Spinnato J A, Clark A L, Pierangeli S S, Harris E N
Department of Obstetrics and Gynecology, University of Louisville School of Medicine, Kentucky.
Am J Obstet Gynecol. 1995 Feb;172(2 Pt 1):690-4. doi: 10.1016/0002-9378(95)90595-2.
Our purpose was to study the influence of intravenous immunoglobulin on pregnancy outcome.
Pregnancy outcomes were evaluated in five patients with 17 unsuccessful previous pregnancies. Each patient received 400 mg/kg immunoglobulin for 5 days monthly beginning in the first or early second trimester. Four patients with previous thromboembolic events were treated with concomitant heparin prophylaxis. Four patients received 81 mg of aspirin daily.
Short- and long-term decreases of anticardiolipin immunoglobulin G were noted in three patients. Four patients were delivered of healthy infants at term, one at 32 weeks' gestation with a diagnosis of fetal distress. Neither preeclampsia nor fetal intrauterine growth retardation were observed. The immunoglobulin therapy was not associated with major side effects. Significant placental histologic anomalies were not identified.
The observations suggest that immunoglobulin therapy may improve pregnancy outcomes beyond that observed with heparin and aspirin. A prospective trial is encouraged.
我们的目的是研究静脉注射免疫球蛋白对妊娠结局的影响。
对5例既往有17次妊娠失败的患者的妊娠结局进行评估。每位患者从孕早期或孕中期开始，每月接受400mg/kg免疫球蛋白治疗，持续5天。4例既往有血栓栓塞事件的患者同时接受肝素预防治疗。4例患者每天服用81mg阿司匹林。
3例患者抗心磷脂免疫球蛋白G出现短期和长期下降。4例患者足月分娩健康婴儿，1例在孕32周时因胎儿窘迫诊断而分娩。未观察到先兆子痫和胎儿宫内生长受限。免疫球蛋白治疗未出现严重副作用。未发现明显的胎盘组织学异常。
观察结果表明，免疫球蛋白治疗可能比肝素和阿司匹林更能改善妊娠结局。鼓励进行前瞻性试验。
