Student.
Associate Professor, School of Medical and Life Sciences/Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China.
Obstet Gynecol Surv. 2022 Jun;77(6):355-366. doi: 10.1097/OGX.0000000000001033.
Recurrent spontaneous abortion (RSA) is a distressing condition experienced by approximately 1% of women trying to conceive. However, the treatment of RSA is a challenge both for clinicians and patients.
The aim of this review is to discuss the medical and surgical approach to the management of RSA, including those caused by anatomical, genetic, male, infectious, endocrine, and immune factors.
A literature search using MeSH terms for each topic was undertaken using PubMed, supplemented by hand searching for additional references. Retrieved articles were reviewed, synthesized, and summarized.
Available treatments target hypothetical risk factors for RSA, although the effectiveness of many treatment options is controversial. Intervention should depend on the benefit-to-risk ratio of the proposed treatment.
The etiology of RSA is heterogeneous, and patients often lack specific clinical manifestations, which has hindered the progress in predicting and preventing RSA to some extent. Despite intensive workup, at least 50% of couples do not have a clear underlying pathology. In addition, an evidence-based treatment is not available in most patients even if abnormal test results are present. Many new treatment directions are also still actively exploring; empirical and combined multiple treatments are still the main methods.
复发性自然流产（RSA）是约 1%试图怀孕的女性经历的一种令人痛苦的情况。然而，RSA 的治疗对临床医生和患者都是一个挑战。
本综述旨在讨论 RSA 管理的医学和手术方法，包括由解剖学、遗传、男性、感染、内分泌和免疫因素引起的 RSA。
使用 PubMed 中的 MeSH 术语对每个主题进行了文献检索，并通过手工搜索补充了其他参考文献。对检索到的文章进行了审查、综合和总结。
现有的治疗方法针对 RSA 的假设风险因素，但许多治疗方案的有效性存在争议。干预措施应取决于拟议治疗的获益与风险比。
RSA 的病因是异质的，患者通常缺乏特定的临床表现，这在一定程度上阻碍了 RSA 的预测和预防的进展。尽管进行了深入的检查，但至少有 50%的夫妇没有明确的潜在病理。此外，即使存在异常的检查结果，大多数患者也没有基于证据的治疗方法。许多新的治疗方向也在积极探索中；经验性和联合多种治疗方法仍然是主要方法。
