Objective: The asymptomatic colonization of the urinary tract in pregnant women may result in severe medical and obstetric complications. The aim of this study was to study the prevalence of asymptomatic bacteriuria in cases of elevated levels of the anticardiolipin antibody in women who experience spontaneous abortions. Materials and Methods:A total of 12 women were enrolled in this case control study, including 60 patients with a history of three or more abortions and 60 healthy pregnant women. All participants were screened for ACL (IgG) and with a urine culture. Results:Overall, 19 (31.7%) patients and seven (11.7%) healthy pregnant women were positive for ACL. The mean concentrations were 67.1±27.2 IU/mL in the patients and 17.41±6.12 IU/mL in the healthy controls (p≤0.05). In the 60 patients, only 17 (28.3%) had significant bacteriuria, whereas 5 (8.3%) women in the control group had significant bacteriuria. The statistical analysis revealed a highly significant difference. Of the 19 patients with a positive elevation of ACL, 11 (57.9%) had significant bacteriuria, and eight (42.1%) had non-significant bacteriuria. Six patients had ACL-negative results associated with significant bacteriuria. The statistical analysis revealed a highly significant difference. Conclusion:A high serum anticardiolipin level was prevalent in women who experienced recurrent abortions associated with asymptomatic bacteriuria.Key Words: Abortion, Anticardiolipin, Asymptomatic bacteriuria Özet Amaç: Gebe kadınlarda idrar yolu asemptomatik kolonizasyonu ciddi tıbbi ve obstetrik komplikasyonlara neden olabilir. Bu çalışmanın amacı kendiliğinden düşük yapan kadınlarda antikardiyolipin antikor düzeylerinin artması durumunda asemptomatik bakteriüri prevalansını araştırmaktır. Gereç ve Yöntem:Bu vaka kontrollü çalışmaya 12 kadın dahil edildi. Geçmiş düşükleri üç ve daha fazla olan 60 ve sağlıklı 60 gebe çalış-maya dahil edildi. Tüm ACL (IgG) ve idrar kültürü açısından tarandı. Bulgular:Tüm hastaların 19'unda (%31.7) ve yedi (%11.7) sağlıklı gebede ACL pozitifti. Ortalama konsantrasyonlar hastalarda 67.1±27.2 IU/mL, sağlıklı kontrollerde 17.41±6.12 IU/mL olarak tespit edildi. 60 hastadan sadece 17 hastada (%28.3) anlamlı bakteriüri varken sağlıklı kontrollerde 5 kişi (%8.3) anlamlı bakteriüri bulunmaktaydı. İstatistik-sel analiz ile oldukça anlamlı fark olduğunu saptanmıştır. 19 hastanın 11'inde (%57.9) ACL'nin pozitif bir elevasyonu varken sekiz hastada (%42.1) anlamlı olmayan bakteriüri olduğu tespit edildi. Altı hastada ACL negatif sonuç ile ilişkili anlamlı bakteriüri mevcuttu.Sonuç: Asemptomatik bakteriüri ile ilişkili tekrarlayan düşüklü kadın-larda yüksek serum antikardiyolipin düzeyi yaygın idi.

Background: Accumulating body of evidence suggests a role for the complement system in the etiology of abortion. Objectives: To evaluate levels of complements (C3, C4) in cases of abortion with or without circulating antiphospholipid (APL) and anticardiolipin (ACL) autoantibodies. Patients and Methods: A total of 103 women were enrolled in this case controlled study including 73 patients with a history of three or more abortion and 30 healthy parous women. For all, ACL, APL, C3, C4 levels were estimated. Results: The means and ranges of circulating complements (C3, C4) were as follows [C3 level: (90 ± 9; 39-115 mg/dl versus 109±16;95-138 mg/dl) in patients and controls respectively; C4 level: (18±10; 11-25 mg/dl; versus 36±7; 23-39 mg/dl) in patients and controls respectively]. The differences in the means between patients and controls were highly significant (p ≤ 0.01). In the patients' group, according to the mean, the range of C4, C3 and the elevation of both ACL and APL, three subgroups (A, B, C) were recognizable. Group A included 21 aborting women with high levels of ACL and APL. Their complement levels (mean ± S.D; range) were as follows:[C3: (59.7±11.6; 39-65 mg/dl); C4: (14.7±5.2; 11-16 mg/dl)]. Group B included 34 aborting women with normal levels of ACL & APL. Their complement levels (mean ± S.D, range) were as follows: [C3: (88.6±19.3; 59-90 mg/dl ) and C4:(18.4±7.3; 15-21 mg/dl)]. Group C included 18 aborting women with normal levels of AC & APL and their complement levels (mean ± S.D; range) were as follows:[C3: (102.7± 15.1; 90-115 mg/dl) and C4: (21.4 ± 5.8; 17-25 mg/dl)]. The differences between the means of C3 in these subgroups were highly significant (p < 0.01), while the differences between the means of C4 between B and C were not significant. Conclusion: Low C3 & C4 levels were detected in recurrent aborting women with or without autoantibodies (APL & ACL). These data may suggest a role for these complements in the pathogenesis of recurrent pregnancy loss.

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