[Antiphospholipid autoantibodies in women treated for infertility]. / Wystepowanie autoprzeciwcial antyfosfolipidowych u kobiet leczonych z powodu nieplodnosci.

OBJECTIVE: To evaluate an occurrence of selected antiphospholipid antibodies (APL) in infertility women. STUDY DESIGN: An enzyme-linked immunoabsorbent assay (ELISA) has been used to determine a titre of anticardiolipin antibodies (ACA). APTT (activated partial thromboplastin time) and PT (prothrombin time) measurements and direct commercial assay have been also used to study occurrence of LAC (lupus anticoagulant antibodies). The group of 268 observed women has been divided into five subgroups according to the cause of infertility: I-endometriosis, II-tubal occlusion caused by others diseases than endometriosis, III-occurrence of antisperm antibodies (ASA), IV-polycystic ovariorum syndrome (PCOS) and V-unexplained etiology. Results have been compared to 44 healthy controls. RESULTS: Occurrence of ACA has been found statistically more often in patients suffering from infertility than in controls (17.9% vs 4.5%, p < 0.05). Moreover ACA have been statistically more often observed in patients with endometriosis (21 from 44, 47.7%). ACA were more common in patients with other cause of infertility (except PCOS) compared to controls, though statistically this was not significant. Frequency of ACA was also more common than LAC (17.9% vs 13.6%). Compared to controls LAC tests were more often positive in infertile women with endometriosis (I), tubal occlusion (II) and with the occurrence of antisperm antibodies (III) but results were not statistically significant. CONCLUSIONS: Antiphospholipid antibodies are observed more often in patients suffering from infertility compared to women with a regular fertility. This suggests a role of APL in etiology of infertility. The occurrence of anticardiolipin antibodies in almost every second woman suffering from endometriosis suggests existing of autoimmunologic disturbances in this disease.

[Clinical consequences of antiphospholipid antibodies in obstetrics and gynecology]. / Kliniczne znaczenie autoprzeciwcial antyfosfolipidowych w poloznictwie i ginekologii.

Antiphospholipid antibodies have been reported to be associated with many common clinical settings. Many gynaecologists and obstetricians have suggested their role in the pathogenesis of infertility, recurrent spontaneous abortions (RSA), ectopic pregnancy, intrauterine growth retardation (IURG), intrauterine foetus decay, pregnancy induced hypertension (PIH), preterm rupture of the membranes (PROM) and preterm labour and premature detachment of the placenta and oligohydramnios and abnormalities of the foetus. Based on our trials and many papers it can be assumed that regular treatment, initiated as early as possible, with using acetylsalicylic acid, heparin, prednisone and IgG allows to prevent diseases above-mentioned.

[Comparison of platelet activation and procoagulant activity of blood cells in healthy pregnant women and EPH-gestosis patients]. / Porównanie wybranych parametrów koagulologicznych oraz stanu pobudzenia krwinek plytkowych u ciezarnych kobiet z ciaza fizjologiczna i powiklana gestoza EPH.

OBJECTIVES: EPH-gestosis is one of the most frequent complications of pregnancy, labour and puerperium. Despite its unknown ethiology, many authors suggest a vital role played by platelets as an ethiopathogenic factor. The aim of this study was to observe the level of platelets activation in EPH-gestosis subjects. STUDY DESIGN: Platelets activation level has been observed in 16 EPH-gestosis third semester pregnant women and 14 normotensive third semester pregnant controls. Platelets double-labeled with monoclonal antibodies and a flow cytometer have been used in assessment of platelet activation level. Anti-P-selectin (GMP 140- Granule Membrane Protein) has been used as a marker of the platelet released reaction. Fibrinogen, D-dimers, antithrombin and thrombin-antithrombin complexes levels have been analyzed. RESULTS: An increased platelet activation (p < 0.005) as well as the increased level of thrombin-antithrombin (p < 0.005) in pregnant EPH-gestosis women comparing to control group, has been observed in the study. CONCLUSIONS: A state of hypercoaguability and enhanced platelet activation in pregnant EPH-gestosis women have been observed.