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Abstract

Diagnostic work-up and preventive strategies in couples with a history of previous recurrent spontaneous abortion

Recurrent miscarriage is rather a syndrome than a distinct disease entity. Diagnostic evaluation is usually appropriate after a history of three previous miscarriages. There is a strong correlation between the risk of miscarriage and maternal age and the number of previous miscarriages. It is suggested to run a standardized diagnostic workup including karyotyping of both partners, vaginal endosonography and hysteroscopy, endocrine evaluation, screening of hereditary and acquired thrombophilia, evaluation of antiphospholipid antibody, homocystein levels and screening for chlamydial infection. Possible treatment options include resection of uterine septum, cerclage, myomectomy, treatment of ovulatory defects and of hyperprolaktinemia, administration of progesterone and of thyroxin and anticoagulation with low molecular weight heparin and aspirin. The rationale for the use of immunotherapy and immunomodulation is broadly discussed.

CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol 2013; 9(1): 38–58

Keywords
Recurrent spontaneous abortion, epidemiology, screening, prevention, immunotherapy

Emese Balogh1, Thomas Steck2
1 Frauenklinik des Klinikums Passau, Passau
2 Kinderwunsch Zentrum Mainz, Mainz
Reviewer: Arvind Chandra, Bad Münder,
und Ulrich Knuth, Hamburg

Steck T. Diagnostische ... Gynakol Geburtsmed Gynakol Endokrinol 2013; 9(1): 38–58 publiziert 31.03.2013 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2013 ISSN 1614-8533