RESUMO
The Authors record the results in a group of patients with immunologic recurrent abortion (IRA) treated with two different immunoprophylaxis regimen. The first one is an active prophylaxis therapy with preparation and administration from donor mononucleates. According to their previous original experience, the Authors started giving high doses of IV-Ig (HD IV-Ig) in a second group of pregnant patients with the same diagnosis of immunologic recurrent abortion (IRA). The results of this not randomized study show better reproductive outcome in the group treated with use of HD IV-Ig.
Assuntos
Aborto Habitual/imunologia , Aborto Habitual/prevenção & controle , Imunização Passiva/métodos , Adulto , Antígenos de Neoplasias/imunologia , Autoimunidade , Feminino , Humanos , Imunidade Celular , Técnicas In Vitro , Leucócitos Mononucleares/imunologia , Pessoa de Meia-Idade , GravidezRESUMO
Up to now the only effective therapy for recurrent abortion syndrome due to the absence of the so-called blocking-factor has been active immunotherapy with partner or third-party donor mononucleates. The Authors report their in vivo and in vitro experience with high-dose intravenous gammaglobulin (i IV Ig) in order to treat women with recurrent abortion syndrome. In the Authors opinion there are sufficient experimental reasons for continuing this research with IV Ig obtained from multiparous women plasma pools.
Assuntos
Aborto Habitual/terapia , gama-Globulinas/uso terapêutico , Aborto Habitual/etiologia , Aborto Habitual/imunologia , Antígenos de Neoplasias/deficiência , Feminino , Humanos , Injeções Intravenosas , Teste de Cultura Mista de Linfócitos , GravidezRESUMO
The recurrent abortion syndrome has been considered a serious obstetrical problem, since it was not possible to diagnose the causes in over 40% of the cases. Great progress has now been made with the knowledge of the immunological mechanisms involved in the maintenance of pregnancy. The disorders of such immunological mechanisms, both due to auto- or alloimmune problems, are demonstrated in about 40% of the cases of recurrent abortions. The Authors have studied a group of 56 patients with recurrent abortion syndrome in a complex diagnostic work-up involving: 1) The research of an autoimmune cause; 2) The research of the presence of the Blocking-factors by means of one-way mixed lymphocyte cultures; 3) The research of an altered antipaternal lymphocytotoxic activity or of an excessive HLA-sharing. According to the results of the investigations, several forms of therapeutic management have been used: 1) Steroids-aspirin-calcic heparin for Autoimmune cases. 2) Active immunotherapy for the cases due to the lack of blocking factors. 3) Calcic heparin for the altered antipaternal lymphocytotoxic activity. At the moment it is difficult to evaluate the results of pregnancy rate with this type of therapeutic management because of the too short follow-up.
