The course and outcomes of pregnancy in women with idiopathic recurrent miscarriage during immunocytic therapy
Pregravid preparation that can be done by different methods occupies a special place in the treatment of idiopathic recurrent miscarriage (RM).Saribegova V.A., Tetruashvili N.K., Krechetova L.V., Agadzhanova A.A., Vtorushina V.V.
Objective. To assess the course and outcomes of pregnancies in women with idiopathic RM, whose pregravid preparation included immunocytic therapy (ICT).
Subjects and methods. The investigation enrolled 127 women with RM. The pregravid preparation encompassed ICT as monotherapy (Group 1, n = 45) and that in combination with dydrogesterone (Group 2; n = 39). Group 3 (n = 23) consisted of women who received no pregravid preparation.
Results. The investigation showed that the course of pregnancy was characterized by significantly fewer complications in women undergoing pregravid preparation. Preterm labor was more common in Group 3. The course and outcome of pregnancy did not differ in the groups of women receiving different types of pregravid preparation.
Conclusion. The findings make it possible to recommend that ICT should be included in a pregravid preparation program for married couples with idiopathic RM.
Keywords
habitual miscarriage
alloimmune genesis
pregestational preparation
immunocytotherapy
dydrogesterone
Supplementary Materials
- Table 1. The course of pregnancy in groups with predgestatsionnoy preparations (Iand II) and without (III)
- Table 2. Outcomes of pregnancy in groups with predgestatsionnoy preparations (I andII) and without (III)
- Table 3. Pregnancy course in women with idiopathic MI after pre-gestational training
- Table 4. Pregnancy outcomes in women with idiopathic MI after pre-gestational training
References
1. Сидельникова В.М., Сухих Г.Т. Невынашивание беременности. Руководство для практикующих врачей. М.: МИА; 2011: 291-4. [Sidelnikova V.M., Sukhikh G.T. Unintention of pregnancy. A guide for practicing doctors. Moscow: MIA; 2011: 291-4. (in Russian)]
2. Carp H.J.A., ed. Recurrent pregnancy loss: causes, controversies and treatment. CRC Press; 2015: 255-65.
3. Chong P.J., Matzner W.L., Ching W.T. Benefit of leukocyte immunizations? Fertil. Steril. 1993; 59(1): 247-9.
4. Chong P.J., Matzner W.L., Ching W.T. Controversy about immunotherapy. Fertil. Steril. 1993; 59(5): 1138-9.
5. Yang H., Qiu L., Di W., Zhao A., Chen G., Hu K., Lin Q. Proportional change of CD4+CD25+ regulatory T cells after lymphocyte therapy in unexplained recurrent spontaneous abortion patients. Fertil. Steril. 2009; 92(1): 301-5.
6. Saito S., Shima T., Nakashima A., Shiozaki A., Ito M., Sasaki Y. What is the role of regulatory T cells in the success of implantation and early pregnancy? J. Assist. Reprod. Genet. 2007; 24(9): 379-86.
7. Сухих Г.Т., Ванько Л.В. Иммунология беременности. М.: Издательство РАМН; 2003. 400с. [Sukhikh G.T., Vanko L.V. Immunology of pregnancy. Moscow: Publishing house RAMS; 2003. 400p. (in Russian)]
8. Посиссева Л.В., Малышкина А.И., Бойко Е.Л., Сотникова Н.Ю., Перетятко Л.П., Фетисова И.Н. Реабилитация репродуктивного здоровья супружеских пар с невынашиванием беременности. Иваново: «Изд-во Иваново»; 2008. 240с. [Posisseva L.V., Malyshkina A.I., Boyko E.L., Sotnikova N.Yu., Peretyatko L.P., Fetisova I.N. Rehabilitation of the reproductive health of married couples with miscarriage. Ivanovo: „Ivanovo Publishing House”; 2008. 240p. (in Russian)]
9. Кречетова Л.В., Степанова Е.О., Николаева М.А., Вторушина В.В., Голубева Е.Л., Хачатрян Н.А., Тетруашвили Н.К., Сухих Г.Т. Динамика субпопуляционного состава лимфоцитов периферической крови женщин с привычным выкидышем при предгестационной иммуноцитотерапии. Акушерство и гинекология. 2015; 4: 37-43. [Krechetova L.V., Stepanova E.O., Nikolaeva M.A., Vtorushina V.V., Golubeva E.L., Khachatryan N.A., Tetruashvili N.K., Sukhikh G.T. Time course of changes in the peripheral blood lymphocyte subpopulation composition of women with recurrent miscarriage during pregravid immunocytotherapy. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2015; 4: 37-43. (in Russian)]
10. Khonina N.A., Broitman E.V., Shevela E.Y., Pasman N.M., Chernykh E.R. Mixed lymphocyte reaction blocking factors (MLR-Bf) as potential biomarker for indication and efficacy of paternal lymphocyte immunization in recurrent spontaneous abortion. Arch. Gynecol. Obstet. 2013; 288(4): 933-7.
