Significance of antinuclear antibody testing in unexplained second and third trimester XXXX .

@entity1 @entity5617
The purpose of this study was to determine if a group of @entity1 with unexplained second or third trimester fetal demise have an increased prevalence of antinuclear antibodies (ANA) when compared to controls. During a 5-year period from January 1989 through December 1993, the records of all @entity5617 > or = 500 g or > or = 20 weeks of gestation that occurred at our institution were reviewed. In these @entity1 the ANA titers were checked at the discretion of the physician. The proportion of positive ANA tests in the group of @entity1 with @entity5617 was compared to that in @entity1 with @entity5617 . These results were then compared to a control group of healthy gravidas presenting to labor and delivery in the third trimester. During this time period, 848 @entity5617 were recorded. Our study population consisted of 286 @entity1 who had an unexplained second or third trimester fetal demise with a record of having an ANA drawn. Of the 376 @entity5617 , 190 had an ANA assayed. The control group included 299 healthy third trimester gravidas. In the group of @entity1 with unexplained @entity5617 , 11.5% (33/286) had a positive ANA, whereas 16% (31/190) of ANA tests were positive in cases of explained @entity5617 (P = 0.17). In the control group, 14% (43/299) had a positive ANA. There were three distinct immunofluorescence patterns: nucleolar, speckled, and homogeneous. The first two were seen more often in the control group, whereas the latter was seen more frequently in those @entity1 with @entity5617 (P = 0.10). The incidence of a significant circulating ANA titer was similar in @entity1 and controls. Moreover, there was no significant association between circulating antinuclear antibody titers and fetal outcome. More @entity1 with a @entity5617 had a homogeneous nuclear fluorescence pattern when compared to controls; however, this finding was not statistically significant. Therefore, we do not recommend routine testing for ANA in @entity1 with unexplained second or third trimester @entity5617 .
