Open AccessEffectiveness of high‐dose i.v. immunoglobulin therapy for pregnant women with aspirin–heparin‐resistant secondary antiphospholipid syndrome
Author(s) -
Maesawa Yoko,
Deguchi Masashi,
Tanimura Kenji,
Morizane Mayumi,
Ebina Yasuhiko,
Yamada Hideto
Publication year - 2018
Publication title -
reproductive medicine and biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.005
H-Index - 22
eISSN - 1447-0578
pISSN - 1445-5781
DOI - 10.1002/rmb2.12080
Subject(s) - medicine , antiphospholipid syndrome , recurrent miscarriage , pregnancy , live birth , obstetrics , aspirin , miscarriage , heparin , adverse effect , gynecology , antibody , immunology , biology , genetics
Purpose This study aimed to assess the efficacy of high‐dose i.v. immunoglobulin ( HIVI g) therapy in pregnant women with antiphospholipid syndrome ( APS ) secondary to systemic lupus erythematosus with a history of pregnancy failure, despite receiving low‐dose aspirin plus unfractionated heparin therapy, of which condition being designated as “aspirin–heparin‐resistant APS ” ( AHRAPS ). Methods The HIVI g therapy (20 g/d, 5 days) was performed for the pregnancies of five women with AHRAPS . Results Five of the eight pregnancies ended in live births. The gestational ages of delivery in four of the five pregnancies were extended, compared with previous pregnancies. The HIVI g therapy was considered to be successful for these four pregnancies. Excluding one pregnancy that ended in miscarriage with an abnormal chromosome karyotype of the villi, the HIVI g therapy was considered to be successful in four (57.1%) of the seven pregnancies of the women with AHRAPS . Although all the live newborns were prematurely delivered, no adverse effect of the HIVI g therapy was observed. Conclusions The HIVI g therapy might be beneficial as an immune modifier for pregnant women with AHRAPS . However, the precise indication of which women with AHRAPS who should receive HIVI g therapy remains unknown.