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Sensitization to chorionic gonadotropin: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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The autoimmune factors of a habitual miscarriage include the presence of antibodies to human chorionic gonadotropin (HG). According to I.V. Ponomareva et al. (1996), in serum 26.7% of women suffering from habitual miscarriage have antibodies to the chorionic gonadotropin, which, having high affinity, block the biological effect and in some cases lower the concentration of chorionic gonadotropin. The mechanism of action of antibodies probably consists not only in preventing the binding of chorionic gonadotropin to the receptors of the yellow body of the ovaries, but also in direct damaging effects on cells of the embryonic trophectoderm. 95% of women with high titers of antibodies to the chorionic gonadotropin observed a threat of termination of pregnancy in the first trimester. Antibodies to the chorionic gonadotropin during the enzyme immunoassay cross-react with LH and FSH, which is due to the presence of common antigenic determinants. Such hormonal and alloimmune disorders lead to early development of the DIC syndrome (from 3-8 weeks of pregnancy) and, as a consequence, to the inhibition of the hormone-producing and trophic functions of the trophoblast.
Treatment of sensitization to the chorionic gonadotropin
Treatment of patients with sensitization to chorionic gonadotropin consists in correction of thrombophilia with low molecular weight heparins under the control of the hemostasiogram and administration of glucocorticoids in a dose of 5-15 mg / day in terms of prednisolone. Treatment should begin in the first trimester of pregnancy, since the peak of the production of chorionic gonadotropin and antibodies occurs in the first weeks of pregnancy.
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