Abstract:

Recurrent spontaneous abortion (RSA), which affects 1% to 5% of women of reproductive age,  is difficult to treat in the clinical setting. In the investigations of immunopathogenesis, diagnosis and treatment of RSA since the late 1980s, it was found that RSA was associated with abnormal maternal local or systemic immune response, the pathogenesis of autoimmune RSA was mainly associated with antiphosphlipid antibody (APA）, while that of alloimmune RSA was due to the disturbance of maternofetal immunological tolerance. Systemic etiological screening process and diagnosis systems of RSA with immune type were developed, and anticardiolipin (ACL)+β₂-GP1 combining multiple assay for effective diagnosis of RSA with immune type was initially established. According to dynamic monitoring clinical parameters before and during gestation, low-dose, short-course and individual immunosuppressive therapy and lymphocyte immunotherapy for RSA with immune type were initiated. The outcomes of the offsprings of patients with RSA were followed up, and the safety and validity of the therapies were confirmed. The research achievement leads to great progress in the diagnosis and treatment of RSA in China.

Key words: recurrent spontaneous abortion, autoimmune, alloimmune, pathogenesis, diagnosis, immunotherapy