The Prognosis Of Pregnancy In Undifferentiated Connective Tissue Disease

OBJECTIVE: Autoimmune-related abortion has both physical and psychological effects on patients and families,making it particularly important to raise awareness of the diagnosis,risk factors,and interventions of related connective tissue diseases.However,the clinical identification of undifferentiated connective tissue disease(UCTD)and its association with abortion remains to be perfected.Abnormal coagulation function and immune system disorder are important pathogenesis of UCTD-related abortion.This topic mainly reviews previous UCTD-related pregnancy studies,discusses possible risk factors for UCTD-related abortion patients,and explores the role of current immunomodulatory therapy and anticoagulant therapy in patients with UCTD-related recurrent spontaneous abortion(RSA).Intervention and improvement of the prognosis of UCTD combined pregnancy provide a theoretical basis.METHODS: This study collected a retrospective case-control study of patients with UCTD-related abortions from the Department of Rheumatology at Renji Hospital from July 2016 to November 2017.Logistic regression,generation of ROC curves,calculation of Spearman correlation coefficient,were utilised to explore risk factors in coagulation function;A prospective cohort study of patients with UCTD-related recurrent spontaneous abortion(RSA)were recruited from January 2017 to May 2018 to discuss the role of low-dose prednisone and hydroxychloroquine(HCQ)Immunomodulatory therapy and antiplatelet anticoagulant therapy with aspirin(ASA)and low molecular weight heparin(LMWH).RESULTS: This retrospective study collected 34 patients with UCTD-related abortion.Fibrinogen(Fg)and protein S can establish an effective predictive abortion model with OR values of 0.279(0.1,0.78),1.076(1.015,1.141),and cutoff values obtained from the ROC curve(Fg ? 3.05 g/L,protein).After S>74.7%),the probability of abortion was ?19.3% and 13.3% respectively(predicted accuracy was 79.41%,82.35%).68 prospective cohort studies were followed up for immunotherapy and antiaggregate-anticoagulation therapy.Under the combination of treatment,the live birth rate reached 97.1%,the adverse pregnancy events accounted for 7.35%,the UCTD disease activity during pregnancy accounted for 7.35%,and no patient with UCTD progressed to defined CTD.CONCLUSIONS: The diagnosis of UCTD in autoimmune-related abortion is very important.The abnormal hemostatic-coagulation function is related to UCTD-related abortion.Fibrinogen ?3.05 g/L may be one of the risk factors for predicting pregnancy outcome in patients with UCTD-related abortion.The combination of low-dose prednisone and HCQ immunomodulatory therapy with anti-platelet anticoagulant therapy based on ASA and LMWH can effectively improve the live birth rate of UCTD-related RSA patients and reduce adverse pregnancy events.Treatment initiation time and low molecular weight heparin use may improve pregnancy outcomes.