Uterine and placental blood flow indexes and antinuclear autoantibodies in unexplained recurrent pregnancy loss: should they be investigated in pregnancy as correlated potential factors? A retrospective study.
Background: The potential role of antinuclear antibodies (ANA) in recurrent pregnancy loss (RPL) pathogenesis is still debated, although some evidences suggest that they could affect pregnancy outcome, leading to a higher miscarriage rate in these patients. A hypothesized mechanism is through change...
| Publicado en: | BMC Pregnancy & Childbirth Vol. 20; no. 1; pp. 1 - 10 |
|---|---|
| Autores principales: | , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
BioMed Central
1/20/2020
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=141291610&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 141291610 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712393 1CII jtl: BMC Pregnancy & Childbirth issn: 14712393 maglogo: N pubinfo: dt: 1/20/2020 vid: 20 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 141291610 141291610 NLM31959152 10.1186/s12884-020-2724-6 NLM31959152 141291610 ppf: 1 ppct: 9 formats: tig: atl: Uterine and placental blood flow indexes and antinuclear autoantibodies in unexplained recurrent pregnancy loss: should they be investigated in pregnancy as correlated potential factors? A retrospective study. aug: au: Bruno, Valentina Ticconi, Carlo Martelli, Federica Nuccetelli, Marzia Capogna, Maria Vittoria Sorge, Roberto Piccione, Emilio Pietropolli, Adalgisa affil: Academic Department of Biomedicine and Prevention, Section of Gynecology, University of Rome "Tor Vergata", Via Montpellier, 1 –, 00133, Rome, Italy sug: subj: Uterus Blood Supply Arteries Abortion, Habitual Placenta Autoantibodies Immunology Heparin, Low-Molecular-Weight Therapeutic Use Blood Flow Velocity Imaging, Three-Dimensional Abortion, Habitual Immunology Blood Circulation Ultrasonography, Doppler Ultrasonography, Prenatal Anticoagulants Therapeutic Use Abortion, Habitual Prevention and Control Adult Female Uterus Physics Pregnancy Pilot Studies Adult: 19-44 years Female ab: Background: The potential role of antinuclear antibodies (ANA) in recurrent pregnancy loss (RPL) pathogenesis is still debated, although some evidences suggest that they could affect pregnancy outcome, leading to a higher miscarriage rate in these patients. A hypothesized mechanism is through changes in uterine flow in pre-conceptional stage, by modifying endometrial receptivity in RPL. However, scant data are available, in pregnancy, about their role in RPL placental perfusion, also in relation to its potential treatments, such as low molecular weight heparin (LMWH). The aim of this study is to retrospectively further investigate the correlation between two-dimensional (2D) and three-dimensional (3D) uterine and placental flow indexes and the presence or the absence of ANA in women with unexplained RPL (uRPL), treated or not treated with LMWH.Methods: 2D Doppler measurement of pulsatility index (PI) of the uterine arteries and 3D ultrasonography determination of vascularization index (VI), flow index (FI) and vascularization flow index (VFI) was carried out with the aid of the virtual organ computer-aided analysis (VOCAL) technique in LMWH treated (n 24) and not treated-uRPL patients (n 20) and in the relative control group (n 27), each group divided in ANA+ and ANA- subgroups. Serum assay for the presence of ANA was performed in all women.Results: No differences were found in PI, VFI and VI values, by comparing the different groups. A difference in VI values was found for ANA- patients between RPL women not treated with LMWH and the treated ones (p = 0,01), which have lower VI values and similar to controls. By considering only ANA- treated and not treated RPL patients, the ROC curve shows an area of 0,80 and at the VI cut-off of 11,08 a sensitivity of 85% and a specificity of 67%.Conclusions: LMWH could exert a potential beneficial effect in restoring the physiological blood flow supply in terms of VI in uRPL ANA- status, suggesting to include ANA and VI investigations in the RPL diagnostic algorithm in a research context, since further studies are needed to clarify this challenging hypothesis in order to try to ameliorate ANA and abnormal placental vascularization negative influence on RPL pregnancy outcome . pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|