Skip to main content

2014 | OriginalPaper | Buchkapitel

32. Vorgehen bei wiederholten Fehlgeburten

verfasst von : L.-M. Wallwiener, B. Toth

Erschienen in: Perikonzeptionelle Frauenheilkunde

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Das Auftreten von rezidivierenden Aborten (“recurrend spontaneous abortion”, RSA) betrifft etwa 1–3 % aller Paare im reproduktionsfähigen Alter.
Literatur
Zurück zum Zitat Abalovich M, Gutierrez S, Alcaraz G, Maccallini G, Garcia A, Levalle O (2002) Overt and subclinical hypothyroidism complicating pregnancy. Thyroid 12: 63–8PubMedCrossRef Abalovich M, Gutierrez S, Alcaraz G, Maccallini G, Garcia A, Levalle O (2002) Overt and subclinical hypothyroidism complicating pregnancy. Thyroid 12: 63–8PubMedCrossRef
Zurück zum Zitat Bellver J, Meseguer M, Muriel L, Garcia-Herrero S, Barreto MA, Garda AL et al. (2010) Y chromosome microdeletions, sperm DNA fragmentation and sperm oxidative stress as causes of recurrent spontaneous abortion of unknown etiology. Hum Reprod 25: 1713–21PubMedCrossRef Bellver J, Meseguer M, Muriel L, Garcia-Herrero S, Barreto MA, Garda AL et al. (2010) Y chromosome microdeletions, sperm DNA fragmentation and sperm oxidative stress as causes of recurrent spontaneous abortion of unknown etiology. Hum Reprod 25: 1713–21PubMedCrossRef
Zurück zum Zitat Branch W (2011) Report of the Obstetric APS Task Force: 13th International Congress on Antiphospholipid Antibodies, 13th April 2010. Lupus 20: 158–64PubMedCrossRef Branch W (2011) Report of the Obstetric APS Task Force: 13th International Congress on Antiphospholipid Antibodies, 13th April 2010. Lupus 20: 158–64PubMedCrossRef
Zurück zum Zitat Christiansen OB, Pedersen B, Rosgaard A, Husth M (2002) A randomized, double-blind, placebo-controlled trial of intravenous immunoglobulin in the prevention of recurrent miscarriage: evidence for a therapeutic effect in women with secondary recurrent miscarriage. Hum Reprod 17: 809–16PubMedCrossRef Christiansen OB, Pedersen B, Rosgaard A, Husth M (2002) A randomized, double-blind, placebo-controlled trial of intravenous immunoglobulin in the prevention of recurrent miscarriage: evidence for a therapeutic effect in women with secondary recurrent miscarriage. Hum Reprod 17: 809–16PubMedCrossRef
Zurück zum Zitat Clark P, Walker ID, Langhorne P, Crichton L, Thomson A, Greaves M et al. (2010) SPIN (Scottish Pregnancy Intervention) study: a multicenter, randomized controlled trial of low-molecular-weight heparin and low-dose aspirin in women with recurrent miscarriage. Blood 115: 4162–7PubMedCrossRef Clark P, Walker ID, Langhorne P, Crichton L, Thomson A, Greaves M et al. (2010) SPIN (Scottish Pregnancy Intervention) study: a multicenter, randomized controlled trial of low-molecular-weight heparin and low-dose aspirin in women with recurrent miscarriage. Blood 115: 4162–7PubMedCrossRef
Zurück zum Zitat Debbs RH, Chen J (2009) Contemporary use of cerclage in pregnancy. Clin Obstet Gynecol 52: 597–610PubMedCrossRef Debbs RH, Chen J (2009) Contemporary use of cerclage in pregnancy. Clin Obstet Gynecol 52: 597–610PubMedCrossRef
