Asthma drug could prevent miscarriages

A common treatment for asthma could help prevent women having recurrent miscarriages.

A common treatment for asthma could help prevent women having recurrent miscarriages.

British researchers have found that the steroid prednisolone can destroy certain cells that appear to be linked to miscarriage. The £1-a-week drug is a breakthrough in an area where doctors still have little knowledge of why some women can become pregnant, but then lose their baby.

There are currently no treatments or preventative therapies for miscarriage.

Two women in an early study have had babies following the treatment, and another three are pregnant and considered out of the risk period for miscarriage.

The findings were presented at the annual conference of the European Society of Human Reproduction and Embryology in Copenhagen yesterday.

Women who suffer three miscarriages in a row are considered to have a recurrent problem. Two per cent of all women of reproductive age are affected.

Dr Siobhan Quenby, of the Department of Developmental and Reproductive Medicine at the University of Liverpool, studied 29 women, some of whom had suffered as many as 33 miscarriages. All the women had higher than average numbers of so-called uterine natural killer (uNK) cells. The cells are found in the uterus and in the deciduas, the special lining the uterus develops during pregnancy.

They are also very close to the outermost cells of the early embryo, suggesting that they play a role in the way that some women miscarry. The uNKs have steroid hormone receptors on their surface, indicating that they may be sensitive to steroids.

On average, 14 per cent of the cells in the endometriums of the women in the study were found to be uNKs, compared to five per cent in the normal population. Some had as much as 72 per cent.

The women were asked to take prednisolone tablets for three weeks. Afterwards they had an average of nine per cent uNK cells, and the researchers believe the rates could fall even further.

Dr Quenby said: "This is very exciting, but the research is still at an early stage and I now need to conduct a large-scale trial. Recurrent miscarriage is awful - these women get a positive pregnancy test, are very happy and then lose their baby time after time after time. In 50 per cent of cases, we simply don't know the cause of it. The doctors feel frustrated because we can't find a cause and the patients feel that it is not acceptable that we can't tell them why they are losing a baby over and over again."

One advantage of the treatment is that, as it is already widely used for treating conditions such as asthma and eczema, it is considered a safe drug.

'After the fourth, I felt something was absolutely wrong with me'

Ruth Hirst had miscarried five times in two and a half years before she saw a mother on a daytime TV show who gave her a glimmer of hope.

The woman, on Richard and Judy, had had a similar number of miscarriages but had a successful pregnancy after being treated for raised uterine NK cells, an immunology disorder. Mrs Hirst, 42, a midwife with three children, tracked down the specialist - Dr Siobhan Quenby, at Liverpool University's Department of Developmental and Reproductive Medicine.

"I had always wanted four children. After the fourth miscarriage I felt something was absolutely wrong with me. Before that I'd just felt I was unlucky," she said.

After a biopsy last year, Mrs Hirst, who lives in Huddersfield, took the steroid prednisolone, which can destroy cells that may be linked to miscarriage. The number of uterine NK cells fell. "I had always wanted four children and I was desperate. I felt I had a good chance when they found that my uterine NK cells had reduced," she said. After three months of taking the steroid, she gave birth to Harry - on 4 June.

"I feel convinced that if I had not had the treatment, I would not have had Harry," Mrs Hirst said.

Arifa Akbar