THE MANAGEMENT OF RECURRENT MISCARRIAGE TOWARD THE UNDERLYING CAUSE WITH A TREATABLE ETIOLOGY OR PATHOPHYSIOLOGY

Arsana Wiyasa, Muhamad Nofa Cholili
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Abstract

Miscarriage occurs when the fetus is unable to survive outside the womb and the results of conception are expelled. Although the issue of RPL is still controversial, current information about the suggested treatment offers effective treatment to improve reproductive quality and can provide appropriate therapy in a woman with RPL based on the etiology. The time restriction until the fetus is pronounced viable or capable of surviving outside the womb varies by country. According to the World Health Organization, over 21.6 million abortions occurred worldwide in 2008, with almost all of these cases occur in developing countries. The risk of miscarriage increases most significantly at the age of 35 years. Women aged 35 years have twice the risk of miscarriage compared to women aged < 35 years. Antiphospholipid syndrome is a risk factor for recurrent miscarriage, which occurs in about 15% of patients. The reason of recurrent miscarriage can be linked to both fetal and maternal factors. Diagnostic examinations are not recommended in patients with recurrent miscarriage unless certain criteria are met. However, screening can be used to identify risk factors. The management of recurrent miscarriage should be addressed toward the underlying cause with a treatable etiology or pathophysiology.      
复发性流产的管理与可治疗的病因或病理生理学的根本原因
当胎儿不能在子宫外存活,受孕的结果被排出时,就会发生流产。虽然RPL的问题仍然存在争议,但目前关于建议治疗的信息提供了有效的治疗方法来提高生殖质量,并可以根据病因为患有RPL的女性提供适当的治疗。胎儿能在子宫外存活的时间限制因国家而异。据世界卫生组织统计,2008年全世界发生了2 160多万例堕胎,几乎所有这些案例都发生在发展中国家。流产的风险在35岁时显著增加。35岁的妇女流产的风险是35岁以下妇女的两倍。抗磷脂综合征是复发性流产的危险因素,约有15%的患者发生。反复流产的原因可能与胎儿和母体因素有关。除非符合某些标准,复发性流产患者不建议进行诊断性检查。然而,筛查可以用来识别危险因素。复发性流产的管理应针对潜在的原因与可治疗的病因或病理生理学。
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