Zurück zum Zitat Fertl KI, Bergner A, Beyer R, Klapp BF, Rauchfuss M (2009) Levels and effects of different forms of anxiety during pregnancy after a prior miscarriage. Eur J Obstet Gynecol Reprod Biol 142: 23–9PubMedCrossRef Fertl KI, Bergner A, Beyer R, Klapp BF, Rauchfuss M (2009) Levels and effects of different forms of anxiety during pregnancy after a prior miscarriage. Eur J Obstet Gynecol Reprod Biol 142: 23–9PubMedCrossRef
Zurück zum Zitat Franssen MT, Korevaar JC, Leschot NJ, Bossuyt PM, Knegt AC, Gerssen-Schoorl KB et al. (2005) Selective chromosome analysis in couples with two or more miscarriages: case-control study. BMJ 331: 137–41PubMedCrossRef Franssen MT, Korevaar JC, Leschot NJ, Bossuyt PM, Knegt AC, Gerssen-Schoorl KB et al. (2005) Selective chromosome analysis in couples with two or more miscarriages: case-control study. BMJ 331: 137–41PubMedCrossRef
Zurück zum Zitat Glueck CJ, Wang P, Goldenberg N, Sieve-Smith L (2002) Pregnancy outcomes among women with polycystic ovary syndrome treated with metformin. Hum Reprod 17: 2858–64PubMedCrossRef Glueck CJ, Wang P, Goldenberg N, Sieve-Smith L (2002) Pregnancy outcomes among women with polycystic ovary syndrome treated with metformin. Hum Reprod 17: 2858–64PubMedCrossRef
Zurück zum Zitat Hutton B, Sharma R, Fergusson D et al. (2007) Use of intravenous immunoglobulin for treatment of recurrent miscarriage: a systematic review. BJOG 114 (2): 134–142PubMedCrossRef Hutton B, Sharma R, Fergusson D et al. (2007) Use of intravenous immunoglobulin for treatment of recurrent miscarriage: a systematic review. BJOG 114 (2): 134–142PubMedCrossRef
Zurück zum Zitat Inkster ME, Fahey TP, Donnan PT, Leese GP, Mires GJ, Murphy DJ (2009) The role of modifiable pre-pregnancy risk factors in preventing adverse fetal outcomes among women with type 1 and type 2 diabetes. Acta Obstet Gynecol Scand 88: 1153–7PubMedCrossRef Inkster ME, Fahey TP, Donnan PT, Leese GP, Mires GJ, Murphy DJ (2009) The role of modifiable pre-pregnancy risk factors in preventing adverse fetal outcomes among women with type 1 and type 2 diabetes. Acta Obstet Gynecol Scand 88: 1153–7PubMedCrossRef
Zurück zum Zitat Ishikawa S, Cheung MO, Gilbert EF, Bruyere HJ Jr (1979) Acetylsalicylic acid-induced morphological changes in the ductus arteriosus of the chick embryo. Experientia 35: 92–3PubMedCrossRef Ishikawa S, Cheung MO, Gilbert EF, Bruyere HJ Jr (1979) Acetylsalicylic acid-induced morphological changes in the ductus arteriosus of the chick embryo. Experientia 35: 92–3PubMedCrossRef
Zurück zum Zitat Jakubowicz DJ, Iuorno MJ, Jakubowicz S, Roberts KA, Nestler JE (2002) Effects of metformin on early pregnancy loss in the polycystic ovary syndrome. J Clin Endocrinol Metab 87: 524–9PubMedCrossRef Jakubowicz DJ, Iuorno MJ, Jakubowicz S, Roberts KA, Nestler JE (2002) Effects of metformin on early pregnancy loss in the polycystic ovary syndrome. J Clin Endocrinol Metab 87: 524–9PubMedCrossRef
Zurück zum Zitat James AH, Brancazio LR, Price T (2008) Aspirin and reproductive outcomes. Obstet Gynecol Surv 63: 49–57PubMedCrossRef James AH, Brancazio LR, Price T (2008) Aspirin and reproductive outcomes. Obstet Gynecol Surv 63: 49–57PubMedCrossRef
