RESEARCH - Recurrent spontaneous miscarriages and hyperhomocysteinemia

[Guest guest]

Minerva Ginecol. 2004 Oct;56(5):379-83.

[Recurrent spontaneous miscarriages and hyperhomocysteinemia]

[Article in Italian]

Del Bianco A, Maruotti G, Fulgieri AM, Celeste T, Lombardi L, Amato NA,

Pietropaolo F.

Unita Operativa di Ginecologia e Ostetricia Universitaria, Universita degli

Studi di Foggia, Foggia.

AIM: Recurrent fetal loss is defined as the number of consecutive

miscarriages which is not less than 2 occurred within the 16th week of

gestation and it is a very interesting pathology of pregnancy. Further to

thrombophilia, very important causes have been identified, since the damage

of the vascular system supporting the placenta may cause a deficiency of

placenta functions and development, leading to a loss of the conception

product, also in a condition of hyperhomocystinemia, causing a damage to the

vascular endothelium. Hyperhomocystinemia seems to be a risk factor for

artero-venous thrombotic diseases, even not in pregnancy. METHODS: We have

examined 40 patients referred to our Institute for unexplained fetal loss

(at least 2 consecutive miscarriages within the 16th week of gestation) and

the same number of patients who had at least 1 spontaneous delivery with a

healthy and alive newborn and none abortion nor fetal death nor abruptio

placentae. RESULTS: The mean levels of homocystinemia observed were

significantly different in the 2 groups (p = or < 0.05). In the control

group the values of plasmatic homocysteine were 10+/-4 micromol/L,

corresponding to normal range, while in the other group the values of

plasmatic homocysteine were 21+/-6 micromol/L, values certainly elevated,

also because during the 1st trimester of pregnancy the levels of

homocysteine decrease, reaching the lowest value during the 2nd trimester of

pregnancy. In particular, high levels of homocysteine have been found in 25%

(10) of women with unexplained early fetal loss.

CONCLUSION: Hypercystinemia, as a consequence of an interaction between a

primary genetic defect and a nutrition condition (folate deficiency), may be

a cause of recurrent miscarriages. Therefore, in these cases, a possible

hypercystinemia should be searched and an association of folic acid and

vitamin B6, a non teratogenic treatment, should be useful to restore the

metabolic picture and to favour the pregnancy outcome.

PMID: 15531854 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=15531854 & itool=iconabstr & query_hl=6

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org