Antagonists of TNFα for recurrent miscarriages: 2 Illustrative cases

Eur J Obstet Gynecol Reprod Biol. 2019 May:236:263-264. doi: 10.1016/j.ejogrb.2019.02.036. Epub 2019 Mar 6.

Abstract

Approximately 1 to 3% of women have recurrent early miscarriages, defined as ≥3 pregnancy losses before 14 weeks of gestation. The immune deregulation and tolerance rupture could be the origin of these miscarriages in at least 30% of these women. Chronic intervillositis of unknown etiology (CIUE) is a rare placental lesion characterized by intrauterine deaths, growth restriction and high recurrence rate. In cases with recurrent obstetrical adverse events and intrauterine deaths, we previously reported the benefit of hydroxychloroquine combination to prednisone. Even few data raised the potential value of TNF antagonists in early recurrent miscarriages, these cases show its potential value in the setting of recurrent refractory chronic intervillositis and unexplained miscarriages.

Keywords: Adalimumab; Chronic intervillositis; Miscarriages; Outcome.

Publication types

  • Case Reports

MeSH terms

  • Abortion, Habitual / prevention & control*
  • Adalimumab / therapeutic use*
  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Aspirin / therapeutic use*
  • Drug Therapy, Combination
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Prednisone / therapeutic use*
  • Pregnancy
  • Pregnancy Outcome
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*

Substances

  • Anti-Inflammatory Agents
  • Fibrinolytic Agents
  • Tumor Necrosis Factor-alpha
  • Adalimumab
  • Aspirin
  • Prednisone