Zurück zum Zitat Kaandorp SP, Goddijn M, van der Post JA, Hutten BA, Verhoeve HR, Hamulyak K et al. (2010) Aspirin plus heparin or aspirin alone in women with recurrent miscarriage. N Engl J Med 362: 1586–96PubMedCrossRef Kaandorp SP, Goddijn M, van der Post JA, Hutten BA, Verhoeve HR, Hamulyak K et al. (2010) Aspirin plus heparin or aspirin alone in women with recurrent miscarriage. N Engl J Med 362: 1586–96PubMedCrossRef
Zurück zum Zitat Kitaya K, Yasuo T (2011) Immunohistochemistrical and clinicopathological characterization of chronic endometritis. Am J Reprod Immunol 66: 410–5PubMedCrossRef Kitaya K, Yasuo T (2011) Immunohistochemistrical and clinicopathological characterization of chronic endometritis. Am J Reprod Immunol 66: 410–5PubMedCrossRef
Zurück zum Zitat Kwak-Kim JY, Chung-Bang HS, Ng SC, Ntrivalas EI, Mangubat CP, Beaman KD et al. (2003) Increased T helper 1 cytokine responses by circulating T cells are present in women with recurrent pregnancy losses and in infertile women with multiple implantation failures after IVF. Hum Reprod 18: 767–73PubMedCrossRef Kwak-Kim JY, Chung-Bang HS, Ng SC, Ntrivalas EI, Mangubat CP, Beaman KD et al. (2003) Increased T helper 1 cytokine responses by circulating T cells are present in women with recurrent pregnancy losses and in infertile women with multiple implantation failures after IVF. Hum Reprod 18: 767–73PubMedCrossRef
Zurück zum Zitat Laskin CA, Spitzer KA, Clark CA, Crowther MR, Ginsberg JS, Hawker GA et al. (2009) Low molecular weight heparin and aspirin for recurrent pregnancy loss: results from the randomized, controlled HepASA Trial. J Rheumatol 36: 279–87PubMedCrossRef Laskin CA, Spitzer KA, Clark CA, Crowther MR, Ginsberg JS, Hawker GA et al. (2009) Low molecular weight heparin and aspirin for recurrent pregnancy loss: results from the randomized, controlled HepASA Trial. J Rheumatol 36: 279–87PubMedCrossRef
Zurück zum Zitat Laughlin SK, Baird DD, Savitz DA, Herring AH, Hartmann KE (2009) Prevalence of uterine leiomyomas in the first trimester of pregnancy: an ultrasound-screening study. Obstet Gynecol 113: 630–5PubMed Laughlin SK, Baird DD, Savitz DA, Herring AH, Hartmann KE (2009) Prevalence of uterine leiomyomas in the first trimester of pregnancy: an ultrasound-screening study. Obstet Gynecol 113: 630–5PubMed
Zurück zum Zitat Laurino MY, Bennett RL, Saraiya DS, Baumeister L, Doyle DL, Leppig K et al. (2005) Genetic evaluation and counseling of couples with recurrent miscarriage: recommendations of the National Society of Genetic Counselors. J Genet Couns 14: 165–81PubMedCrossRef Laurino MY, Bennett RL, Saraiya DS, Baumeister L, Doyle DL, Leppig K et al. (2005) Genetic evaluation and counseling of couples with recurrent miscarriage: recommendations of the National Society of Genetic Counselors. J Genet Couns 14: 165–81PubMedCrossRef
Zurück zum Zitat Leong H, Stachnik J, Bonk ME, Matuszewski KA (2008) Unlabeled uses of intravenous immune globulin. Am J Health Syst Pharm 65: 1815–24PubMedCrossRef Leong H, Stachnik J, Bonk ME, Matuszewski KA (2008) Unlabeled uses of intravenous immune globulin. Am J Health Syst Pharm 65: 1815–24PubMedCrossRef
