Some Immunological Studies In Repeated Spontaneaous Abortions :

Elsayd Mohamed Abd El Ghany

This work aims studying of some immunological features of womensuffering from unexplained spontaneous abo rtions, These studies include1) prevalence of HLA-B12 and -B17 among cases with sharing with theirspouses. 2) prevalence of C.M.V. IgG and IgM antibodies and theirimmune response to C.M.V. 3) prevalence of ANA positive test results4) Determination of serum total IgM.Ninety two couples with repeated spontaneous abortions and fiftycontrol couples were included in this study.Study group was divided into different subgroups according to type ofabortion, frequency of abortion and age subgroups.Both groups also were divided into further subgroups in case ofC.M.V. according to residence and socioeconomic levels.It is concluded that HLA-B12 and -B17 were nearly similar prevalentin both study and control groups. Also sharing of these antigens betweenpartners was nearly similar between both groups. Prevalence of positiveresults of C.M.V. IgG antibodies were significantly lower in study groupthan control group. Also positive results of ANA were significantly higherin study group than control group. Total serum IgM gammopathy wasnon significantly higher in study group than in control group.Secondary aborters were more positive for HLA-B12 and sharingthan primary aborters. Also they were more positive for HLA-B17.Primary aborters were more significantly seropositive for C.M.V.IgG antibodies, but less as regard to C.M.V. IgM antibodies thansecondary aborters. Primary aborters were more positive for ANA, butless as regard to IgM gammopathy than secondary aborters.Women who aborted less than five times were more positive for HLAB12and HLA-B17 than women who aborted more than five times. Alsothey were more seropositive for C.M.V. IgG antibodies but less for C.M.V.IgM antibodies and for ANA positive results. IgM gammopathy was moreprevalent in women who aborted less than five times than those abortedmore than five times.HLA-B12 was more prevalent in age group 26 to 30 years, but HLAB17more prevalent in age group 19 to 25 years C.M.V. IgG antibodiesseropositive results were more prevalent at age group 3Uo 35 years, butC.M.V. IgM antibodies were more at 26 to 30 years age group.ANA positive test results were more prevalent at age group 19 to 25years, also IgM gammopathy was more prevalent in this age group.In case of C.M.V. IgG antibodies low socioeconomic patients weremore seropositive and also for C.M.V. IgM antibodies than highsocioeconomic level patients.Rural patients were more positive for C.M.V. IgG and C.M.V. IgMantibodies than urban patients.Recommendations :1- In this study it was found that the degree of HLA sharing can notalways be directly associated with habitual abortions. So it is notrecomended as a common investigation to do HLA typing andsharing for these patients with their partners.2- As the response of these patients for C.M.V. is lower than normal.Other serological studies of these women should includeconsideration of immune responses to other viruses such as otherherpes group viruses.3- Screening patients for ANAis an important test and should bedone routinely. Also screening patients with other autoimmuneconditions such as:- rheumatoid arthritis, scleroderma, mixedconnective tissue disease, polymyositis, and dermatomyositis isrecommended.