Goddijn M, van den Boogaard E, Steepers E A P, Erwich J J H M, Macklon N S, Land J A, Ankum W M
Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Verloskunde en Gynaecologie, Amsterdam.
Ned Tijdschr Geneeskd. 2008 Jul 26;152(30):1665-70.
--In 2007, the Dutch Society for Obstetrics and Gynaecology issued a revised version of the 1999 guideline on recurrent miscarriage. --The new guideline was developed according to the principles of evidence-based guideline development and includes levels of evidence. --The guideline contains recommendations for effective diagnosis and treatment and explicitly mentions certain diagnostic tests and treatments that should be avoided. --After a thorough investigation of a couples'-history, the type of diagnostic tests that should be offered to the couple can be determined. Patients with a low risk of having cytogenetic abnormalities or thrombophilia may be excluded from parental karyotyping and thrombophilia screening, respectively. --Women with confirmed antiphospholipid antibody syndrome should be offered anticoagulation treatment before and during subsequent pregnancies. --Effective therapy for unexplained recurrent miscarriage is lacking. However, the probability of a successful future pregnancy is high. This probability can be estimated based on the number of previous miscarriages and maternal age.
2007年,荷兰妇产科学会发布了1999年复发性流产指南的修订版。新指南是根据循证指南制定原则制定的,包括证据等级。该指南包含有效诊断和治疗的建议,并明确提及了某些应避免的诊断测试和治疗方法。在对夫妇病史进行全面调查后,可以确定应向夫妇提供的诊断测试类型。细胞遗传学异常或血栓形成倾向风险较低的患者可分别不进行父母染色体核型分析和血栓形成倾向筛查。确诊为抗磷脂抗体综合征的女性在随后的妊娠前和妊娠期间应接受抗凝治疗。目前缺乏针对不明原因复发性流产的有效治疗方法。然而,未来成功妊娠的概率很高。这一概率可根据既往流产次数和产妇年龄进行估算。