Zurück zum Zitat Makrigiannakis A, Petsas G, Toth B, Relakis K, Jeschke U (2011) Recent advances in understanding immunology of reproductive failure. J Reprod Immunol 90: 96–104PubMedCrossRef Makrigiannakis A, Petsas G, Toth B, Relakis K, Jeschke U (2011) Recent advances in understanding immunology of reproductive failure. J Reprod Immunol 90: 96–104PubMedCrossRef
Zurück zum Zitat Musters AM, Repping S, Korevaar JC, Mastenbroek S, Limpens J, van der Veen F et al. (2011) Pregnancy outcome after preimplantation genetic screening or natural conception in couples with unexplained recurrent miscarriage: a systematic review of the best available evidence. Fertil Steril 95: 2153–7, 7 e1–3PubMedCrossRef Musters AM, Repping S, Korevaar JC, Mastenbroek S, Limpens J, van der Veen F et al. (2011) Pregnancy outcome after preimplantation genetic screening or natural conception in couples with unexplained recurrent miscarriage: a systematic review of the best available evidence. Fertil Steril 95: 2153–7, 7 e1–3PubMedCrossRef
Zurück zum Zitat Ng SC, Gilman-Sachs A, Thaker P, Beaman KD, Beer AE, Kwak-Kim J (2002) Expression of intracellular Th1 and Th2 cytokines in women with recurrent spontaneous abortion, implantation failures after IVF/ET or normal pregnancy. Am J Reprod Immunol 48: 77–86PubMedCrossRef Ng SC, Gilman-Sachs A, Thaker P, Beaman KD, Beer AE, Kwak-Kim J (2002) Expression of intracellular Th1 and Th2 cytokines in women with recurrent spontaneous abortion, implantation failures after IVF/ET or normal pregnancy. Am J Reprod Immunol 48: 77–86PubMedCrossRef
Zurück zum Zitat Nigro G, Mazzocco M, Mattia E, Di Renzo GC, Carta G, Anceschi MM (2011) Role of the infections in recurrent spontaneous abortion. J Matern Fetal Neonatal Med 24: 983–9PubMedCrossRef Nigro G, Mazzocco M, Mattia E, Di Renzo GC, Carta G, Anceschi MM (2011) Role of the infections in recurrent spontaneous abortion. J Matern Fetal Neonatal Med 24: 983–9PubMedCrossRef
Zurück zum Zitat Nonaka T, Takakuwa K, Ooki I, Akashi M, Yokoo T, Kikuchi A et al. (2007) Results of immunotherapy for patients with unexplained primary recurrent abortions–prospective non-randomized cohort study. Am J Reprod Immunol 58: 530–6PubMedCrossRef Nonaka T, Takakuwa K, Ooki I, Akashi M, Yokoo T, Kikuchi A et al. (2007) Results of immunotherapy for patients with unexplained primary recurrent abortions–prospective non-randomized cohort study. Am J Reprod Immunol 58: 530–6PubMedCrossRef
Zurück zum Zitat Ouzounian S, Bringer-Deutsch S, Jablonski C, Theron-Gerard L, Snaifer E, Cedrin-Durnerin I et al. (2007) Hypothyroidism: from the desire for pregnancy to delivery. Gynecol Obstet Fertil 35: 240–8PubMedCrossRef Ouzounian S, Bringer-Deutsch S, Jablonski C, Theron-Gerard L, Snaifer E, Cedrin-Durnerin I et al. (2007) Hypothyroidism: from the desire for pregnancy to delivery. Gynecol Obstet Fertil 35: 240–8PubMedCrossRef
Zurück zum Zitat Porter TF, La Coursiere Y, Scott JR (2006) Immunotherapy for recurrent miscarriage. Cochrane Database of systematic reviews 2, Art. No.: CD000112. DOI: 10.1002/14651858.CD000112.pub2 Porter TF, La Coursiere Y, Scott JR (2006) Immunotherapy for recurrent miscarriage. Cochrane Database of systematic reviews 2, Art. No.: CD000112. DOI: 10.1002/14651858.CD000112.pub2
