Treatment and prevention of miscarriage in women with undifferentiated connective tissue dysplasia | Ukrainian Medical Journal

Aim: to review of available literature on methods of treatment and prevention of miscarriage in women with undifferentiated connective tissue dysplasia (UCTD). Materials and methods. Analysis of foreign publications on the topic in professional journals, as well as data from Internet resources such as PUBMED, GOOGLE SCHOLAR, CAS, and EMBASE. Results. In a randomized trial involving 364 women with signs of UCTD and a history of unexplained recurrent miscarriage, the live birth rate was 69.1% in the aspirin plus nadroparin group. A double-blind, randomized, placebo-controlled trial in 160 patients with unexplained recurrent miscarriage showed that adding prednisolone to heparin and aspirin may be beneficial: 70.3% of women in the prednisolone group had a successful pregnancy outcome compared with 9.2% in the placebo group.Data from 68 pregnancies in the treatment protocol ILIFE showed that the live birth rate was 97.1% in women with UCTD and recurrent miscarriages treated with hydroxychloroquine and low-dose prednisone in combination with anticoagulant therapy. A study of 133 pregnancies in patients with UCTD demonstrated evidence of the safety of hydroxychloroquine therapy during pregnancy. Conclusions. UCTD are the most common systemic rheumatic disorder that predominantly occurs in women of reproductive age and are associated with an increased rate of miscarriage. Antiplatelet and anticoagulant therapy is considered a safe way to reduce the risk of preterm birth in women with UCTD. The ILIFE treatment protocol (immunosuppressive therapy to safe fetus) is the most effective method of treating miscarriage in women with UCTD. Pregnant women with signs of undifferentiated connective tissue dysplasia require observation by a rheumatologist and pre-gravid preparation to reduce the risk of obstetric and perinatal complications.

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