Efectividad del tratamiento inmunomodulador con leucocitos alogénicos, en aborto involuntario recurrente. Revisión sistemática y metaanálisis

Abstract

Involuntary recurrent abortion (IRA) is defined as the history of three or more abortions before 20 weeks of gestation. Within its etiology has been proposed and allogeneic or autoimmune causes, with the implementation of therapies that try to immunize women against "foreign" cells of a future pregnancy like the trophoblast membrane immunization, active immunization with allogeneic leukocytes partner or donor and the use of intravenous immunoglobulin (IVIG). The available evidence regarding their effectiveness is scarce and contradictory, which is why we want to conduct a systematic review to assess the effectiveness of this treatment, measured by the rate of live births in women with AIR, who were treted by immunomodulator, and the adverse events presented in the mother and child. Asystematic review of the literature will be conducted. First, a search will be make through the following databases: Medline, Embase, Cochrane Library and Scielo. Also a search made through the registration of clinical trials at the National Institute of Health in the United States (www.clinicaltrials. gov) and finally manual search will be made through the references of the selected studies following the snowball strategy. The following search terms will be used: Human, pregnancy, involuntary recurrent abortion, prevention, control, immunotherapy, immunization, allogeneic leukocytes, trophoblast, newborn, controlled clinical trials, cohort, in different combinations. If the studies allow a quantitative analysis of the information will be made. This systematic review will provide evidence about the effectiveness of immunomodulatory treatments to achieve pregnancy and live birth and assess

gestational week at birth and complications in the newborn. The results will serve to discuss the use of inmunomodulator treatment in cases of IRA. It will serve as a starting point for the implementation of a treatment strategy that is beneficial to patients and complement existing clinical practice protocols.