolipin antibodies, and the activated partial thromboplastin time (APTT) and complement levels of their plasma were determined. Cellular reactivity and blocking antibody were studied in one-way mixed lymphocyte culture (MLC). None of the women had any signs of autoimmune disease. However, in 77 of the 337 women (22%) increased anti-cardiolipin antibody levels were found, in 19 (7%) above 10 units. Most patients with high anti-cardiolipin antibody levels had lowered values of complement factor C4. We consider the mere occurrence of anti-cardiolipin antibody in women with habitual abortion to be no absolute cause for treatment with prednisolone, and this is true even in cases with very elevated anti-cardiolipin values. Treatment with prednisolone and acetylsalicylic acid (ASA) during pregnancy should be given to only those women who have high levels of anti-cardiolipin antibodies concomitant with high APTT values, and low values of complement C4. Anti-cardiolipin antibody was also investigated during pregnancy in 136 normal pregnant women. Eleven of them (8%) were positive at any of four sampling occasions, but only one (1%) had high levels. These data differ significantly from those of the habitual aborters. Thus the development of anti-cardiolipin antibody is no normal feature of pregnancy in Swedish women and so the high frequency found among healthy Swedish women with habitual abortion remains unexplained. We have introduced an immunization programme of third party leukocyte transfusions in habitual abortion.(ABSTRACT TRUNCATED AT 250 WORDS)
Unander
A M
AM
Department of Obstetrics and Gynecology, Sahlgren Hospital, Göteborg, Sweden.
Norberg
R
R
Wenneström
H
H
Siösteen
C
C
Lindholm
A
A
Stigendal
L
L
Haeger
M
M
Arfors
L
L
D000026:Abortion, Habitual / Q000276:immunology / Q000628:therapy*; D000906:Antibodies / Q000032:analysis*; D000974:Antibodies, Antinuclear / Q000032:analysis; D001241:Aspirin / Q000627:therapeutic use; D001323:Autoantibodies / Q000032:analysis*; D002308:Cardiolipins / Q000276:immunology*; D003181:Complement C4 / Q000032:analysis; D005260:Female; D006801:Humans; D007959:Lymphocyte Culture Test, Mixed; D010314:Partial Thromboplastin Time; D011239:Prednisolone / Q000627:therapeutic use; D011247:Pregnancy
D000906:Antibodies; D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D002308:Cardiolipins; D003181:Complement C4; D011239:Prednisolone; D001241:Aspirin