Abstract
Recurrent spontaneous abortion (RSA) is a health problem that affects approximately 1% to 5% reproductive age woman. Yet, in around half of these patients, the mechanism for RSA is unexplained. Recent studies have indicated that placental ischemia/hypoxia and endothelial dysfunction are important factors in miscarriage. Other studies have indicated that the level and expression of soluble FMS-like tyrosine kinase-1 (sFlt1) is increased under a hypoxic environment. However, decreased sFlt-1 in the maternal circulation during the first trimester has recently been proposed as a potential marker for identifying risk of pregnancy loss. In this prospective study clinical samples were obtained within a short time after the fetal death, protein expression and maternal serum levels of sFlt1 were assessed and compared to samples taken from those with normal pregnancies. Our results indicate that levels of VEGF and sFlt-1 are both increased in women during early pregnancy compared women that are not pregnant (p<0.05) indicating that VEGF and sFlt-1 are both associated with pregnancy. More importantly, we detected a significant (p<0.05) increase in sFlt1 and VEGF levels and expression in the RSA patients who suffered subsequent miscarriages compare to controls. These results demonstrate that there is likely a relationship between VEGF, sFlt-1 and RSA suggesting that the high levels and over expression of sFlt-1 and VEGF might be associated with the pathogenesis of RSA.
Highlights
Recurrent spontaneous abortion (RSA) is defined as having had at least two consecutive embryo miscarriages within the first or early second trimester of pregnancy [1]
Recent studies have indicated that placental ischemia/hypoxia and endothelial dysfunction may contribute to cases of RSA [6,7]
Results of immunohistochemistry for Vascular Endothelial Growth Factor (VEGF) and sFlt-1 expression in chorionic villus tissues showed that in RSA patients had a high expression compared to the normal pregnancy controls (p
Summary
Recurrent spontaneous abortion (RSA) is defined as having had at least two consecutive embryo miscarriages within the first or early second trimester of pregnancy [1]. RSA affects approximately 1% to 5% of reproductive age women[2,3]. Various factors have been identified that are thought to play a role in about 50% of cases of RSA including genetic, endocrine, anatomical or autoimmune issues and infections. Recent studies have indicated that placental ischemia/hypoxia and endothelial dysfunction may contribute to cases of RSA [6,7]. Recent studies reported that sFlt-1 levels are markedly decreased in RSA patients [8,9]. In another study, expression levels of sFlt-1 mRNA and VEGF mRNA were found to be significantly higher in the chorionic villus tissue of women with RSA than in the control group [10]
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