Gerhard I, von Wendt A, von Holst T, Runnebaum B
Geburtshilfe Frauenheilkd. 1981 Nov;41(11):797-803. doi: 10.1055/s-2008-1036993.
According to several literature surveys women with three consecutive and clinically ascertained spontaneous abortions appear to have without treatment an abortion risk of 50 to 60 per cent in the course of any further pregnancy. For improving prognostication various conditions leading to habitual abortions have to be clarified before the onset of a new pregnancy. Among our patients corpus luteum dysfunctions (35 per cent) and anomalies of the uterus (17 per cent) showed the highest frequency. Our patients also had an increased frequency of pathological spermiograms. Their influence on the incidence of habitual abortions remains, however, unclear. Infectious diseases and metabolic disorders (5 per cent) as well as chromosomal aberrations (6 per cent) appeared to be less frequent. Controversial views on the consequences of blood group incompatibilities of the spouses continue to exist. Conflict-oriented personalities of patients seem to play a major role. After evaluating the findings in literature pertaining to habitual abortions and on the basis of our own results (110 patients) diagnostic and therapeutic guidelines have been worked out. By employment of the individually required therapy 90 per cent of the patients with habitual abortions were able to successfully complete a further pregnancy.
根据多项文献调查,连续三次经临床确诊为自然流产的女性,若不接受治疗,在后续任何一次怀孕过程中出现流产的风险为50%至60%。为改善预后,在开始新一轮妊娠之前,必须明确导致习惯性流产的各种情况。在我们的患者中,黄体功能不全(35%)和子宫异常(17%)出现的频率最高。我们的患者精液分析异常的频率也有所增加。然而,其对习惯性流产发生率的影响仍不明确。传染病和代谢紊乱(5%)以及染色体畸变(6%)的出现频率似乎较低。关于配偶血型不相容后果的观点仍存在争议。患者具有冲突导向型人格似乎起主要作用。在评估了有关习惯性流产的文献研究结果并基于我们自己的研究结果(110例患者)后,制定了诊断和治疗指南。通过采用个体化所需的治疗方法,90%的习惯性流产患者能够成功完成后续妊娠。