| The recurrent spontaneous abortion (RSA) is defined as the occurrence of two or more consecutive spontaneous abortions,which is a common pregnancy outcome.The etiology for RSA is related to many factors including genetic, endocrine, anatomical and infectional etal. Forty to sixty percents of unexplained RSA are proposed to have an immunologic cause. Two theories, the alloimmune and the autoimmune theories,explain the immunologic cause. Recent reproductive immunology suggests that autoimmune antibody are an important factor in immunology for RSA. It is found that 30% of unexplained RSA would have autoantibodies and have autoimmune problems.esespecially antiphospholipid antibody (APA) have a higher positive rate in late abortion (12 and more than 12 weeks), the object of this study is 210 patients with a history of unexplained RSA, 148 cases of RSA is APA (mainly for the ACA and LAC) positive patients, including 90 cases of low-dose aspirin treatment for the study group. 58 cases of not receiving treatment and another 62 cases of APA negative patients for the control groups.the objective is to discusse the value of low-dose aspirin in APA-positive patients with recurrent spontaneous abortion and related factors. the pathogenic mechanism of APA is multifaceted, involvees vascular endothelial, platelet, anticoagulation and coagulation and fibrinolysis, and other pathologi- cal way, although the mechanism antiphospholipid antibodies lead to RAS is not entirely clear, but pathology change caused by thrombosis of placental results in embryos and fetuses ischemia, hypoxia, death.this view have been confirmed by placental pathology.To address this clinical characteristics used mainly to anticoagulant, antiembolism and immuno suppressive therapies. Drugs commonly used are anticoagulant, enteric-coated aspirin, heparin, and prednisone etal. But there is no accepted treatment method, the current domestic ACA positive patients commonly used treatment of glucocorticoid and heparin, although the effect certainly, but there is multiples obvious defects, such as the high cost of treatment,the complex treatment process, increasing the suffering of the patients and drug side effects. Oral low-dose aspirin, simple, practical, low-cost, and without frequent monitoring of blood coagulation function, oral treatment relieve patients pain. success rate of Low-dose aspirin on APA positive RSA is 67.78%(61/90), significantly higher than 29.31%(17/58) of no therapy, there were significant differrences (P<0.01),an less complications. Late abortion (≥12weeks)component of Power (77.78%,21/27) was higher than that of early (<12weeks) abortion group (23.81. %,5/21), two more significant difference (P<0.01). Prove that the effect of low-dose aspirin on late APA positive RSA is better, the best time to start treatment for one month before pregnancy. The effect of low-does aspirin have no relation with the number of previous abortions, but not treatment, the risk of spontaneous abortion will increase with pregnancy loss frequency, but this conclusion need more samples,and more detailed study to further proof. success rate of low-dose aspirin on APA negative RSA is 33.87%(21/62) ,there was no significant difference (P>0.05)from not treatment group 29.31%(17/58), so it is not routine preventive medication for APA negative RSA, but whether the hign-dose aspirin or low-dose aspirin joint programmes with other drugs is effective, need further study.
|
PDF Full Text Request