Habituelle Abortneigung: Evidenzbasierte Diagnostik und Therapie

 

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Zusammenfassung

Etwa 1–3 % aller Paare mit Kinderwunsch erleiden wiederholte Fehlgeburten. Aufgrund des steigenden mütterlichen Alters bei der ersten Schwangerschaft, insbesondere in Westeuropa, gibt es eine zunehmende Tendenz, bereits Frauen mit 2 Fehlgeburten einer ausführlichen Diagnostik zu unterziehen, obwohl die WHO mindestens 3 aufeinanderfolgende Aborte als rezidivierendes Abortgeschehen definiert. Dabei sollte eine sinnvolle Abklärung primär alle relevanten Abortursachen umfassen, gleichzeitig aber auch kosteneffektiv sein sowie zu evidenzbasierten, therapeutischen Konsequenzen führen. Dies ist insbesondere vor dem Hintergrund der Fülle der vorliegenden aktuellen Daten und möglichen Therapieoptionen von entscheidender Bedeutung. Experimentelle therapeutische Ansätze sollten nur unter Studienbedingungen erprobt werden.

Abstract

About 1–3 % of all couples suffer recurrent miscarriages during their childbearing years. Due to the increase in maternal age at the first pregnancy, especially in Western Europe, there is a tendency to carry an extensive diagnostic work-up after two miscarriages, although the WHO definition of recurrent miscarriage defines it as three or more consecutive pregnancy losses. Causal clarification should primarily focus on possible risk factors for miscarriages while being cost-effective and leading to promising therapeutic consequences. In view of the large number of studies and therapeutic options, an evidence-based concept for diagnostic and therapeutic guidelines on recurrent miscarriages is essential. New treatment strategies need to be confirmed in large randomized placebo-controlled trials.

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Dr. med. Nina Rogenhofer

Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe
Klinikum der Universität München
Campus Großhadern

Marchioninistraße 15

81377 München

Email: nina.rogenhofer@med.uni-muenchen.de