Increased plasma adrenomedullin in women with recurrent pregnancy loss.
OBJECTIVE
To evaluate vascular changes and uterine perfusion in women with recurrent pregnancy loss.


METHODS
We measured plasma levels of adrenomedullin of 100 pregnant women in the midluteal phase of a nonpregnant cycle (control group: n = 62; recurrent pregnancy loss group: n = 38). We measured the pulsatility index (PI) in the uterine arteries by transvaginal pulsed Doppler ultrasonography at the same time.


RESULTS
The plasma level of adrenomedullin in women with recurrent pregnancy loss (5.6 +/- 1.9, mean +/- standard deviation) was significantly higher (P >.001) than that in control women (3.6 +/- 1.7). Uterine arterial PI of women with recurrent pregnancy loss (2.70 +/- 0.47) was significantly higher (P >.001) than that in control women (2.09 +/- 0.39). Plasma level of adrenomedullin had a significant positive correlation with uterine arterial PI both in the control group (r =.58, P <.001) and in the recurrent pregnancy loss group (r =.78, P <.001). Both plasma adrenomedullin concentration (7.2 +/- 2.3) and uterine arterial PI (3.06 +/- 0.36) were significantly high in women with antiphospholipid antibodies.


CONCLUSIONS
Plasma adrenomedullin may serve as a useful biochemical marker for recurrent pregnancy loss caused by impaired uterine perfusion.
Nakatsuka
Mikiya
M
Department of Obstetrics and Gynecology, Okayama University Medical School, Okayama, Japan. mikiya@cc.okayama-u.ac.jp
Habara
Toshihiro
T
Noguchi
Soichi
S
Konishi
Hideki
H
Kudo
Takafumi
T
D000026:Abortion, Habitual / Q000097:blood* / Q000503:physiopathology; D053607:Adrenomedullin; D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000032:analysis; D004717:Endometrium / Q000473:pathology; D005260:Female; D006801:Humans; D008183:Luteal Phase / Q000502:physiology; D010455:Peptides / Q000097:blood*; D011446:Prospective Studies; D018617:Ultrasonography, Doppler, Pulsed; D014599:Uterus / Q000098:blood supply
D017152:Antibodies, Antiphospholipid; D010455:Peptides; D053607:Adrenomedullin