Zurück zum Zitat Rodger MA, Paidas M, McLintock C, Middeldorp S, Kahn S, Martinelli I et al. (2008) Inherited thrombophilia and pregnancy complications revisited. Obstet Gynecol 112: 320–4PubMedCrossRef Rodger MA, Paidas M, McLintock C, Middeldorp S, Kahn S, Martinelli I et al. (2008) Inherited thrombophilia and pregnancy complications revisited. Obstet Gynecol 112: 320–4PubMedCrossRef
Zurück zum Zitat Saravelos SH, Yan J, Rehmani H, Li TC (2011) The prevalence and impact of fibroids and their treatment on the outcome of pregnancy in women with recurrent miscarriage. Hum Reprod 26: 3274–9PubMedCrossRef Saravelos SH, Yan J, Rehmani H, Li TC (2011) The prevalence and impact of fibroids and their treatment on the outcome of pregnancy in women with recurrent miscarriage. Hum Reprod 26: 3274–9PubMedCrossRef
Zurück zum Zitat Scarpellini F, Sbracia M (2009) Use of granulocyte colony-stimulating factor for the treatment of unexplained recurrent miscarriage: a randomised controlled trial. Hum Reprod 24: 2703–8PubMedCrossRef Scarpellini F, Sbracia M (2009) Use of granulocyte colony-stimulating factor for the treatment of unexplained recurrent miscarriage: a randomised controlled trial. Hum Reprod 24: 2703–8PubMedCrossRef
Zurück zum Zitat Scott JR (2003) Immunotherapy for recurrent miscarriage. Cochrane Database Syst Rev CD000112 Scott JR (2003) Immunotherapy for recurrent miscarriage. Cochrane Database Syst Rev CD000112
Zurück zum Zitat Shamsi MB, Venkatesh S, Pathak D, Deka D, Dada R (2011) Sperm DNA damage & oxidative stress in recurrent spontaneous abortion (RSA). Indian J Med Res 133: 550–1PubMed Shamsi MB, Venkatesh S, Pathak D, Deka D, Dada R (2011) Sperm DNA damage & oxidative stress in recurrent spontaneous abortion (RSA). Indian J Med Res 133: 550–1PubMed
Zurück zum Zitat Shapiro S, Siskind V, Monson RR, Heinonen OP, Kaufman DW, Slone D (1976) Perinatal mortality and birth-weight in relation to aspirin taken during pregnancy. Lancet 1: 1375–6PubMedCrossRef Shapiro S, Siskind V, Monson RR, Heinonen OP, Kaufman DW, Slone D (1976) Perinatal mortality and birth-weight in relation to aspirin taken during pregnancy. Lancet 1: 1375–6PubMedCrossRef
Zurück zum Zitat Shokeir TA (2005) Hysteroscopic management in submucous fibroids to improve fertility. Arch Gynecol Obstet 273: 50–4PubMedCrossRef Shokeir TA (2005) Hysteroscopic management in submucous fibroids to improve fertility. Arch Gynecol Obstet 273: 50–4PubMedCrossRef
Zurück zum Zitat Stephenson MD, Kutteh WH, Purkiss S, Librach C, Schultz P, Houlihan E et al. (2010) Intravenous immunoglobulin and idiopathic secondary recurrent miscarriage: a multicentered randomized placebo-controlled trial. Hum Reprod 25: 2203–9PubMedCrossRef Stephenson MD, Kutteh WH, Purkiss S, Librach C, Schultz P, Houlihan E et al. (2010) Intravenous immunoglobulin and idiopathic secondary recurrent miscarriage: a multicentered randomized placebo-controlled trial. Hum Reprod 25: 2203–9PubMedCrossRef
