Studies on immunohcmatological Factors as predisposing to recurrent miscarriage in Sudanese women

Abstract

Recurrent miscarriage is a critical problem in which many factors play a crucial role such as antiphospholipid antibodies (APA) and anticardiolipin antibodies (ACA). This study was a case control study, conducted in Khartoum State; it determined the haemostatic abnormalities and the frequency of ABO and Rh blood group in women with history of recurrent miscarriage (RM). A total of 200 women with three or more consecutive recurrent miscarriage asvcase group and 200 non complicated pregnant women as control group were enrolled in this study and were interviewed through clinically structured questionnaire to assess the risk factors for RM and an informed consent were obtained from them. All samples were tested for ABO, Rh (D) and anti—cardiolipin ( |gM, |gG), anti- phospholipids ( lgM, lgG), protein C and protein S deficiency ,complement 3 and 4 and Prothrombin time (PT) and activated partial thromboplastin time (AP"l'l'), complement receptor 1 ,2. All tests were analyzed using Statistical Packages of Social Sciences Version 17 (SPSS program). Results showed that, the 0 group was most common frequently occurred (55% ) , followed by group A (26%) group B was found ( 14% ) and least common was group AB (5%) .The frequency of the Rh (D) was most common frequently occurred (95%). The frequency of anti- cardiolipin |gM was (5.5%), while anti—cardiolipin IgG was highest common frequently (6.5%), the frequency of anti-phospholipids lgM was (10%), while antl-phospholipids lgG was (6.5%), The levels of C3 (17.5%) and C4 levels (18.5%) were found to be lower in women with recurrent miscarriage, We propose that the decreased levels of sCD21 (1.5%) and sCD35 (29.5%) , An increased frequency of protein S deficiency (13%) compared to protein C deficiency (2%) in the case group. The data concluded that the ABO and Rh blood group system, Proteln C and protein S deficiency, low levels of C3 and C4, the presence of anticardiolipin antibodies (|gM/|gG) and the presence of the antiphospholipid antibodies were significantly associated the immune- pathogenesis of recurrent miscarriage. The current study recommends measuring of APA, ACA, Protein C, S, level of C3 and C4, and ABO and Rh blood group in all women with 3 or more consecutive recurrent miscarriage.