OBJECTIVE: To observe the clinical efficacy of heat-sensitive moxibustion combined with western medication for preconception intervention in prethrombotic state of recurrent spontaneous abortion (RSA) with kidney deficiency and blood stasis. METHODS: A total of 100 RSA patients of prethrombotic state with kidney deficiency and blood stasis were randomized into a combination group (50 cases, 5 cases were eliminated) and a medication group (50 cases, 5 cases were eliminated). In the medication group, the aspirin enteric-coated tablet was given orally at a dose of 75 mg a time, once daily. On the basis of the treatment in the medication group, in the combination group, heat-sensitive moxibustion was applied at the heat-sensitive points selected among the areas of Guanyuan (CV4), Shenque (CV8), and bilateral Sanyinjiao (SP6), Zusanli (ST36), Qihai (CV6), Taixi (KI3), Zigong (EX-CA1), Luanchao (Extra), Xuehai (SP10), and Yinlingquan (SP9), about 40 min a time, once every two days. Both groups were treated for 3 menstrual cycles continuously. Pregnancy success rate of 12 weeks was recorded in the two groups in follow-up of 3 months after treatment completion, during which conception was tried under the guidance of doctor. The TCM symptom score was observed and the coagulation-fibrinolysis indexes (activated partial thromboplastin time [APTT], prothrombin time [PT], platelet count [PLT], D-dimer [D-D], fibrinogen [FIB], protein S [PS], protein C [PC] and antithrombin Ⅲ [AT-Ⅲ]) were detected before and after treatment in the two groups. RESULTS: The pregnancy success rate of 12 weeks was 80.0% (32/40) in the combination group, which was higher than 54.3% (19/35) in the medication group (P<0.05). After treatment, the TCM symptom scores were decreased compared with those before treatment in the two groups (P<0.05), and the TCM symptom score in the combination group was lower than that in the medication group (P<0.05). Compared before treatment, the APTT and PT was prolonged (P<0.05), the levels of PLT, FIB and D-D were reduced (P<0.05), the activity of AT-Ⅲ, PS and PC was increased (P<0.05) after treatment in the two groups. After treatment, in the combination group, the APTT was longer (P<0.05), the levels of PLT, FIB and D-D were lower (P<0.05), the activity of AT-Ⅲ, PS and PC was higher (P<0.05) than those in the medication group. CONCLUSION Heat-sensitive moxibustion combined with western medication can effectively improve the prethrombotic state and TCM clinical symptoms in RSA patients with kidney deficiency and blood stasis, enhance pregnancy success rate, its mechanism may be related to ameliorating hypercoagulability.
Humans ; Female ; Moxibustion ; Adult ; Pregnancy ; Abortion, Habitual/blood* ; Young Adult ; Combined Modality Therapy ; Kidney/drug effects* ; Acupuncture Points ; Aspirin/administration & dosage*

This study was undertaken to investigate the antioxidant/oxidant status in recurrent miscarriage patients. Antioxidants including glutathione peroxidase (GPx), catalase (CAT), glutathione reductase (GR), reduced glutathione (GSH) and selenium (Se), as well as the oxidants hydrogen peroxide (H2O2), oxidised glutathione (GSSG) and lipid peroxidation were assayed in plasma, whole blood and placental tissue of non-pregnant women (NP), healthy pregnant women (HP), and recurrent miscarriage (RM) patients. Results indicated that all antioxidant activities and levels in plasma and whole blood of HP women were consistently moderately lower, and much more significantly lower in RM patients when both were compared to those seen in NP women (P<0.05 and P<0.001, respectively). Furthermore, whereas plasma antioxidant activities and levels were significantly lower in RM patients, those of whole blood and placental tissue were much more significantly lower when compared with HP women (P<0.001). Concurrent with these findings there were consistent increases of equal statistical significance and magnitude in the levels of all investigated oxidants assayed in all samples when compared in between subjects of the study as indicated above. Data thus illustrated a distinct shift in favor of oxidative reactions and reactive oxygen species (ROS) generation, and very significant decreases in the GSH/GSSG ratios in whole blood and placental tissue of RM patients when compared to HP and NP women (P<0.001). The above noted oxidative stress could have been a major causative factor of recurrent miscarriage.
Abortion, Habitual/*blood/*epidemiology ; Adult ; Antioxidants/analysis ; Biomarkers/*blood ; Catalase/blood ; Female ; Glutathione/blood ; Glutathione Peroxidase/blood ; Glutathione Reductase/blood ; Humans ; Hydrogen Peroxide/analysis ; Lipid Peroxidation ; *Oxidative Stress ; Placenta/metabolism ; Pregnancy ; Reactive Oxygen Species/metabolism ; Saudi Arabia/epidemiology ; Selenium/blood

OBJECTIVETo study the immunoregulation effects of Tiaomian No. 3 (TM3) for recurrent spontaneous abortion (RSA) caused by shortage of blocking antibodies.

