Abstract

Ameena S. M. Juma1, * and Shaimma L. Salman

A total of 120 women with spontaneous abortion and 6 women with induced abortion from medical causes were enrolled in this study. Enzyme-linked immunosorbent assay (ELISA) test, for the detection of specific immunoglobulin M (IgM) and immunohistochemistry method for the detection of antigen in tissue were used as diagnostic methods for Toxoplasma gondii. Twenty-six (26) women were found to have Toxoplasma infection by immunohistochemistry (IHC) method, while 23 women were found to have Toxoplasma infection by ELISA method (the same samples that had T. gondii infection by IHC). From the remaining negative cases by IHC, of the 120 cases, 26 women were selected as patient control group. Those patient control cases were matched with those 26 positive by the age and gestational age. Venous blood samples were collected from all patients for the detection of specific anti-Toxoplasma IgM in the serum using the ELISA test. At the same time, trophoblastic tissue during curettage was collected for immunohistochemical analysis for the detection of T.gondii antigen and evaluation of caspase 8. The results obtained indicate a high frequency 19.17% of the infection by ELISA method and 21.67% by immunohistochemistry among women with abortion. This may be due to multiple pathways of parasite exposure and transmission. The sensitivity and specificity of ELISA was 88.46 and 100%, respectively, while the sensitivity and specificity of IHC was 100 and 96.91%, respectively. The frequency of the number of miscarriages was studied. It was observed that within the positive group, the highest percentage of patients was among those who had no previous miscarriages and to a lesser percentage that had a previous single miscarriage. The same result was found within the patient control group, while the entire six control groups had no previous miscarriages. The frequency of gestational weeks during which abortion had occurred was studied. The highest frequency within the positive group was 12 gestational weeks, then, 8 gestational weeks. While the frequency of gestational weeks was between 10-12, within the control group. The highest percentage of caspase 8 was within the positive group for T. gondii then lower than this was within the patient control for T. gondii and the lowest percentage was within the control group. This may indicate that T. gondii infected cells undergo apoptosis more than non-infected cells, while the cells of the control group was with the lowest level of apoptosis because of the absence of apoptotic trigger (for example, T. gondii). The results obtained show that there was a significant difference in the percent of caspase 8 between the positive and control groups. A significant difference in the percent of caspase 8 was also found between the patient control group and the control group, while there was no significant difference in the percent of caspase 8 between the positive and patient control group