11. Nonaka T., Takakuwa K., Ooki I., Akashi M., Yokoo T., Kikuchi A., Tanaka K. Results of immunotherapy for patients with unexplained primary recurrent abortions – prospective non-randomized cohort study. Am. J. Reprod. Immunol. 2007; 58(6): 530-6.
12. Recurrent Miscarriage Immunotherapy Trialists Group. Worldwide collaborative observational study and meta-analysis on allogenic leukocyte immunotherapy for recurrent spontaneous abortion. Am. J. Reprod. Immunol. 1994; 32(2): 55-72.
13. Сидельникова В.М. Подготовка и ведение беременности у женщин с привычным невынашиванием. Методические пособия и клинические рекомендации. М.: МЕДпресс-информ; 2011: 190-6. [Sidelnikova V.M. Prepare and manage pregnancy in women with habitual miscarriage. Methodical manuals and clinical recommendations. Мoscow: MEDpress-inform; 2011: 190-6. (in Russian)]
14. Clark D.A., Wong K., Banwatt D., Chen Z., Liu J., Lee L. et al. CD200-dependent and nonCD200-dependent pathways of NK cell suppression by human IVIG. J. Assist. Reprod. Genet. 2008; 25(2-3): 67-72.
15. Saccone G., Schoen C., Franasiak J.M., Scott R.T. Jr., Berghella V. Supplementation with progestogens in the first trimester of pregnancy to prevent miscarriage in women with unexplained recurrent miscarriage: a systematic review and meta-analysis of randomized, controlled trials. Fertil. Steril. 2017; 107(2): 430-8. e3.
16. Carp H. A systematic review of dydrogesterone for the treatment of threatened miscarriage. Gynecol. Endocrinol. 2012; 28(12): 983-90.
Received 15.02.2017
Accepted 17.02.2017
About the Authors
Saribegova Victoria A., Graduate student, Department of Pregnancy Loss Prevention and Therapy, Research Center for Obstetrics, Gynecology and Perinatology,Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381477. E-mail: saribegova_v@rambler.ru
Tetruashvili Nana K., Doctor of Medicine, Head of the Department of Pregnancy Loss Prevention and Therapy, Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381183. E-mail: tetrauly@mail.ru
Krechetova Lyubov V., Ph.D. in medical sciences, Head of Laboratory of Clinical Immunology, Research Center for Obstetrics, Gynecology and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381183. E-mail: k_l_v_@mail.ru.
Agadzhanova Anna, Doctor of Medicine, Doctor of Department of Pregnancy Loss Prevention and Therapy, Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381183. E-mail: aagadjanova@mail.ru
Vtorushina Valentina V., Ph.D. in medical sciences, doctor of laboratory diagnostics in Laboratory of Clinical Immunology, Research Center for Obstetrics,
Gynecology and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381183. E-mail: vtorushina@inbox.ru
For citations: Saribegova V.A., Tetruashvili N.K., Krechetova L.V.,
Agadzhanova A.A., Vtorushina V.V. The course and outcomes of pregnancy in women with idiopathic recurrent miscarriage during immunocytic therapy.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (8): 68-73. (in Russian)
http://dx.doi.org/10.18565/aig.2017.8.68-73
Similar Articles
