Aktuelles zur rationellen Diagnostik und Therapie habitueller Frühaborte

 

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Zusammenfassung

Habituelle Frühaborte, also mehr als zwei aufeinander folgende Fehlgeburten, betreffen etwa 1 - 2 % aller Partnerschaften. Traditionell werden chromosomale, anatomische, hämostaseologische, endokrine, autoimmunologische, infektionsbedingte sowie fraglich alloimmunologische Pathologien mit solchen habituellen Frühaborten assoziiert; jedoch wird bei fast 50 % der untersuchten Paare keine zugrunde liegende Abortursache gefunden. Die vorliegende Übersichtsarbeit soll einerseits Ansatzpunkte zur rationellen Diagnostik bei Paaren mit wiederholten Fehlgeburten liefern, zum anderen sollen verschiedene, zum Teil sehr umstrittene Therapieansätze auf dem Hintergrund aktueller Studien und Metaanalysen kritisch diskutiert werden.

Abstract

Recurrent early miscarriage, defined as more than two consecutive spontaneous abortions, affects 1 - 2 % of all couples. Traditionally, chromosomal, anatomic, hemostaseologic, endocrine, autoimmunologic, infectious and -hypothetically-alloimmunologic pathologies have been associated with recurrent abortion. However, in up to 50 % of cases, the underlying pathology remains unclear. It is the aim of this review to enhance the efficiency in the diagnosis of recurrent miscarriages. Furthermore, therapeutic options, including questionable methods, will be critically discussed on the basis of the latest studies and meta-analyses.

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Michael K. Bohlmann

Universitäts-Frauenklinik

Calwer Straße 7

72076 Tübingen

Email: michael.bohlmann@med.uni-tuebingen.de