The efforts of University of Utah School of Medicine obstetrics and gynecology researchers to prevent recurrent pregnancy loss are featured in the Aug. 15 Newsweek cover story on "Miscarriages."
In a seven-page exploration of why pregnancies fail, Newsweek reports on the work of a number of researchers across the nation, including Dr. James R. Scott, professor and chairman of the U. Department of Obstetrics and Gynecology, and Dr. D. Ware Branch, assistant professor in the department.Of the many possible causes of miscarriage - genetic flaws, anatomical abnormalities in the mother, infections, environmental hazards and the like - the Utah team is focusing on the immune system for answers to recurrent pregnancy loss, which they define as three or more consecutive miscarriages or fetal deaths.
The immune system protects the body by producing antibodies that attack foreign tissue such as viruses or bacteria. "We have found that some cases of recurrent pregnancy loss seem to be related to autoimmune disease, in which the immune system attacks the body's own tissues, including the growing fetus," the physicians explained.
The two cite systemic lupus erythem-atosus as the most common autoimmune disease in young women.
"Some women are asymptomatic. They act fine and feel fine, but if they are tested, we discover they are producing autoantibodies, which react with normal human tissues," said the Utah researchers. They have found a particularly strong association between pregnancy loss and the two autoantibodies known as lupus anti-coagulant and anti-cardiolipin.
At the U. Hospital, Drs. Scott and Branch have been involved in the treatment of 30 patients with lupus anti-coagulant antibody who had experienced a total of over 100 previous pregnancy losses. Following a drug regimen of daily doses of prednisone and aspirin, 70 percent of these women had successful births. This therapy has been tried at a few hospitals nationwide with similar success.
Another treatment regimen developed at the U. for this problem is intravenous immune globulin, which produced a live birth in a woman who had experienced 10 previous fetal deaths.
A variety of other abnormal immune responses also have been implicated as causes of recurrent miscarriages. To treat these, the Utah obstetricians are investigating the effect of injections of husband's and donor white cells to produce normal pregnancies.
The result of this ongoing study will ultimately answer important questions regarding the success rate of this approach.