METHODSTotally 61 patients with RSA caused by shortage of blocking antibodies were randomly assigned to the treatment group (31 cases) and the control group (30 cases) by lot method. Patients in the treatment group were treated with TM3, while those in the control group were treated with active immunotherapy using lymphocytes of their spouses. The therapeutic course for all was 3 months. Another 10 healthy females in the same age ranges were recruited as the healthy control group. The blocking antibodies (Ab1), anti-idiotypic antibodies (Ab2), T-lymphocyte cell subsets (CD4 and CD8), serum interleukin 10 (IL-10), and macrophage colony-stimulating factor (M-CSF) levels were determined before and after treatment.

RESULTS(1) After treatment the positive conversion rate of Ab1 and/or Ab2 was 87.1% (27/31) in the treatment group and 86.7% (26/30) in the control group, showing no statistical difference (P > 0.05). (2) In the two groups, CD4 decreased and CD8 increased. The CD4/CD8 ratio was in the normal level after treatment, showing statistical difference when compared with before treatment (P < 0.05). (3) In the two groups, IL-10 and M-CSF levels were higher after treatment, showing statistical difference when compared with before treatment (P < 0.05). (4) The 1-year conception rate was 58.1% (18/31) in the treatment group, significantly higher than that in the control group (46.7%, 14/30, P < 0.05).

CONCLUSIONSTM3 could promote the positive conversion rate of Ab1, promote the production of IL-10 and M-CSF cytokines, thus strengthening the protection for fetus by the mother and the normal maintenance for pregnancy. The 1-year successful pregnancy rate obviously increased in the treatment group.

Abortion, Habitual ; drug therapy ; immunology ; Adult ; Antibodies, Anti-Idiotypic ; Antibodies, Blocking ; CD4-CD8 Ratio ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Humans ; Immunotherapy, Active ; Interleukin-10 ; blood ; Macrophage Colony-Stimulating Factor ; blood ; Phytotherapy ; Pregnancy ; T-Lymphocyte Subsets

Abortion, Habitual ; drug therapy ; immunology ; Antibodies, Anticardiolipin ; blood ; Aspirin ; administration & dosage ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Heparin ; administration & dosage ; Humans ; Integrative Medicine ; methods ; Prednisone ; therapeutic use ; Pregnancy

OBJECTIVETo explore the effectiveness of intravenous immunoglobulin (IVIG) in treating patients with unexplained recurrent spontaneous abortion (URSA) and the effect of IVIG on the level of soluble human leucocyte antigen G (sHLA-G).

METHODSThis prospective trial conducted at PUMC Hospital between 2004 and 2008 included 60 women with URSA. The patients were allocated into IVIG group (30 cases) and control group (30 cases). IVIG was intravenously used before conception at a dose of 0.2g/kg; once pregnancy was confirmed,IVIG was continued every 4 weeks till the 20th gestational week. Traditional Chinese medicine or/and progesterone were used in control group. The outcome of pregnancy was evaluated by live birth rate and effective rate(defined as the embryo living 4 week longer than previous pregnancy). Serum samples were collected randomly before pregnancy and in the 6th-8th gestational week from IVIG group (15 samples),control group (15 samples),and healthy women (20 samples). The levels of sHLA-G,interferon γ (IFN-γ), interleukin-2 (IL-2), and interleukin-10 (IL-10) were determined by enzyme-linked immunosorbant assay (ELISA).

RESULTSThe pregnancy rate was 93.3% in IVIG group. The live birth rate and effective rate were 85.7% (24/28) and 92.9% (26/28) in IVIG group,which were significantly higher than those in control group [56.7% (17/30) (P=0.021) and 63.3% (19/30) (P=0.011)]. Emesis occurred in one woman (3.3%) in IVIG group had during IVIG infusion but was relieved by lowering the speed of infusion. The mean sHLA-G level was (61.37∓35.57) U/ml in control group and (62.70∓37.24) U/ml in IVIG group (P>0.05); both of them were significantly lower than that of healthy women (88.49∓25.37) U/ml (Pü0.05). After pregnancy was achieved, the levels of sHLA-G and IL-10 were (34.19∓14.21) U/ml and (11.71∓2.75) pg/ml, respectively in the IVIG group, which were significantly higher than those in control group [(23.71∓12.83) U/ml and (8.71∓3.01) pg/ml, respectively] (P=0.008).

