Objectives: Recurrent spontaneous abortions (RSA) are one of the most painful experiences for couples expecting a child. A significant proportion of these unexplained RSA cases may be caused by immunopathological failure. Therefore immunotherapy have been used to treat women with otherwise unexplained recurrent pregnancy loss.
Method & Materials: In a cross sectional study 120 cases of RSA which non-immunopathological reasons were excluded on them underwent a detailed immunological screening protocol including alloimmune and autoimmune examinations. Based upon these parameters, the immunopathological background of RSA was certified or excluded. In patients with immunopathological problems immunotherapy (Aspirin, low molecular weight heparin, Intravenous Immunoglobulin …) depends on their background disorder was applied during their next pregnancy.
Results: Overall live births were reported in 79.2% of pregnancies. 83.5% (102) of cases got aspirin, 80.8% (97) LMWH and 65.8% (77) IVIG therapy. In 86.3% ASA, 92.2% LMWH and 80.8% of cases (59/73) IVIG treatment was successful, with the outcome of healthy newborn. A direct relation has been found between number of abortions in previous pregnancies and unsuccessful pregnancy outcome in our study (p value<0.001), also abnormal CD3 and CD4 percentage no IVIG in our course of treatment and failure of pregnancy. (P value<0.001 & 0.05).
Conclusion: Results show that immunopathological checkup and immunotherapy are useful treatments for the patients with unexplained RSA. However the success of this method depends on the adherence of the checkup protocol, because unsuccessful therapy of non-clear cases can reduce the efficiency. More high quality clinical trial studies are required in this area.