ARS, Aborto Ricorrente Spontaneo: fattori immunologici

Ultimo aggiornamento 2021-04-08  15:13:16
La patologia  uterina morfologica e funzionale, le alterazioni ormonali  e cromosomiche sono considerate  con certezza  come fattori etiologici di aborti ricorrenti spontanei (ARS), recenti studi si orientano verso i fattori immunolgici come causa di ARS nel 20% circa dei casi (1). 
HLA – Tipizzazionein coppie con abortività ripetuta per consentire una fine interpretazione immunologica del fenomeno abortivo, attraverso la valutazione del grado di condivisione degli aplotipi HLA tra le coppie di partners a rischio.
Pannello Autoanticorpi (ANA, ENA, ASMA, LAC, ACA, AOA, ATGA, APA)ANA – ENA – ASMA – LAC – ACA. Analisi della reazione immunitaria materna.
Test di EmbriotossicitàAnalisi di fattori embriotossici materni
La terapia si avvale dell’utilizzo di eparina, prednisone (Deltacortene© cpr 25 mg: una compressa al dì) e basse dosi di aspirina (100 mg/die) e γ-globuline (2-4).
1) Y.J. Meir, L. Fischer Tamaro, N. Di Giusto, G. D’Ottavio e G. P.Mandruzzato: Aborto ripetuto immunologico (Atti SIGO, Congresso Napoli 2000; Fratelli Ferraro Editore, SRL; pagg 165-174).
2) Franklin RD, Kutteh WH. “Antiphospholipid antibodies (APA) and recurrent pregnancy loss: treating a unique APA positive population”. Hum Reprod. 2002 Nov;17(11):2981-5.
3) Backos M, Rai R, Baxter N, Chilcott IT, Cohen H, Regan L.: “Pregnancy complications in women with recurrent miscarriage associated with antiphospholipid antibodies treated with low dose aspirin and heparin”.Br J Obstet Gynaecol. 1999 Feb;106(2):102-7.
4) Sher G, Matzner W, Feinman M, Maassarani G, Zouves C, Chong P, Ching W.: “The selective use of heparin/aspirin therapy, alone or in combination with intravenous immunoglobulin G, in the management of antiphospholipid antibody-positive women undergoing in vitro fertilization”. Am J Reprod Immunol. 1998 Aug;40(2):74-82.


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