Chromosomal abnormalities in recurrent miscarriages by conventional karyotyping analysis

Frequency of chromosomal syndromes in the Brazilian population between 2017 and 2021

Objective: To evaluate the frequency of chromosomal syndromes in the Brazilian population between 2017 and 2021. Methods: This is an active search of open access databases of the Information System on Live Births (SINASC) from the Brazilian Ministry of Health from 2017 to 2021. For statistical analysis, Analysis of Variance (One-way ANOVA) was followed by the Bonferroni post-test, considering a significant level of p < 0,05. The chi-square test was used for correlation analysis. Results: The underreporting of congenital anomalies in Brazil has decreased over the last few years, showing significant values; however, those numbers varied between regions. The chromosomal syndromes with the highest incidence were Down Syndrome (76.15%), Edwards and Patau Syndromes (14.59%) grouped in the same ICD-10, with the South and Southeast regions, with an average frequency of 0.07%, as the leader in notifications. The maternal variables with a higher incidence of chromosomal syndromes were women over 35 years of age, with 8 to 11 years of schooling, and married. Conclusion: There was a decrease in the value related to underreporting over the years. The data show a disparity in the notification of chromosomal syndromes between regions and outline the maternal profile of a higher incidence of chromosomal syndromes.

Cross-sectional study of chromosomal aberrations and immunologic factors in Iraqi couples with recurrent pregnancy loss

BACKGROUND

Parental chromosomal aberrations are important causes of recurrent pregnancy loss (RPL). Some immunological factors such as antiphospholipid antibodies and interleukin-6 (IL-6) also contribute to this complication. The aim of this study was to determine the frequency of chromosomal abnormalities and to evaluate some of the immunological factors in couples with RPL from different cities in Iraq.

METHODS

This study was conducted on 25 couples (50 individuals) who had more than two first trimester abortions in the past and 25 healthy females as controls. Karyotyping was performed on peripheral blood of all participants. Anticardiolipin (IgG and IgM), antiphosopholipid (IgG and IgM), lupus anticoagulant, and IL-6 were assayed. Data were analyzed using appropriate statistical tests.

RESULTS

Chromosomal abnormalities were found in 28.0% (n = 7/25) of RPL couples. Of these five (10.0%) were female and two (4.0%) were male. The types of structural abnormalities were as follows: 45, XX, t(21; 21); 45, XX, rob (14, 15); 46, XX, add (21) (p13); 46 XY, add (21)(p13); 46, XX, 21ps+; 46, XY, per inv (9) (p11q12) and 45, XX, t(13q, 13q). No chromosomal abnormalities were found in the control group. Also, no significant differences were found in the immunological parameters of the couples with RPL and the control group.

CONCLUSION

In this study, karyotyping revealed a high number of chromosomal abnormalities associated with the RPL in Iraqi couples. Since identification of genetic causes of miscarriage is important for genetic counseling and educating couples about the risk of future pregnancies, it is recommended that conventional karyotyping be investigated in patients with RPL.

Lipid emulsion therapy in women with recurrent pregnancy loss and repeated implantation failure: The role of abnormal natural killer cell activity

Altered immune and/or inflammatory response plays an important role in cases of recurrent pregnancy loss (RPL) and repeated implantation failure (RIF). Exacerbation of the maternal immune response through increased NK cell activity and inflammatory cytokines can cause embryo rejection leading to abortion or embryo implantation failure. Immunosuppressors or immunomodulators can help or prevent this condition. Currently, lipid emulsion therapy (LET) has emerged as a treatment for RPL and RIF in women with abnormal NK cell activity, by decreasing the exacerbated immune response of the maternal uterus and providing a more receptive environment for the embryo. However, the mechanisms by which the intralipid acts to reduce NK cell activity are still unclear. In this review, we focus on the studies that conducted LET to treat patients with RPL and RIF with abnormal NK cell activity. We find that although some authors recommend LET as an effective intervention, more studies are necessary to confirm its effectiveness in restoring NK cell activity to normal levels and to comprehend the underlying mechanisms of the lipids action in ameliorating the maternal environment and improving the pregnancy rate.