Assessment of anticardiolipin and antiphosphatidylserine antibodies in women with recurrent abortion

Objective: To assess the prevalence of anticardiolipin (ACL) and antiphosphatidylserine (APS) antibodies in women with repeated abortion in Mosul region. Methods: Women with history of three or more recurrent spontaneous abortions in their first trimester were studied, for ACL and APS antibodies in their sera by enzyme linked immunosorbent (ELISA). Fifty normal pregnant women during the first trimester were included as a control. Chi –squared test was utilized for evaluation. Results: One hundred –sixty women were tested. ACL and APS were detected in 45/160 (28%) & 22/160 (13.7%) respectively. These antibodies were negative in all control group. Conclusion: Positivisty of ACL antibodies among women with recurrent spontaneous abortion is a common finding in Mosul region. The use of low dose aspirin plus heparin in management of such women had successful result. ةصلاخلا : فدهلا : نيبيلويدراكلا داضم دوجو ىدم ةفرعم (ACL) نيريس لياديتافسوفلا داضمو (APS) ل ءاسنلا ىد لصوملا ةقطنم يف ةرركتم تاضاهجإ نهيدل يتلالا . ثحبلا قئارط : لولاا ثلثلا يف لماوحلا ءاسنلا ةساردلا تلمش تاضاهجا ةثلاث خيرات نهيدل نمم لمحلا نم رثآأ وأ ةيئاقلت جإب ر ءا نم لكل ةداضم ماسجا دوجو نع يرحتلل صوحف ACL ، APS ةقيرطب مدلا لصم يف ELISA تلمش امآ ةساردلا نم ةرطيس ةعومجم ) ٥٠ ( اضيأ لمحلا نم لولاا ثلثلا يفو لمحلا ةيعيبط ةأرما باسحب جئاتنلا تميق ياآ عبرم ) X 2 ( . جئاتنلا : صحفلا لمش ١٦٠ ةأرما . دجو ACL ، APS ىدل ٤٥ ) ٢٨ (% و ٢٢ ) ١٣,٧ (% يأ دجن ملو ، يلاوتلا ىلع نيداضملا نيمسجلل نيصحفلا يلأ ةيباجيا ةجيتن ACL ، APS ةرطيسلا ةعومجم يف ءاسنلا ىدل . جاتنتسلاا : صحف ةيباجيا نا ACL ةقطنم يف ثودحلا ةريثآ ةرركتم ةيئاقلت تاضاهجا خيرات نهيدل يتاوللا ءاسنلا ىدل لصوملا . دت يف نيرابيهلا عم ةريغص ةيموي تاعرجب نيريبسلاا لامعتسا ناو ةيبط جئاتن يطعي تلااحلا هذه ريب . Annals of the College of Medicine Vol. 34 No. 1, 2008 © 2008 Mosul College of Medicine 55 he aetiology of recurrent abortion is multifactorial. Patients with recurrent abortion after excluding anatomical, physiological and endocrine pathology and still had unexplained recurrent abortion not infrequently demonstrate other abnormalities including APS and ACL antibodies. These antibodies are directed against anionic phospholipids or protein phospholipids complexes as in antiphospholipid syndrome (characterized by thrombosis, placental dysfunction, fetal death and the present of circulating antiphospholipid antibodies) . History of recurrent pregnancy loss necessitating testing for antiphospholipid (APL) including (ACL and APS) antibodies Even with implantation failure by miscarriage , (APL) antibodies have been detected (5,6) . The ACL antibodies positivity may be the most sensitive method in detecting and thus helping in preventing fetal loss . The aim of this report is to assess the status of such antibodies among women with recurrent abortion in Mosul. Patients and Methods: Women with history of three or more consecutive unexplained repeated abortion during the first trimester were included in the study. Women were visitors of a private clinic. For all women, serum samples were tested for the presence of ACL IgG and APS IgG antibodies by ELISA technique in a private laboratory according to the principle of Harris et al. Fifty normal pregnant women during the first trimester were included as a control. The study extended from January 2003 until December 2006. Both antibodies were tested twice with an interval of 5-6 weeks for each woman. Results of the tests were calculated against concentration , were interpreted in GPL units as <15 (negative),15-19 (border line), 20 -80 as (positive) and > 80 (high positive) . Percentage calculation and Chisquare test were performed to find out the significance of ACL and APS antibodies among the total . Results : One – hundred – sixty women with unexplained recurrent spontaneous abortion were included. Their mean age was (28 years +4). Forty five (28%) of these women had positive ACL IgG antibodies and were negative for APS antibodies. In the remaining 115 (negative ACL IgG antibodies) women, 22(19%) were positive for APS antibodies. So both ACL and APS antibodies were found in (41.8%) (67/160) of women with recurrent abortion. Ninety three (58.2%) women with repeated abortion were found to have a negative ACL and APS antibodies in their serum. The ACL IgG antibodies were more significantly seen than APS IgG antibodies with ( P< 0.001). There was no significant difference for both ACL and APS antibodies between positive and high T Annals of the College of Medicine Vol. 34 No. 1, 2008 © 2008 Mosul College of Medicine 56 positive cases. These antibodies were negative in all control cases. Those cases with positive ACL IgG or APS IgG antibodies on one occasion, they received aspirin tablet 100 mg daily until 36 weeks of pregnancy and those who are positive on two occasions, they received heparin 5000 IU two times daily subcutaneously up to 36 weeks of gestation. Such cases completed their pregnancy without complications and they had full term baby . Women with negative antibodies (ACL and APS) they did not received such therapy and we had a difficulty to follow them .