الفهرس 
Recurrent pregnancy lossOnly 14 pages are availabe for public view
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Abstract
Recurrent pregnancy loss (RPL) is defined by the American society for reproductive medicine as the presence of two or more failed pregnancies, proved either by sonographic examination or histopathology.
RPL may be either a primary or secondary process: primary , RPL refers to those women with RPL who never had a live birth before,where as secondary RPL is occurrence of two or more consecutive spontaneous miscarriage after previous viable pregnancy.
Serum amyloid A (SAA) is a family of closely related apo-lipoproteins associated with high density lipoprotein (HDL). Subclasses of SAA isoforms are differentially expressed constitutively and during inflammation.In addition to maternal blood were collected, SAA and CRP reached the maximum maternal serum levels 24 hours after delivery, while cytokines remained constant over time.
Currently, no information is available on maternal SAA levels in early pregnancy loss.
The purpose of this study was to evaluate maternal circulating SAA level in women with RPL by comparing them with healthy control.
In this presentstudy ofserum amyloid A level the first important finding showed a highlysignificant increase(p-value<0.001) in patients with recurrent pregnancy loss collectively when compared with healthy control group.
It is not clear whether elevated SAA level is the direct cause forpregnancy failure or just a marker of underling dysfunction in the innate immune systemthat causes abnormal production of cytokines or growth factors that over-induce SAA synthesis.
Second important finding was serum amyloid A had an excellent discriminating value so can be used as useful markers for those patients with primary unexplained RPL loss due to abnormal innateimmune response or abnormally exaggerated local inflammatory reaction who can be candidates for new therapeutic modalities like gene therapy or immune receptor antagonists.
In study design we find that after adjusting for age and gestational age, serum amyloid A level was an independent predictor for primary unexplained recurrent pregnancy loss (OR, 1.12; 95% CI, 1.06 to 1.19; p-value <0.001).