CONCLUSIONSLow-dose IVIG before and after pregnancy is a safe and effective in treating URSA. IVIG improves the development of fetus by up-regulating sHLA-G and IL-10 levels.

Abortion, Habitual ; blood ; drug therapy ; immunology ; Adult ; Female ; HLA-G Antigens ; blood ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Pregnancy ; Prospective Studies ; Treatment Outcome

OBJECTIVETo explore the role of CD4+ CD25+ regulatory T cells (CD4+ CD25+ Tr) in the pathogenesis of recurrent spontaneous abortion.

METHODSPeripheral blood samples were collected from 29 women with unexplainable recurrent spontaneous abortion (the URSA group) and another 20 with normal pregnancy (the control group). The percentage of CD4+ CD25+ Tr in the peripheral blood was measured by flow cytometry.

RESULTSThe rate of CD4+ CD25bright Tr in the URSA patients ([1.98 +/- 0.96]%) was significantly lower than that in the control group ([3.21 +/- 1.25]%, P < 0.05), while the percentages of CD4+ CD25+ and CD4+ CD25dim and the ratio of CD4+ CD25bright/CD4+ were not significantly different between the two groups (P > 0.05).

CONCLUSIONURSA might be associated with the decreased percentage of CD4+ CD25bright Tr, which plays an important role in fetomaternal immunologic tolerance.

Abortion, Habitual ; blood ; immunology ; Abortion, Spontaneous ; blood ; immunology ; Adult ; CD4 Antigens ; blood ; Case-Control Studies ; Female ; Flow Cytometry ; Humans ; Immune Tolerance ; Interleukin-2 Receptor alpha Subunit ; blood ; Pregnancy ; T-Lymphocytes, Regulatory ; immunology

BACKGROUND: Plasma coagulation factor XIII (FXIII) catalyzes the formation of covalent bounds between fibrin monomers, thus stabilizing the fibrin clot and increasing its resistance to fibrinolysis. Alteration of FXIII may contribute to bleeding, wound dehiscence and recurrent abortion. However, standard clotting tests cannot detect the FXIII deficiency. In this study, we evaluated a newly developed FXIII test kit (CoalinkTM, PeopleBio Inc., Seoul, Korea) in patients with various clinical conditions. METHODS: We evaluated the linearity and precision of the new FXIII test kit and compared the results of the new kit and the Pefakit FXIII assay. The FXIII was tested in idiopathic thrombocytopenic purpura (ITP) (n=40) patients, chronic renal failure (CRF) (n=20) patients, liver cirrhosis (LC) (n=40) patients, EDTA-induced pseudothrombocytopenia (EDTAIP) (n=10) patients, and in normal healthy persons (n=50). In the normal healthy persons, we determined a complete blood count (CBC), Ed-highlight-the second (n=50) is redundant. prothrombin time (PT) measurement and activated partial prothrombin time (aPTT) measurement and evaluated the results using the two assays. RESULTS: Serial dilution experiments with five samples provided good linearity (r2=0.9717). The intra- and inter assay precisions (CV) were 2.3~8.6% and 3.9~14.9%, respectively (n=20). There was a significant correlation between the use of the new kit and the Pefakit FXIII assay (r=0.8798, n=50). The FXIII activities of the normal healthy persons, ITP, CRF, LC and EDTAIP patients were 103.3+/-23.3%, 79.7+/-41.0%, 117.9+/-82.3%, 56.9+/-23.7% and 130.0+/-29.0%, respectively and they were significantly decreased in the ITP and LC patients (P<0.05). The rates below 80% of the FXIII level were 67.5% in the ITP patients, 90.0% in the LC patients, 35.0% in the CRF patients and 0.0% in the EDTAIP patients. FXIII activities were closely related to platelet count (r=0.832, P<0.05) and negatively correlated with PT (r=-0.389, P<0.05) and aPTT (r=-0.326, P<0.05). CONCLUSION: The new kit was determined to have good linearity and precision. Moreover, it was simple and rapid to perform. This method may prove useful for the evaluation of FXIII.
Abortion, Habitual ; Blood Cell Count ; Blood Coagulation Factors* ; Blood Coagulation* ; Factor XIII* ; Female ; Fibrin ; Fibrinolysis ; Hemorrhage ; Humans ; Kidney Failure, Chronic ; Liver Cirrhosis ; Plasma ; Platelet Count ; Pregnancy ; Prothrombin Time ; Purpura, Thrombocytopenic, Idiopathic ; Seoul ; Wounds and Injuries

OBJECTIVETo investigate the association of Coxsackie B virus (CBV) with habitual abortion.

