Pathogenetic Aspects of the First Trimester Miscarriage

Abstract

Purpose: To examine the profile of cytokines and gormones in maternal serum of first-trimester pregnancies complicated by threatened abortion (TACP).Materials and Methods: Serum levels of interleukin-2 and -6, tumor necrosis factor alpha (TNF-alpha), corticotropin-releasing hormone (CRH), activin A, VEGF, sFlt, PGF were measured, by ELISA, in 24 women with TACP and adverse outcome (group IV) and compared with the corresponding levels of 35 women with TACP and successful outcome (group II) and 21 miscarriage (group III) and 26 women with first-trimester uncohreatened abortionmplicated pregnancy (group I) who served as controls. AtteStat 7.3, MedCalc, Microsoft Excel 2003, Statistica 6.0, Spirmen or Wilcoxon test were used for analysis.Results: IL-2 and -6 were detected lower and TNF-alpha and activin A were detected higher with no significant difference in group I, compared to all other groups. Only TNF-alpha in group II were detected lower with significantly levels, compared to I group. sFlt in all groups was detected lower, compared to I group. VEGF and CRH were detected lower in II and III groups and higher in IV group, compared to I group. PGF was detected higher in III group and lower in II and IV groups, compared to I group.Summary: In first-trimester TACP with adverse outcome, allteration of maternal angiogenic factors, activin A, IL and CRH levels, compared to first-trimester uncomplicated pregnancy and TACP wihreatened abortionth successful outcome, is relevant to the occurrence of miscarriages.

Keywords

• missed abortion
• interleukin
• tnf-alpha
• angiogenesis