Unexplained repeated pregnancy loss and T helper cells

Objective: To know the prevalence of immunology as a cause of unexplained repeated pregnancy loss (RPL) by comparing T helper cell 1(Th1) and T helper cell 2 (Th2) in the decidua of women with RPL, at the time of miscarriage with the decidua of women, at the time of induced abortion. Study design: case control study Setting: Academic medical centre Subjects: 36 Women requiring surgical evacuation, with history of previous one or more spontaneous abortions enrolled as cases. 37 patients undergoing surgically induced termination of pregnancy taken as control. Inclusion criteria- women who presented to the hospital with signs of abortion requiring surgical evacuation, with history of previous one or more spontaneous abortion. Exclusion criteria- women who had taken progesterone for present pregnancy, prior to this miscarriage. Also women who had clinical evidence of autoimmune disease, who were critically ill and who had biohazard exposures like HIV, HCV, HBsAg. Intervention: The decidual tissue obtained was subjected to histopathology and immunohistochemistry staining for Th1 and Th2 cells. Statistical analysis: Data entered in MS EXCEL spreadsheet and analysis done using Statistical Package for Social Sciences (SPSS) version 21.0. Results: The Th1 cells were found to be positive in 25 % women in cases and 29.73 % women in controls group whereas Th2 cells were positive in 16.67 % women in cases and 8.11 % in control group. Both Th1 and Th2 cells were seen in 16.44 % of total women. (p- 0.678) Conclusion: No statistically significant difference in Th1 and Th2 cells in the decidua of patients undergoing recurrent abortion when compared to women undergoing medical termination of pregnancy. Therefore, routine screening for immunological factors and cytokine testing is not recommended. Patients of RPL should not be offered immune treatment routinely. (C) 2020 Elsevier B.V. All rights reserved.