Human Reproduction, Vol. 10, No. 12, pp. 3301-3304, 1995
© 1995 European Society of Human Reproduction and Embryology
research-article |
High prospective fetal loss rate in untreated pregnancies of women with recurrent miscarriage and antiphospholipid antibodies
1Department of Obstetrics and Gynaecology 2Department of Haematology, St Mary’s Hospital Medical School London W2 1PG, UK
Correspondence: 3To whom correspondence should be addressed
Antiphospholipid antibodies (APA), lupus anticoagulant (LA) and/or anticardiolipin antibodies (ACA), are associated with thrombosis and recurrent miscarriage. We studied the outcome of 20 pregnancies in women (median age 32 years; range 23–41) with APA (14 LA positive; three immunoglobulin (Ig) G ACA positive; two IgM ACA positive and one LA and IgG ACA positive) and history of recurrent miscarriage (median 4; range 3–11) who declined pharmacological treatment in their next pregnancy. Comparison was made with a cohort of 100 consecutive women (median age 33 years; range 23–44) with recurrent miscarriage (median 4; range 3–10), in whom no underlying cause to account for their pregnancy losses was found. Of the 20 women with APA, 18 (90%) miscarried compared to 34 of the 100 women (34%) with normal investigations (P < 0.001). The majority (94%) of miscarriages in women with APA occurred in the first trimester. Fetal heart activity was seen prior to fetal death in 86% of women with APA compared to 43% of women with normal investigations (P < 0.01). The first trimester loss of embryonic pregnancies is the most common type of miscarriage in women with APA. This may be a result of defective implantation and subsequent placentation.
Key words: antiphospholipid antibodies/pregnancy/prospective study/recurrent miscarriage
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  S. Monien, O. Kadecki, S. Baumgarten, A. Salama, T. Dorner, and H. Kiesewetter Use of Heparin in Women With Early and Late Miscarriages With and Without Thrombophilia Clinical and Applied Thrombosis/Hemostasis, December 1, 2009; 15(6): 636 - 644. [Abstract] [PDF]
|
|
|
|
 |
|
 F. Scarpellini and M. Sbracia Use of granulocyte colony-stimulating factor for the treatment of unexplained recurrent miscarriage: a randomised controlled trial Hum. Reprod., November 1, 2009; 24(11): 2703 - 2708. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Nelson and I. A. Greer The potential role of heparin in assisted conception Hum. Reprod. Update, November 1, 2008; 14(6): 623 - 645. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Bates, I. A. Greer, I. Pabinger, S. Sofaer, and J. Hirsh Venous Thromboembolism, Thrombophilia, Antithrombotic Therapy, and Pregnancy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition) Chest, June 1, 2008; 133(6_suppl): 844S - 886S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Cervera and J. Balasch Bidirectional effects on autoimmunity and reproduction Hum. Reprod. Update, May 22, 2008; (2008) dmn013v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Sabatini, M. Torricelli, V. Scaccia, D. Fineschi, M. Pescaglini, L. Gasparri, P. Florio, and F. Petraglia Increased Plasma Concentrations of Antiprothrombin Antibodies in Women with Recurrent Spontaneous Abortions Clin. Chem., February 1, 2007; 53(2): 228 - 232. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Francis, R. Rai, N. J. Sebire, S. El-Gaddal, M. S. Fernandes, P. Jindal, A. Lokugamage, L. Regan, and J. J. Brosens Impaired expression of endometrial differentiation markers and complement regulatory proteins in patients with recurrent pregnancy loss associated with antiphospholipid syndrome Mol. Hum. Reprod., July 1, 2006; 12(7): 435 - 442. