Korean J Obstet Gynecol.
2000 May;43(5):871-876.
Chromosome Analysis of Abortuses in Recurrent Spontaneous Aborters with Serum Anticardiolipin Antibodies
Abstract
OBJECTIVE
It has been suggestes that various mechanism of fetal loss are associated with anticardiolipin(ACA) and humoral immunity
in the patients with recurrent spontaneous abortion. Thus we have investigated the relationship between ACA and chromosomal anomaly
to know the clinical impact of ACA to early fetal loss as comparing to the chromosomal anomaly in the patients of recurrent spontaneous
abortions. MATERIALS AND METHODS: Patients(n=88) with a history of recurrent spontaneous abortion (2 or more) between January 1, 1994
and June 30, 1999 were included in this study. Quantitative measurement of serum ACA was performed by ELISA and chromosomal
analysis of chorionic villi obtained from aborted conceptuses was done by using standard G-banding technique.
RESULTS
The incidence rate of ACA positive was 27%(24/88) and that of chromosomal abnormality was 57%(50/88).
The incidence rate of abnormal karyotype was 54% (13/24) in ACA positive. Among 24 ACA positive, 10 had IgG-ACA positive,
10 had IgM-ACA positive and 4 had both types of ACA. The incidence rate of chromosomal anomalies was 30% (3/10) in IgG-ACA positive,
90%(9/10) in IgM-ACA positive and there was significant difference between these two groups (p=0.02). The incidence rate
of chromosomal trisomy was 59% (23/37) in ACA negative, 62% (8/13) in ACA positive and there was no significance between
two groups. CONCLUSIONS: The significantly low incidence of chromosomal abnormalities in conceptal products of patients
with IgG-ACA comparing that of patients with IgM-ACA suggests that this isotype of antibody have influence on the genesis
of spontaneous abortions in genetically normal pregnancy. In further studies, additional trials are mandatory for obtaining
a definitive conclusions about relationship between pathologic changes of conceptal products and pathophysiologic effects of IgG-ACA.