Pildner von Steinburg S, Schneider KTM |
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Recurrent Spontaneous Abortions- An Update on Diagnosis and Management Journal für Reproduktionsmedizin und Endokrinologie - Journal of Reproductive Medicine and Endocrinology 2009; 6 (1): 11-16 Volltext (PDF) Summary Praxisrelevanz - Recurrent spontaneous abortions have to be considered as a multi-causal condition, with genetic fetal or parental chromosomal abnormalities, anatomic, infectious, endocrine, immunologic, and thrombophilic factors playing a role in its etiology. - If diagnostic testing suggests infectious or endocrine etiology, specific treatment should be applied; surgical procedures may be offered for uterine anomalies. - Patients with antiphospholipid syndrome should receive a combination of heparin and aspirin, patients with inherited thrombophilia in the majority of cases heparin, although evidence is incomplete. - For RSA of unknown etiology, heparin is suggested to be effective, randomised studies are still in progress; dedicated care may beneficially influence pregnancy outcomes as well. - However, independent of the therapeutic management offered, the overall miscarriage rate cannot decrease. |