Life Science Journal 2013;10(1) http://www.lifesciencesite.com 999 Role of Antiphospholipid Antibodies in Unexplained Recurrent Abortion and Intrauterine Fetal Death Alaa El-Deen M. Ismail 1 , Ebtesam M El-Gezawy 2 , Tahra Sherif 2 and Khalid A Nasif 3 1 Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Egypt. 2 Department of Clinical Pathology, Faculty of Medicine, Assiut University, Egypt. 3 Department of Biochemistry, Faculty of Medicine, Minia University, Egypt dr.alaa_ismail@yahoo.com Abstract: Background: Women with antiphospholipid antibodies (aPL) have a significant risk of reproductive failure and adverse pregnancy outcomes, the recurrent miscarriages, intrauterine fetal deaths, and intrauterine fetal growth restriction is significant among these patients. Women with a history of recurrent abortion and unexplained fetal death or a history of recurrent thrombotic episodes should be screened for the presence of antiphospholipid antibodies. We studied the incidence of anticardiolipin antibodies (aCL) and lupus anticoagulant (LA) factor in recurrent unexplained miscarriages and intrauterine fetal deaths. Subjects and Methods: We performed a cohort study among women who attended the department of Obstetrics and Gynecology, Assiut University hospitals, Assiut, Egypt, between October 2007 and October 2011 after being referred due to recurrent miscarriage (≥ 2 consecutive pregnancy losses). All women underwent a standardized investigation sequence. Women with other reasons for recurrent miscarriage were excluded. Lupus anticoagulants and Anticardiolipin antibodies were performed for all cases. Results: A total of 927 women met the selection criteria, 164 women were selected for this study by virtue of having unexplained recurrent fetal wastage. These comprised 140 cases of recurrent ( 3) mainly first and sometimes second trimester abortions and 24 cases of recurrent ( 2) late intrauterine fetal death. An increased incidence of anticardiolipin antibodies was found in women with unexplained recurrent fetal loss. Lupus anticoagulants was found in forty five (45) cases (27.4%) anticardiolipin antibodies IgM and or IgG positive cases shows prevalence of fifty eight (58)cases (35.4%). The prevalence of APS in the studied group was seventy eight (78) cases (47.6%). Conclusions: All women with recurrent first-trimester miscarriage and all women with one or more second-trimester miscarriage should be screened before pregnancy for aPL. [Alaa El-Deen M. Ismail, Ebtesam M El-Gezawy, Tahra Sherif and Khalid A Nasif. Role of Antiphospholipid Antibodies in Unexplained Recurrent Abortion and Intrauterine Fetal Death. Life Sci J 2013;10(1):999-1003]. (ISSN: 1097-8135). http://www.lifesciencesite.com . 155 Keywords: Antiphospholipid antibodies, anticardiolipin; antiphospholipid syndrome; recurrent pregnancy loss. 1. Introduction A miscarriage is a pregnancy that ends spontaneously before the fetus has reached a viable gestational age, while IUFD is defined as fetal death after the age of viability which differ internationally between 20-24 weeks of gestation [1]. Recurrent miscarriage is common, with an incidence of 0.4–2% amongst couples who try to conceive (depending on the definition of two or three consecutive miscarriages) [2,3]. Major determinants of the prognosis following recurrent miscarriage are maternal age, the number of preceding miscarriages, and whether or not an underlying cause is found. Therefore, diagnosing an underlying cause is essential for appropriate counseling of couples with recurrent miscarriage. Known risk factors for recurrent miscarriage include anatomical, hormonal or chromosomal abnormalities and the antiphospholipid syndrome (APS) [4]. However, the cause of recurrent miscarriage remains unexplained in more than 50% of couples with recurrent miscarriage [5,6]. Antiphospholipid syndrome is an acquired condition, defined as the presence of thrombosis or pregnancy loss or maternal morbidity and persistent circulating antiphospholipid antibodies (aPL) in plasma [6, 7]. The prognosis of a subsequent pregnancy in women with APLAs and recurrent miscarriage is not clearly elucidated. Most descriptions stem from randomized trials that have assessed the efficacy of aspirin, with or without heparin, to improve the live birth rate in women with APLAs after recurrent miscarriage [8]. Because participants in trials do not necessarily reflect the general population, these results are not easily translated to daily practice. Antiphospholipid antibodies are a family of approximately 20 antibodies directed against negatively changed phospholipid binding proteins. To diagnose APS, it is mandatory that the woman has two positive tests at least 12 weeks apart for either lupus anticoagulant (LA) or anticardiolipin antibodies (aCL) of immunoglobulin G and/or immunoglobulin M class present in a medium or high titer over 40 g/l or ml/l ,or above the 99 th percentile).In the detection of lupus anticoagulant, the dilute Russell’s viper venom time test together with a platelet neutralization