ULTRASONOGRAPHIC FINDINGS OF PREGNANCY LOSSES AFTER TREATMENT FOR RECURRENT PREGNANCY LOSS - INTRAVENOUS IMMUNOGLOBULIN VERSUS PLACEBO

Objective: To describe the ultrasonographic findings of pregnancies th at terminated in repeat abortion in women participating in an ongoing randomized placebo-controlled clinical trial evaluating the efficacy o f intravenous (IV) immunoglobulin (Ig) in the treatment of recurrent s pontaneous abortion (SA). Design: A prospective descriptive study of u ltrasonographic findings of pregnancies from 27 women experiencing rep eated recurrent SAs after entry into a clinical trial. Setting: Clinic al practice at the Genetics & IVF Institute in Fairfax, Virginia. Pati ents: Women experiencing two or more consecutive recurrent SAs receive d either 500 mg/ kg per mo IV Ig or placebo (albumin). To date 90 wome n have been enrolled in the clinical trial and 52 have achieved pregna ncy. The outcome of the 52 pregnancies include 16 deliveries, 9 ongoin g pregnancies, and 21 losses. Interventions: Ultrasonographic examinat ions performed in 27 women experiencing pregnancy loss are the subject of this study. Main Outcome Measures: The frequency of ultrasonograph ic findings of empty gestational sac (blighted ovum) and intrauterine fetal demise (IUFD) is compared between patients receiving IV Ig and p lacebo. Results: Ultrasonogaphic findings of the 21 pregnancies losses included II blighted ova and 16 IUFDs. Of 11 blighted ova, 8 (73%) we re in women receiving IV Ig and 3 (27%) were receiving placebo. Sixtee n IUFDs were observed: 3 (19%) in women receiving IV Ig and 13 (81%) i n women receiving placebo. Of II pregnancy losses occurring in women r eceiving IV Ig, 8 (73%) were blighted ova, 3 (27%) were IUFDs. Sixteen pregnancy losses occurred in women receiving placebo: 3 (19%) were bl ighted ova and 13 (81%) were IUFDs. The differences in frequency of bl ighted ova between IV Ig- and placebo-treated women was significant. C onclusion: IV Ig is not effective in preventing blighted ova and may b e effective in preventing IUFDs.