RECURRENT FIRST TRIMESTER SPONTANEOUS-ABORTION ASSOCIATED WITH ANTIPHOSPHOLIPID ANTIBODIES - A PILOT-STUDY OF TREATMENT WITH INTRAVENOUS IMMUNOGLOBULIN

Background. Antiphospholipid antibodies, unassociated with an underlyi ng connective tissue disease, have repeatedly been detected in women s uffering from recurrent spontaneous abortions. Several therapeutic reg imens have been advocated for pregnant women with recurrent fetal loss and antiphospholipid antibodies. However, most of these approaches we re empirical, using several drugs simultaneously, and most reports des cribe single cars or limited series. Patients and interventions. Ln a pilot study, thirty-eight women with a history of three or more consec utive first trimester spontaneous abortions and antiphospholipid antib odies were treated with intravenous immunoglobulin. As soon as pregnan cy had been confirmed, intravenous immunoglobulin was administered at a dose of 300 mg/kg bodyweight, and infusions were repeated at three-w eekly intervals until the 16th-17th week of pregnancy. Results. Pregna ncy proceeded beyond the first trimester in 34 of the patients (89.4%) , and 31 patients (81.4%) gave birth to healthy infants at 37 to 42 we eks' gestation. Conclusions. Although the results are promising, rando mized placebo-controlled trials are necessary to exclude the influence of other factors (e.g. intense obstetric supervision and psychologica l Factors) on pregnancy outcome and confirm the effectiveness of intra venous immunoglobulin in patients with recurrent spontaneous abortions and antiphospholipid antibodies.