Increased plasma adrenomedullin in women with recurrent pregnancy loss

OBJECTIVE: To evaluate vascular changes and uterine perfusion in women with recurrent pregnancy loss. METHODS: We measured plasma levels of adrenomedullin of 100 pregnant women in the midluteal phase of a nonpregnant cycle (control group: n = 62; recurrent pregnancy loss group: n = 38). We measured the pulsatility index (PI) in the uterine arteries by transvaginal pulsed Doppler ultrasonography at the same time. RESULTS: The plasma level of adrenomedullin in women with recurrent pregnancy loss (5.6 ± 1.9, mean ± standard deviation) was significantly higher (P > .001) than that in control women (3.6 ± 1.7). Uterine arterial PI of women with recurrent pregnancy loss (2.70 ± 0.47) was significantly higher (P > .001) than that in control women (2.09 ± 0.39). Plasma level of adrenomedullin had a significant positive correlation with uterine arterial PI both in the control group (r = .58, P < .001) and in the recurrent pregnancy loss group (r = .78, P < .001). Both plasma adrenomedullin concentration (7.2 ± 2.3) and uterine arterial PI (3.06 ± 0.36) were significantly high in women with antiphospholipid antibodies. CONCLUSION: Plasma adrenomedullin may serve as a useful biochemical marker for recurrent pregnancy loss caused by impaired uterine perfusion.