评论文章:早期复发性妊娠流产

Hiba Ahmed Suhail
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引用次数: 0

摘要

2%-5%的女性会反复妊娠流产,这对女性健康来说是一个重大问题。子宫畸形、抗磷脂综合征、代谢或内分泌疾病以及染色体异常是经常报告的既定原因。也有人提出了其他病因,如慢性子宫感染、遗传性血栓性疾病、黄体功能不全或男性 DNA 分解率过高,但仍有待商榷。由于采用了循证疗法,包括染色体异常的手术修复、阿司匹林以及抗心磷脂紊乱的抗凝治疗等,反复流产患者的治疗效果不断提高。不过,约有 50%的情况仍未得到解决,因此需要通过雌激素增强、抗凝和/或免疫刺激疗法来有效控制。无论原因如何,反复出现胎儿死亡的夫妇的长期前景都很好,而且大多数人最终都能安全活产。不过,多次流产可能会对患者造成严重的心理影响,目前人们正在进行大量尝试,以加强疗法或缩短成功受孕所需的时间。本文以莫名其妙的反复流产以及目前使用的经验疗法为重点,回顾了公认的或有争议的病因以及建议的治疗方法。此外,文章还介绍了植入前基因筛查在治疗反复流产中的应用。
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Review Article: Early Recurrent Pregnancy Loss
Recurrent pregnancy loss, which affects 2%–5% of individuals, is just a significant concern for women's health. Uterine malformations, antiphospholipid syndrome, metabolic or endocrine diseases, as well as chromosomal abnormalities are among the often reported established reasons. Alternative aetiologies, like chronic uterine infections, hereditary thrombophilias, luteal stage insufficiency, or excessive male DNA disintegration rates, have been put forward yet remain regarded as debatable. The results for individuals who experience recurrent miscarriage had increased throughout time because to evidence-based therapies including surgical repair of chromosomal abnormalities, aspirin as well as anticoagulation in anticardiolipin disorder. About 50% of the instances, though, are still unsolved, so they are managed effectively with estrogen augmentation, anticoagulation, and/or immunostimulatory therapies. Regardless of the reason, couples who experience recurrent fetal death have a favourable long-term outlook and also the majority ultimately has a safe live delivery. Several miscarriages, though, may have a major psychological impact just on afflicted people, and numerous attempts are now being undertaken to enhance therapies or shorten the time it takes to conceive successfully. With an emphasis on inexplicable repeated fetal loss as well as the current usage of empiric therapies, this article reviews the recognised or contentious aetiologies as well as the suggested therapeutic approaches. As well, it covers the present use of pre - implantation genetic screening inside the treatment of repeated miscarriages.
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