SHORT-TERM THERAPY FOR RECURRENT ABORTION USING INTRAVENOUS IMMUNOGLOBULINS - RESULTS OF A DOUBLE-BLIND PLACEBO-CONTROLLED ITALIAN STUDY

It is still unclear whether i.v. immunoglobulins (Ig) can facilitate t he reproductive prognosis of women who have suffered recurrent pregnan cy loss. We report the results of a multicentre placebo-controlled stu dy on the effect of Ig administration on pregnancy outcome in 46 women who had suffered at least three recurrent miscarriages. All were scre ened to exclude chromosomal or Mullerian abnormalities, the presence o f antinuclear antibodies, lupus anticoagulant (LA) or elevated titres of anticardiolipin antibodies which may have revealed an underlying au toimmune problem. To avoid a selection bias towards ongoing pregnancie s, i.v. Ig or placebo were administered between weeks 5 and 7 of gesta tion for 2 consecutive days as soon as each woman knew she was pregnan t and before embryonic heart activity could be detected. A further inf usion was administered at week 8 when ultrasonography confirmed an ong oing embryonic development. In all, 68% of the women who received Ig w ent to term versus 79% of those who received a placebo (not significan t), with no significant differences in the pregnancy course or the per inatal outcome. These results suggest either that women with recurrent miscarriages who have no recognized cause of pregnancy loss have a go od reproductive prognosis without any treatment or that the emotional care associated with the administration of a placebo can indirectly fa cilitate the progression of pregnancy.