頁籤選單縮合
題 名 | Diagnosis and Treatment of Recurrent Pregnancy Loss |
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作 者 | Coulam,Carolyn B.; | 書刊名 | 中華民國婦產科醫學會會刊雜誌 |
卷 期 | 37:4 1998.12[民87.12] |
頁 次 | 頁115-126 |
分類號 | 417.421 |
關鍵詞 | 重覆性自然流產; Recurrent spontaneous abortion; Antiphospholipid antibody; Antinuclear antibody; Antithyroid antibody; Reproductive autoimmune failure syndrome; |
語 文 | 英文(English) |
英文摘要 | Recurrent pregnancy loss is a health care concern occurring in approximately 7500 couples each day worldwide. Effective treatment is needed for these couples. Before effective treatment can be instituted, the cause of pregnancy loss must be determined. Results of recent research have provided insights into the causes of pregnancy loss. While anatomic and hormonal factors have been previously reported to contribute to recurrent pregnancy loss, genetic and immunologic factors have data supporting their roles in the mechanisms of pregnancy loss. Chromosomal abnormalities are present in 60% of abortuses from women with a history of recurrent spontaneous abortion. Compared to a control group, abortuses with documented aneuploidy are reported to occur more frequently in couple experiencing recurrent spontaneous abortion. Thus, karyotype analysis of the aborted tissue should be considered in all couples with recurrent spontaneous abortion. Prognostic information for subsequent pregnancies and assessment of treatment efficacy can be determined. Tests available to direct an approach to prevention of loss of a karyotypically normal pregnancy include antiphospholipid, antinuclear and antithyroid antibodies as well as quantitation of circulating CD56+ cells and assays for the detection of circulating embryotoxins. Various forms to treat reproductive autoimmune failure syndrome (RAFS) have included aspirin, heparin, glucocorticoids, intravenous (IV) immunoglobulin (Ig), all four or combinations of two or three. IVIg and leukocyte immunization therapies have been successful in the treatment of women experiencing recurrent spontaneous abortion without evidence of RAFS. IVIg has also been used to treat peri-implantation as well as post-implantation losses with significant enhancement of pregnancy rates. The continual clinical challenge is to appropriately identify and treat each individual patient experiencing recurrent pregnancy loss. |
本系統中英文摘要資訊取自各篇刊載內容。