INTRAVENOUS IMMUNOGLOBULIN IN THE PREVENTION OF RECURRENT MISCARRIAGE

Objective This study was undertaken to verify a specific effect of int ravenous immunoglobulin on the outcome of pregnancy in patients with a history of recurrent miscarriage as an alternative to immunotherapy w ith allogeneic leucocytes. Study design In a randomised double-blind m ulticentre study 64 patients with a history of unexplained primary rec urrent miscarriage were treated with intravenous immunoglobulin (verum ) or 5% human albumin (placebo) infusions during their following pregn ancy. Results Success rates for both verum and placebo, were compared excluding seven patients with explained miscarriage (20/27 (74%) versu s 21/30 (70%)) and without any such exclusion (20/33 (61%) versus 21/3 1 (68%)). The difference between the two groups was not statistically significant. Conclusions A specific effect of intravenous immunoglobul in in primary recurrent miscarriage could not be demonstrated. These r esults imply the possibility of psychological influence, i.e. a placeb o effect of intravenous immunoglobulin, on the outcome of pregnancy. S ince success rates for both verum and placebo were in the same range a s for treatment with allogeneic leucocytes, psychological effects migh t be responsible also for other kinds of immunotherapy for prevention of recurrent miscarriage. However, it cannot be excluded that success rates only reflect background values as reported for recurrent miscarr iage patients without any treatment.