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Obstetrics & Gynecology 2003;102:319-324
© 2003 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Increased Plasma Adrenomedullin in Women With Recurrent Pregnancy Loss

Mikiya Nakatsuka, MD, PhD, Toshihiro Habara, MD, PhD, Soichi Noguchi, MD, PhD, Hideki Konishi, MD and Takafumi Kudo, MD, PhD

From the Department of Obstetrics and Gynecology, Okayama University Medical School, Okayama, Japan.

Address reprint requests to: Mikiya Nakatsuka, MD, PhD, Department of Obstetrics and Gynecology, Okayama University Medical School, 2-5-1 Shikata, Okayama-City, Okayama, 700-8558, Japan; E-mail: mikiya{at}cc.okayama-u.ac.jp.

OBJECTIVE: To evaluate vascular changes and uterine perfusion in women with recurrent pregnancy loss.

METHODS: We measured plasma levels of adrenomedullin of 100 pregnant women in the midluteal phase of a nonpregnant cycle (control group: n = 62; recurrent pregnancy loss group: n = 38). We measured the pulsatility index (PI) in the uterine arteries by transvaginal pulsed Doppler ultrasonography at the same time.

RESULTS: The plasma level of adrenomedullin in women with recurrent pregnancy loss (5.6 ± 1.9, mean ± standard deviation) was significantly higher (P > .001) than that in control women (3.6 ± 1.7). Uterine arterial PI of women with recurrent pregnancy loss (2.70 ± 0.47) was significantly higher (P >.001) than that in control women (2.09 ± 0.39). Plasma level of adrenomedullin had a significant positive correlation with uterine arterial PI both in the control group (r = .58, P < .001) and in the recurrent pregnancy loss group (r = .78, P < .001). Both plasma adrenomedullin concentration (7.2 ± 2.3) and uterine arterial PI (3.06 ± 0.36) were significantly high in women with antiphospholipid antibodies.

CONCLUSION: Plasma adrenomedullin may serve as a useful biochemical marker for recurrent pregnancy loss caused by impaired uterine perfusion.






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