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Lim, M. A. Crowther, and J. W. Eikelboom Management of Antiphospholipid Antibody Syndrome: A Systematic Review JAMA, March 1, 2006; 295(9): 1050 - 1057. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. S. Nielsen and O. B. Christiansen Prognostic impact of anticardiolipin antibodies in women with recurrent miscarriage negative for the lupus anticoagulant Hum. Reprod., June 1, 2005; 20(6): 1720 - 1728. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D Le Thi Thuong, N Tieulie, N Costedoat, M-R Andreu, B Wechsler, D Vauthier-Brouzes, O Aumaitre, and J-C Piette The HELLP syndrome in the antiphospholipid syndrome: retrospective study of 16 cases in 15 women Ann Rheum Dis, February 1, 2005; 64(2): 273 - 278. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Y. H. Mak, J. J. Brosens, M. Christian, F. A. Hills, L. Chamley, L. Regan, and J. O. White Regulated Expression of Signal Transducer and Activator of Transcription, Stat5, and its Enhancement of PRL Expression in Human Endometrial Stromal Cells in Vitro J. Clin. Endocrinol. Metab., June 1, 2002; 87(6): 2581 - 2588. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N.J. Sebire, H. Fox, M. Backos, R. Rai, C. Paterson, and L. Regan Defective endovascular trophoblast invasion in primary antiphospholipid antibody syndrome-associated early pregnancy failure Hum. Reprod., April 1, 2002; 17(4): 1067 - 1071. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Heilmann, G.-F. v. Tempelhoff, and S. Kuse The Influence of Antiphospholipid Antibodies on the Pregnancy Outcome of Patients With Recurrent Spontaneous Abortion Clinical and Applied Thrombosis/Hemostasis, October 1, 2001; 7(4): 281 - 285. [Abstract] [PDF]
|
|
|
|
 |
|
 A N Mason, R A Mageed, and C G Mackworth-Young The effects of a human IgM monoclonal anticardiolipin antibody on pregnancy in a transgenic mouse model Lupus, April 1, 2001; 10(4): 289 - 294. [Abstract] [PDF]
|
|
|
|
|
|
R H W M DERKSEN, P. G DE GROOT, H K NIEUWENHUIS, and G C M L CHRISTIAENS How to treat women with antiphospholipid antibodies in pregnancy? Ann Rheum Dis, January 1, 2001; 60(1): 1 - 3. [Full Text]
|
|
|
|
 |
|
 I. Martinelli, E. Taioli, I. Cetin, A. Marinoni, S. Gerosa, M. V. Villa, M. Bozzo, and P. M. Mannucci Mutations in Coagulation Factors in Women with Unexplained Late Fetal Loss N. Engl. J. Med., October 5, 2000; 343(14): 1015 - 1018. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Hewitt, M. K. Pratten, L. Regan, S. M. Quenby, and P. N. Baker The use of whole rat embryo culture as a technique for investigating potential serum toxicity in recurrent miscarriage patients Hum. Reprod., October 1, 2000; 15(10): 2200 - 2204. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. D Walker Thrombophilia in pregnancy J. Clin. Pathol., August 1, 2000; 53(8): 573 - 580. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Vuorela, O. Carpen, M. Tulppala, and E. Halmesmaki VEGF, its receptors and the Tie receptors in recurrent miscarriage Mol. Hum. Reprod., March 1, 2000; 6(3): 276 - 282. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Balasch, J. C. Reverter, M. Creus, D. Tassies, F. Fabregues, F. Carmona, J. Font, and J. A. Vanrell Human reproductive failure is not a clinical feature associated with {beta}2 glycoprotein-I antibodies in anticardiolipin and lupus anticoagulant seronegative patients (the antiphospholipid/cofactor syndrome) Hum. Reprod., August 1, 1999; 14(8): 1956 - 1959. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Cowchock Review : Treatment of antiphospholipid syndrome in pregnancy Lupus, January 1, 1998; 7(2_suppl): S95 - S97. [Abstract] [PDF]
|
|
|
|
|
|
L. Lakasing and L. Poston Adverse pregnancy outcome in the antiphospholipid syndrome: focus for future research Lupus, January 1, 1997; 6(9): 681 - 684. [Abstract] [PDF]
|
|