title: Successful pregnancy in a patient suffering from recurrent mid-trimester miscarriage with C9 deficiency after receiving cervical cerclage followed by clindamycin and progesterone: a case report.
abstract: Complement component 9 (C9) deficiency is relatively common, especially in Japan. Here we present the case of a 27-year-old Japanese woman whose obstetric history involved three mid-trimester miscarriages (at 22 weeks', 18 weeks' and 21 weeks' gestation) and one early spontaneous miscarriage. Her fifth pregnancy was successfully managed by cervical cerclage at 13 weeks' gestation, followed by clindamycin administration (600 mg/day for 7 days) and progesterone injections (250 mg/week). She gave birth to a healthy 3326-g male infant at 40 weeks and 1 day gestation after natural onset of labor. After delivery, the serum complement components were analyzed. C9 protein and activity were undetectable in the patient's serum. We suggest that an immunologic disorder such as C9 deficiency should be considered as a potential complication of undiagnosed recurrent miscarriages.
authors.affiliation: Department of Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan. watanabe-n@ncchd.go.jp
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Watanabe
authors.forename: Tomo
authors.initials: T
authors.lastname: Suzuki
authors.forename: Etsuko
authors.initials: E
authors.lastname: Kitano
authors.forename: Hajime
authors.initials: H
authors.lastname: Kitamura
authors.forename: Michiyo
authors.initials: M
authors.lastname: Hatanaka
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Sago
mesh_terms: D000026:Abortion, Habitual / Q000209:etiology / Q000517:prevention & control*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D023802:Cerclage, Cervical; D002981:Clindamycin / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003186:Complement C9 / Q000172:deficiency*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011374:Progesterone / Q000627:therapeutic use*; D011372:Progestins / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D003186:Complement C9; D011372:Progestins; D002981:Clindamycin; D011374:Progesterone