Autoimmune Disorders and their Relationship to Pregnancy Loss.
Both autoimmune and alloimmune mechanisms have been studied and implicated as causes of recurrent pregnancy loss. Autoimmune disorders are a better studied field with larger amounts of clinical evidence that have linked recurrent pregnancy loss with certain autoimmune disease such as systemic lupus erythematosus and antiphospholipid syndrome. We will further discuss these two diseases, its treatments and patient education in later sections.
Alloimmune mechanisms, in relation to recurrent pregnancy loss, continue to be a field under investigation. In theory, a normal pregnancy requires maternal immunologic recognition and response to paternally deceived antigens on the embryos. There are suggestive mechanisms including the increase of maternal cell-mediated immune attacks with increased natural killer cell activity, or increase in abnormal T-helper lymphocyte activity against the trophoblast antigens. So far there is no definitive clinical evidence that has shown neither the definitive method of diagnosis nor the standard of treatment of alloimmune mechanism. However, we don’t want to entirely eliminate the possibility that alloimmune mechanisms may play a role in specific patients. As a result, we work hard with each patient individually to better evaluate the reason and its corresponding treatment.