Miscarriage occurs in about 1-2% of human pregnancies and is one of the common pregnancy problems before 12 weeks of pregnancy. Anatomical and chromosomal abnormalities, microbial factors and auto and alloimmune reactions have been speculated to attribute in recurrent miscarriage. Unexplained recurrent miscarriage (URM) is defined as three or more repeated abortions, probably caused by maternal immunological rejection . Given that maternal immune system encounters semi-allogeneic fetus, pregnancy outcome is associated with the interaction between maternal immune system and immuno-regulatory capability of the fetus. Effectiveness of treatment approaches in RM patients has been controversial and remained to be discovered. Immunomodulatory agents such as corticosteroids and allogeneic lymphocyte immunization showed variable success rates in RM patients. Therapeutic effects of IVIG in unexplained RM is controversial and most positive results were obtained from the trials in RM women with cellular immune abnormalities, such as increased NK cell level and/or cytotoxicity, and T cell abnormalities. Previous studies have shown that the incidence of genetic abnormalities in children who have received immunosuppressive drugs such as IVIg like normal people and normal society. In this study we used IVIg at the time of positive pregnancy,400 mg/kg IVIG was administered intravenously. Following the first administration, IVIG well given every 4 weeks through 32 weeks of gestation to suppress the immune system in patients with immunological causes of RPL and the results will be compared with a control group that did not receive any type of drug.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
50
Patients will take 400mg/kg IVIg at the time of positive pregnancy,Following the first administration, IVIG well given every 4 weeks through 32 weeks of gestation.
Alzahra hospital
Tabriz, Iran
Changes in NK cells, T reg and Th17 cells frequency.
Flowcytometry
Time frame: up to 8 month of pregnancy
Changes in secretion levels of cytokines related to Treg and Th17 cells(IL-17,IL-21)
Elisa
Time frame: up to 8 month of pregnancy
Changes in exoression of cytokines gene.
RT pcr
Time frame: up to 8 month of pregnancy
Ongoing pregnancy rate in patients with Recurrent Pregnancy Loss (RPL)
by sonography
Time frame: up to 8 month of pregnancy
Live berth rate in patients with Recurrent Pregnancy Loss (RPL).
Monitoring by gynecologists
Time frame: up to 1 year
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