반복 유산의 평가

Evaluation of Couples with Recurrent Pregnancy Loss

Evaluation of Couples with Recurrent Pregnancy Loss

Etiology Diagnostic Evaluation Abnormal Therapy Genetic Karyotype partners 3–5% Genetic counseling, donor gametes Anatomic Hysterosalpingography Hysteroscopy Sonohysterography Magnetic resonance imaging 15–20% Septum transection, myomectomy, adhesiolysis, metroplasty Endocrinologic Midluteal progesterone 8–12% Progesterone   Thyroid-stimulating hormone   Levothyroxine   Prolactin   Dopamine agonists   Fasting insulin:glucose   Metformin Immunologic Lupus anticoagulant, antiphospholipid antibodies 15–20% Heparin + aspirin Microbiologic Cervical cultures 5–10% Antibiotics Thrombophilia Antithrombin III, protein C or S deficiency; factor V Leiden or prothrombin mutation 8–12% Heparin + aspirin, low-molecular-weightheparin   Hyperhomocysteinemia   Folic acid Psychological Interview Questionnaire Varies Support groups, counseling Toxic Tobacco, alcohol use 5% Behavior changes   Exposure to toxins, chemicals   Eliminate exposur