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Yes. Both direct and indirect evidence support this hypothesis. By Michael J. Kupferminc, MD About 15% of all pregnancies end in miscarriage, mainly because of chromosomal abnormalities in the fetus. [...]

Two soluble tumor necrosis factor receptors, p55 and p75, may be present in the blood of pregnant women and in amniotic fluid in the second and third trimesters of pregnancy. Soluble tumor necrosis factor receptors are thought to prevent harmful effects of tumor necrosis factor, such as producing too many diseased cells, which happens in tumors. Tumor necrosis factor may be beneficial during pregnancy as it facilitates growth and control functions related to the fetus and placenta. Researchers analyzed blood samples from 61 healthy pregnant women taken at the time of amniocentesis and at delivery. Concentrations of soluble tumor necrosis factor receptors rose from the second to the third trimester, perhaps to counter the increase in tumor necrosis factor during the same period.

The presence of choroid plexus cysts in the second trimester fetus may be associated with chromosomal abnormalities. A choroid plexus cyst is a type of brain cyst. Amniocentesis is indicated when they are found during ultrasound exam. During a two-year period, 9100 women had second trimester sonograms. One or more choroid plexus cysts were found in 102 (1.1%) fetuses. Four fetuses had multiple congenital anomalies, and three of these had chromosomal anomalies as well. The remaining 98 fetuses appeared normal. Seventy-five of them underwent amniocentesis and chromosomal anomalies were found in four fetuses. The 23 fetuses who had no amniocentesis were all normal at birth. All together, the chromosomal anomaly rate associated with choroid plexus cyst(s) was 1 out of 25. Since this exceeds the 1 in 200 risk of pregnancy loss after amniocentesis as well as the 1 in 126 risk of fetal chromosomal anomaly in a 35-year-old woman, amniocentesis should be offered to women carrying fetuses with choroid plexus cysts.

Immunoreactive tumor necrosis factor-alpha (TNF-alpha) is found in elevated amounts in maternal plasma during the second trimester of pregnancy. TNF-alpha regulates cell growth and proliferation. Fifty-five healthy women undergoing a second trimester amniocentesis had blood drawn as well. Blood was also drawn from 21 healthy women in the third trimester and from 22 healthy nonpregnant women of reproductive age. Blood and amniotic fluid samples were analyzed for TNF-alpha. In the second trimester, TNF-alpha was detected in maternal plasma of 78% of women but not in amniotic fluid. The median concentration was 135 pg/ml (range 0 to 625 pg/ml). Among third trimester women, TNF-alpha was found in the blood serum of 33% of women and the median concentration was 0 pg/ml (range 0 to 110 pg/ml). TNF-alpha was not found in nonpregnant women. During the second trimester, placental blood vessels are invasively growing and proliferating in maternal tissue. TNF-alpha may be helping to regulate this growth.

Tumor necrosis factor-alpha (TNF-alpha) levels may be elevated in the plasma and amniotic fluid of pregnant women with severe preeclampsia. Preeclampsia is a metabolic disorder of late pregnancy marked by high blood pressure, fluid retention, and protein in the urine. TNF-alpha is a cytokine, a chemical messenger involved in immune system regulation. Researchers analyzed blood and amniotic fluid samples from 21 women with severe preeclampsia and 36 healthy pregnant women, 16 of whom were not in labor and 20 of whom were. Plasma and amniotic fluid levels of TNF-alpha were higher in women with preeclampsia than in the comparison group. This finding suggests that abnormal immune system activation may induce preeclampsia, and TNF-alpha may be released to combat the damage produced by preeclampsia. The elevated TNF-alpha levels were not thought to result from infection. TNF-alpha and interleukin-1-beta, another cytokine, have been noted in the plasma and amniotic fluid of women in labor, but they are not usually present before labor and, in this study, were more highly concentrated during labor and elevated before labor.

Life-threatening uterine hemorrhage is responsible for 25 percent of all maternal deaths after the delivery of a pregnancy. It is caused primarily by the failure of the uterus to contract after delivery. Blood loss from such a hemorrhage can be over a liter, causing a dangerous drop in blood pressure. Prompt treatment includes the administration of drugs that promote uterine contraction (oxytocin and ergot therapy), pressure applied directly to the uterus, uterine massage and replacement of lost blood. In cases where these measures are ineffective, removal of the uterus may be necessary. Prostaglandins are hormone-like substances produced by the body naturally, which exert their effect on smooth muscle by stimulating uterine contractions. Injection of prostaglandins into the uterus results in uterine contractions. However, to achieve direct access to the uterus, injections must be given through the abdomen or vagina. To see if bathing the uterine cavity directly with fluid containing prostaglandin E2 is an effective treatment, 22 patients with postpartum hemorrhages not responding to conventional therapy were studied. Patients were given continuous prostaglandin infusions using a small tube inserted into the uterus. In all 22 cases, uterine contractions were achieved and bleeding was stopped within minutes of prostaglandin infusion. None of the patients experienced any side effects. Infusing the uterine cavity with prostaglandin E2 produced dramatic response in women with postpartum hemorrhage. (Consumer Summary produced by Reliance Medical Information, Inc.)