Establishment of a recurrent spontaneous abortion mouse model by intrauterine immunization and development of a new treatment

本研究的目的是探讨大量静脉注射免疫球蛋白(MIVIg)对因不明原因反复自然流产(RSA)的妇女的治疗效果。受试者包括9名妇女和11名孕妇，有4次或4次以上连续RSA病史，病因不明，没有活产。平均丢失胎儿4.5例(流产4~6例)。在为期5天的过程中，以每天20g的速度静脉滴注免疫球蛋白，直到妊娠4-7周(GW)。没有进行额外的输液。两次怀孕分别在6GW和7GW时导致流产。染色体分析发现，两个流产胎均为嵌合体(46XX/48XX，+16，+20)和四倍体(92XXXX)。其他9例妊娠中有8例导致健康新生儿足月分娩。1例发生宫内发育迟缓和胎儿窘迫，导致剖宫产早产(30GW)。因此，排除2例染色体异常的流产，MIVIg治疗对原因不明的RSA妇女的所有9例妊娠都有效。这种MIVIg治疗(在怀孕早期给予100g)可能是以前IVIg输注方法的一种有益的替代方法，应该在进一步研究中进行评估，该研究使用了更多陷入早期妊娠流产高危类别的同质患者。

The aim of this study is to investigate the efficacy of massive intravenous immunoglobulin (MIVIg) treatment for women with a history of recurrent spontaneous abortion (RSA) due to unexplained etiology. Subjects consisted of 9 women and 11 pregnancies having history of 4 or more consecutive RSA with unexplained etiology and no live births. Mean number of fetal losses is 4.5 (ranged from 4 to 6 abortions). Over the course of 5 days, at 20 g/day, immunoglobulin has been infused intravenously duning 4-7 gestational week (GW). No additional infusion has been performed. Two pregnancies resulted in missed abortions at 6 and 7GW,respectively. Mosaicism (46XX/48XX,+16, +20), and tetraploidy (92XXXX) were found by chromosome analyzes of the two abortus. Eight out of the other 9 pregnancies resulted in full term deliveries of healthy neonates. One pregnancy developed an intrauterine growth retardation and fetal distress, resulting in a premature delivery (30GW) by cesarean section. Thus, excluding the 2 abortions with chromosome aberrations, the MIVIg treatment was effective in all 9 pregnancies of RSA women with unexplained etiology. This MIVIg treatment (100g administered in early gestation) may be a benefical alternative to previous IVIg infusion methods and should be evaluated in further studies employing a larger number of homogeneous patients who fall into a high risk catagory of first trimester abortions.