HIgh Cytokines 2nd/3rd trimester

louisa

9 Posts
Reply Posted on: Oct 21, 2012 at 5:56am
Hello,

I sent a post but I think it maybe got lost,
I was hoping you could explain a little about cytokines after the 1st trimester.

As testing isn't done normally at your clinic after 12 weeks - how do you know if the levels stay ok once medications are stopped?

As you normally only monitor the first part, do you find that if cytokines have been managed during this time ( and presumably stayed within range), are any rises later not longer an issue? (miscarriage/possible Autism link) And if not, why?

Thank you Dr Braverman

Dr. Braverman

1998 Posts
RE: HIgh Cytokines 2nd/3rd trimester Posted on: Oct 25, 2012 at 10:10am
Those are very good questions. The current thinking is that the immune attack against the placenta has its contribution to recurrent miscarriage by preventing adequate implantation which is complete by the end of the first trimester. It is the reason we discontinue most therapy at that point. Once the cells that are producting these cytokines are diminished so will the overall production of cytokines later in the pregnancy in our opinion. Rarely have these levels been monitored late into the pregancy , some will treat them if found but there is no data on the benefit of that and we have been successful with only first trimester treatment. There is some data coming out about affects of the high levels of certain inflammatory cytokines in the second trimester with fetal develpment but there is still much work to be done on this. Also data showing that many of the inflammatory cytokines dont cross the placenta once you start the third trimester, so cleary treatment (if neceassay after adequate first trimester management) does not appear to be important past the second trimester.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.