IMMUNOTHERAPY WITH INTRAVENOUS IMMUNOGLOBULIN FOR TREATMENT OF RECURRENT PREGNANCY LOSS - AMERICAN EXPERIENCE

PROBLEM: Recurrent spontaneous abortion (RSA) is the cause of childles sness in 2-5% of reproducing couples. Immunological mechanisms have be en proposed as an etiology in some cases of RSA. Various forms of immu notherapy have been attempted in individuals thought to have an immuno logic mechanism associated with RSA. Intravenous immunoglobulin (IVIG) has been used in a pilot study to successfully treat women with RSA. METHOD: To evaluate the efficacy of IVIG in the prevention of RSA as p rospective randomized, placebo-controlled clinical trial was undertake n. Women experiencing two or more consecutive RSAs receive either IVIG 500 mg/kg/month or placebo (albumin). RESULTS: To date 92 women have been enrolled in the study and 58 pregnancies have been achieved. The outcome of the 58 pregnancies include 20 deliveries, 9 ongoing pregnan cies and 29 losses. Fourteen (49%) of the 29 pregnancy losses were bli ghted ova (empty gestational sacs) and 15 (51%) were intrauterine feta l deaths (IUFD's) occurring in the first trimester of pregnancy. Of 14 blighted ova, 8 were in women receiving IVIG and 6 were receiving pla cebo. Fifteen IUFD's occurred: 3 (20%) in women receiving MG and 12 (8 0%) placebo. Of 11 pregnancy losses occurring in women receiving IVIG, 8 (73%) were blighted ova and 3 (27%) were IUFD's. Eighteen losses oc curred in women receiving placebo: 6 (33%) were blighted ova and 12 (6 7%) were IUFD's. CONCLUSIONS: These preliminary data suggest MG may be effective treatment for RSA. Analysis of data from the completed rand omized placebo-controlled trial will test this suggestion.