title: [Intravenous immunoglobulin treatment of recurrent spontaneous abortion with immunopathological background].
abstract: BACKGROUND
  Recurrent spontaneous abortion (RSA) is diagnosed if three or more spontaneous abortions follow each other typically in the first trimester. The root cause of miscarriages often can not be found. A significant proportion of this unexplained RSA cases may be caused by immunopathological failure.
  
  
  OBJECTIVE
  A multicentric clinical study started in 2000 to introduce an immunological screening protocol for patients suffering in idiopathic habitual abortion, and to use immunotherapy for their treatment if immunological background was defined.
  
  
  METHODS
  The general checkup of the patients was managed based upon a detailed protocol, with which non-immunopathological reasons for RSA were excluded. The unexplained RSA cases underwent an immunological checkup including cellular and humoral immunological, immunogenetic and autoimmune examinations. Based upon these parameters, the immunopathological background of RSA was certified or excluded. In the confirmed immunopathological cases intravenous immunoglobulin (IVIG) therapy was applied during their next pregnancy, with continuous monitoring of the immunological parameters.
  
  
  RESULTS
  120 patients with RSA were examined, and 32 of them got IVIG therapy during their next pregnancy. In 72% of cases (23/32) IVIG treatment for RSA with immunopathological alloimmune background was successful, with the outcome of healthy newborn. Of the 9 unsuccessful cases, in 6 patients subsequently additional non-immunopathological reasons were diagnosed for their RSA. IVIG treatment of patients with clear alloimmune background was successful in 88.5% (23/26).
  
  
  CONCLUSIONS
  Results show that immunopathological checkup and immunotherapy is a useful treatment in the modern medicine for the patients with unexplained RSA. However the success of this method depends on the adherence of the checkup protocol, because unsuccessful therapy of non-clear cases can reduce the efficiency.
authors.affiliation: Országos Gyógyintézeti Központ, Szülészeti es Nogyógyászati Osztály, Budapest.
authors.forename: József
authors.initials: J
authors.lastname: Bátorfi
authors.forename: Beatrix
authors.initials: B
authors.lastname: Kotlán
authors.forename: Agnes
authors.initials: A
authors.lastname: Padányi
authors.forename: Mariann
authors.initials: M
authors.lastname: Réti
authors.forename: Eva
authors.initials: E
authors.lastname: Gyódi
authors.forename: Katalin
authors.initials: K
authors.lastname: Rajczy
authors.forename: Katalin
authors.initials: K
authors.lastname: Miklós
authors.forename: Julianna
authors.initials: J
authors.lastname: Németh
authors.forename: Ferenc
authors.initials: F
authors.lastname: Melicher
authors.forename: István
authors.initials: I
authors.lastname: Vályi-Nagy
authors.forename: Gyozo
authors.initials: G
authors.lastname: Petrányi
authors.forename: Vilmos
authors.initials: V
authors.lastname: Fülöp
mesh_terms: D000026:Abortion, Habitual / Q000188:drug therapy* / Q000276:immunology* / Q000473:pathology; D000328:Adult; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous