RECURRENT MISCARRIAGE
Habitual abortions in 678 healthy patients: investigation and prevention.
Hum Reprod 1999 Aug;14(8):2106-9 (ISSN: 0268-1161)
Reznikoff-Etievant MF; Cayol V; Zou GM; Abuaf N; Robert A; Johanet C; Milliez J
Gynecologie-Obstetrique, Hopital Saint Antoine, 184 rue du Faubourg Saint-Antoine,
75012 Paris, France.
The objective of this study of patients with habitual abortion (HA), was to
determine their autoimmune profile and to try to prevent new abortions using
low-dose aspirin for 7 months with prednisone in the first trimester only, or with
low-dose aspirin alone. A total of 678 healthy patients with three or more HA were
investigated for antiphospholipid antibodies, antinuclear and antithyroid
antibodies. Among these patients, 277 pregnant women were treated, 214 were
given prednisone and aspirin (161 autoantibody-negative and 53
autoantibody-positive women), and 63 autoantibody-negative women received
aspirin alone. Autoantibodies were present in 33.9% of the patients, in 82.6% of
them anticardiolipin antibodies were found to be isolated or associated with
antiprothrombin, antithyroid, circulating anticoagulant, antinuclear or anti-beta2
glycoprotein 1 antibodies. In autoantibody-negative pregnant women treated by
prednisone and aspirin or aspirin alone, the success rate of live births was 90.7%
(146 out of 161) and 74.6% (47 out of 63) respectively (P < 0.01). In
autoantibody-positive patients treated with prednisone and aspirin the success rate
was 84.9% (45 out of 53) (not significant). Prednisone and aspirin seemed to be as
efficient in autoantibody-negative or positive women but better than aspirin alone
in autoantibody-negative women. A double-blind trial is in progress to confirm
these results.
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