IMMUNOSUPPRESSIVE THERAPY FOR RECURRENT ABORTERS WITH POSITIVE ANTIPHOSPHOLIPID ANTIBODIES AND ALTERATION OF 6KETOPGF1 ALPHA TXB2 RATIO/

Twelve women (13 pregnancies) with antiphospholipid antibodies (APA) w ho had suffered from two or more recurrent spontaneous abortions or fe tal deaths and had successful pregnancy outcomes after immunosuppressi ve therapy were studied. APA titers were determined by enzyme-linked i mmunosorbent assay against cardiolipin, phosphatidyl serine and phosph atidyl inositol. Plasma levels of 6ketoprostaglandin F1 alpha (6keto-P GF1 alpha) and thromboxane B2 (TXB2) were determined by radioimmunoass ay. All of the 13 pregnancies resulted in term delivery. None of the 1 3 patients suffered from pregnancy-induced hypertension, and only one showed intrauterine growth retardation. A significant decrease of APA titer was observed after immunosuppressive therapy. The 6ketoPGF1 alph a/TXB2 ratios before the therapy, after it and at the Ist, 2nd and 3rd trimesters of pregnancy were 0.62 +/- 0.398, 0.88 +/- 0.106, 0.84 +/- :0.550, 1.25 +/- 0.834 arid 0.67 +/- 0.413, respectively. The ratio at the 2nd trimester was significantly higher than that before the thera py (P < 0.05, paired t-test, n = 9). The results indicate that the imm unosuppressive therapy affected the physiological balance between thro mboxane A2 and prostacyclin, and improved clinical symptoms such as re current fetal wastage.