METHODSCBV IgM antibody, viral RNA and virions were detected in 86 women with habitual abortion and 40 with induced abortion by means of enzyme-linked immunosorbent assay (ELISA), RT-PCR and virus isolation, respectively.

RESULTSThe positivity rate of CBV IgM were 87.2% and 35% in the two groups, respectively, and the detection rate of the viral RNA was 53.5% and 17.5% in blood lymphocytes, and 59.3% and 17.5% in the placentas. The virions were found in the placentas in 41.9% and 6.9% of the women, respectively. The positivity rates of CBV IgM, viral DNA and virions showed significant difference between the two groups (P<0. 01).

CONCLUSIONCBV might be one of the causes responsible for habitual abortion.

Abortion, Habitual ; blood ; etiology ; Adult ; Antibodies, Viral ; blood ; Coxsackievirus Infections ; complications ; virology ; Enterovirus B, Human ; immunology ; isolation & purification ; Female ; Humans ; Immunoglobulin M ; blood ; Lymphocytes ; ultrastructure ; virology ; Microscopy, Electron ; Pregnancy ; Pregnancy Complications, Infectious ; blood ; virology ; RNA, Viral ; blood

OBJECTIVETo investigate the mechanism of anticoagulation protein defect in the pathogenesis of unexplained recurrent miscarriage.

METHODSFifty-seven patients with a history of unexplained abortion were enrolled as the investigation group for tests of protein C, protein S, antithrombin III (AT-III), as well as activated protein C resistance (APC-R). The control group consisted of fifty healthy women with a history of normal pregnancy and delivery. Blood samples were obtained for, measuring serum activity of protein C, protein S, AT-III, and APC-R. Patients with positive APC-R were tested for factor V (FV) Leiden gene mutation by PCR-RFLP method.

RESULTSOf the 57 patients, 12 (21.1%), 1 (1.8%), and 5 (8.8%) cases were found with protein S, protein C, and AT-III deficiency respectively, and 13 (22.8%) cases with positive results of APC-R. Of the control group, no protein C or AT-III deficiency was ever found, whereas 2 (4.0%) volunteers were presented with protein S deficiency and 3 (6.0%) with positive results of APC-R. No FV Leiden gene mutation was identified in all the patients with positive APC-R results. Late spontaneous abortion cases had higher incidence of anticoagulation protein defect than the early cases.

CONCLUSIONAnticoagulation protein defect may play a role in the pathogenesis of fetal loss, especially for those occurring in late stage of pregnancy.

Abortion, Habitual ; blood ; etiology ; Activated Protein C Resistance ; blood ; complications ; genetics ; Adult ; Antithrombin III ; metabolism ; Antithrombin III Deficiency ; blood ; complications ; Factor V ; genetics ; Female ; Humans ; Point Mutation ; Protein C ; metabolism ; Protein C Deficiency ; blood ; complications ; Protein S ; metabolism ; Protein S Deficiency ; blood ; complications

OBJECTIVETo explore the effect of Chinese herbal medicine Baotai Granule (BTG, a self-made preparation) on CD antigen blocking efficiency, prolactin (PRL) and progesterone (P) in patients with recurrent spontaneous abortion (RSA).

METHODSThirty-four women suffered from RSA were treated with BTG, twice every day, 1 package (10 g) in each time by orally intake. Changes of the efficiency of serum blocking antibody in them to the CD antigen in their husband's peripheral T-lymphocytes before and after treatment were observed. And the changes of blood levels of PRL and P were also monitored.

RESULTSFetus had successfully protected in 30 women (88.2%), in them, the efficiency of blocking to CD3, CD4 and CD8 after treatment were all higher than that before treatment, and levels of PRL and P in peripheral blood increased along with the increase of gestational age, while no obvious change was found in those who failed to complete pregnancy.

CONCLUSIONChinese herbal medicine could protect the fetus by regulating the response between endocrine and immunity network during pregnancy.

Abortion, Habitual ; drug therapy ; immunology ; Adult ; Antibodies, Blocking ; drug effects ; Antigens, CD ; drug effects ; immunology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Phytotherapy ; Pregnancy ; Progesterone ; blood ; Prolactin ; blood ; T-Lymphocytes ; immunology