Recurrent miscarriage

To a habitual abortion or a miscarriage is repeated after the third miscarriage initially unknown cause. Habitual abortions occur in approximately 1 % of all couples wishing to have children, whereby can not find the cause in 40 % of cases.

Classification

From a primary habitual abortion is Repeated miscarriage without previous term pregnancy, from a secondary habitual abortion at a before or in between spoken term pregnancy.

Causes

Of the many possible reasons for recurrent abortion only parental chromosome abnormalities (eg balanced translocations ), the antiphospholipid syndrome generally recognized as an acquired thrombophilia, uterine malformations and a Zervixschwäche. As other causes hormonal imbalances ( hyperprolactinemia, thyroid dysfunction, luteal insufficiency, hyperandrogenism and questionable, the polycystic ovary syndrome ), congenital (eg factor V Leiden mutation, prothrombin mutation, protein S deficiency ), autoimmune diseases ( systemic lupus erythematosus ) or infections caused by ureaplasma, chlamydia and Toxoplasma specified. Other infectious causes are unlikely. As a possible explanation of repeated miscarriages also a disturbed interaction is adopted by the maternal and filial tissues.

Follow

Repeated miscarriages provide for both the mother and the doctors a substantial burden in one third of the women concerned, there is a clinically significant depression in 20% to anxiety. Frustrating is in particular the fact that often do not specify a reason for the miscarriage and, accordingly, no promising treatment can be offered.

Investigation, treatment

In antiphospholipid syndrome due to increased propensity to thrombosis occurs anticoagulation with acetylsalicylic acid ( ASA) and low molecular weight heparins.

In patients with habitual abortion or premature birth slope of the early total cervix occlusion ( ETCO ) potentially may increase the chance to keep one surviving child, clearly.

Literature and sources

• Scott JR. Immunotherapy for recurrent miscarriage. Cochrane Database of Systematic Reviews 2003; 1: CD000112.
• Shakhar K, Rosenne E, Loewenthal R, Shakhar G, Carp H, Ben- Eliyahu S. High NK cell activity in recurrent miscarriage: what are we really measuring? Human Reproduction 2006; 21: 2421-2425.