Zurück zum Zitat Stray-Pedersen B, Stray-Pedersen S (1984) Etiologic factors and subsequent reproductive performance in 195 couples with a prior history of habitual abortion. Am J Obstet Gynecol 148: 140–6PubMedCrossRef Stray-Pedersen B, Stray-Pedersen S (1984) Etiologic factors and subsequent reproductive performance in 195 couples with a prior history of habitual abortion. Am J Obstet Gynecol 148: 140–6PubMedCrossRef
Zurück zum Zitat Takizawa T, Ikeda Y, Kawahata M, Togashi H, Yamamoto M, Arishima K et al. (1998) Increased ductal responsiveness to PGE2 after maternal treatment with aspirin and ibuprofen. J Vet Med Sci 60: 377–9PubMedCrossRef Takizawa T, Ikeda Y, Kawahata M, Togashi H, Yamamoto M, Arishima K et al. (1998) Increased ductal responsiveness to PGE2 after maternal treatment with aspirin and ibuprofen. J Vet Med Sci 60: 377–9PubMedCrossRef
Zurück zum Zitat Ticconi C, Giuliani E, Veglia M, Pietropolli A, Piccione E, Di Simone N (2011) Thyroid autoimmunity and recurrent miscarriage. Am J Reprod Immunol 66: 452–9PubMedCrossRef Ticconi C, Giuliani E, Veglia M, Pietropolli A, Piccione E, Di Simone N (2011) Thyroid autoimmunity and recurrent miscarriage. Am J Reprod Immunol 66: 452–9PubMedCrossRef
Zurück zum Zitat Toth B, Jeschke U, Rogenhofer N, Scholz C, Wurfel W, Thaler CJ et al. (2010) Recurrent miscarriage: current concepts in diagnosis and treatment. J Reprod Immunol 85: 25–32PubMedCrossRef Toth B, Jeschke U, Rogenhofer N, Scholz C, Wurfel W, Thaler CJ et al. (2010) Recurrent miscarriage: current concepts in diagnosis and treatment. J Reprod Immunol 85: 25–32PubMedCrossRef
Zurück zum Zitat Toth B, Wurfel W, Germeyer A, Hirv K, Makrigiannakis A, Strowitzki T (2011) Disorders of implantation–are there diagnostic and therapeutic options? J Reprod Immunol 90: 117–23PubMedCrossRef Toth B, Wurfel W, Germeyer A, Hirv K, Makrigiannakis A, Strowitzki T (2011) Disorders of implantation–are there diagnostic and therapeutic options? J Reprod Immunol 90: 117–23PubMedCrossRef
Zurück zum Zitat Visser J, Ulander VM, Helmerhorst FM, Lampinen K, Morin-Papunen L, Bloemenkamp KW et al. (2011) Thromboprophylaxis for recurrent miscarriage in women with or without thrombophilia. HABENOX: a randomised multicentre trial. Thromb Haemost 105: 295–301PubMedCrossRef Visser J, Ulander VM, Helmerhorst FM, Lampinen K, Morin-Papunen L, Bloemenkamp KW et al. (2011) Thromboprophylaxis for recurrent miscarriage in women with or without thrombophilia. HABENOX: a randomised multicentre trial. Thromb Haemost 105: 295–301PubMedCrossRef
Zurück zum Zitat Winger EE, Reed JL (2008) Treatment with tumor necrosis factor inhibitors and intravenous immunoglobulin improves live birth rates in women with recurrent spontaneous abortion. Am J Reprod Immunol 60: 8–16PubMedCrossRef Winger EE, Reed JL (2008) Treatment with tumor necrosis factor inhibitors and intravenous immunoglobulin improves live birth rates in women with recurrent spontaneous abortion. Am J Reprod Immunol 60: 8–16PubMedCrossRef
Metadaten
Titel
Vorgehen bei wiederholten Fehlgeburten
verfasst von
L.-M. Wallwiener
B. Toth
Copyright-Jahr
2014
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-642-38023-5_32

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.