Habitual abortion
Classification according to ICD-10 | |
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O26.2 | Pregnancy care with a tendency to habitual abortion |
ICD-10 online (WHO version 2019) |
A habitual abortion or a repeated miscarriage is from the third spontaneous miscarriage of an initially unclear cause. Habitual abortions occur in approx. 1% of all couples who wish to have children , with no cause being found in 40% of cases.
Classification
A primary habitual abortion is used in the case of repeated miscarriages without a previous pregnancy, and a secondary habitual abortion in the case of a pregnancy that was carried out before or in between.
causes
Of the many possible reasons for habitual abortions, only parental chromosomal abnormalities (e.g. balanced translocations ), antiphospholipid syndrome as an acquired thrombophilia , uterine malformations and cervical weakness are generally recognized. Other causes include hormonal disorders (hyperprolactinemia, thyroid dysfunction, luteal insufficiency, hyperandrogenemia and polycystic ovary syndrome ), hereditary (e.g. factor V Leiden mutation , prothrombin mutation, protein S deficiency ), autoimmune diseases ( systemic lupus erythematosus ) or infections due to ureaplasma , chlamydia and toxoplasma . Other infectious causes are unlikely. A disturbed interaction between maternal and child tissue is assumed to be a possible explanation for repeated miscarriages.
consequences
Repeated miscarriages are a great burden for both the mother and the treating physician. A third of the women affected experience clinically significant depression , and 20% experience anxiety. What is particularly frustrating is the fact that often no reason for the miscarriage is given and, accordingly, no promising treatment can be offered.
Clarification, therapy
In a antiphospholipid syndrome occurs due to the increased tendency to thrombosis an anticoagulation with acetylsalicylic acid (ASA) and low molecular weight heparins .
In patients with a habitual tendency to abort or premature birth, early total cervical occlusion (ETCO) may significantly increase the chance of keeping a surviving child.
Literature and Sources
- JR Scott: Immunotherapy for recurrent miscarriage. In: Cochrane Database of Systematic Reviews. 2003; 1, p. CD000112.
- K. Shakhar, E. Rosenne, R. Loewenthal, G. Shakhar, H. Carp, S. Ben-Eliyahu: High NK cell activity in recurrent miscarriage: what are we really measuring? In: Human Reproduction . 2006; 21, pp. 2421-2425.
- Individual evidence
- ↑ RM Lee, RM Silver: Recurrent pregnancy loss: summary and clinical recommendations. In: Semin Reprod Med . 2000; 18 (4), pp. 433-440. PMID 11355802
- ↑ Diagnosis and therapy for repeated spontaneous abortions (pdf) AWMF online. December 2013. Archived from the original on December 11, 2015. Info: The archive link was automatically inserted and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved December 26, 2015.
- ^ R. Rai, L. Regan: Recurrent miscarriage. In: Lancet. 2006; 368, pp. 601-611. PMID 16905025
- ↑ M. Dhont: miscarriage Recurrent. In: Curr Womens Health Rep. 2003 Oct; 3 (5), pp. 361-366. PMID 12959693
- ↑ Erich Saling, Monika Schreiber: Formerly total cervical occlusion (FTMV).
Web links
- C. Tempfer: Habitual abortion: diagnosis and prevention. In: Speculum. 19th year, 1/2001. (PDF file; 292 kB)