Pathophysiological implications of apoptosis, hormonal imbalance and immunological factor in first trimester abortion

ABSTRACT

The study aims were to look for the possible role of apoptosis in the pathophysiologic mechanisms of first trimester abortion and to highlight the hormonal imbalance, immunological factor and their possible relation to apoptosis. Placental and foetal tissue samples were obtained from 11 women with missed abortion, [group I], 10 women with inevitable abortion [group II], for detection of apoptosis. Blood samples were taken from both groups and from another 10 women with intact intrauterine pregnancy as [control group III] for detection of serum progesterone and anticardiolipin antibodies, [which is a marker of antiphospholipid antibody syndrome]. Placental and fetal apoptosis were significantly higher in women with missed abortion [group I] than inevitable abortion [group II] [enrichment factor 1.23, 1.37 versus 1.03, 1.03, P < 0.0005 and < 0.05 respectively]. Serum progesterone was significantly lower in missed abortion group and inevitable abortion group than in control group [7.06 ng/ml; 3.49 versus 18.64 ng/ml respectively] P < 0.0005. Anticardiolipin antibodies were significantly higher in missed abortion group. 65.3 GpL/ml and inevitable abortion group 60.3 GpL/ml than control group 22.55 GpL/ml. [P < 0.01] there was no inter-group significant differences as regards serum progesterone and anticardiolipin antibodies in both abortion groups. This study underlines the importance of apoptosis in abortion and reveals a new route for investigating the pathophysiology of abortion. Low serum progesterone should be considered in different types of abortions. Tissue hypoxia induced by anticariolipin antibodies may play a role in triggering aptopsis and consequently abortion