Authors:
Manyonda IT. Ugwumadu AHN.
Institution:
I. T. Manyonda, Dept of Obstetrics and Gynaecology, St George's Hospital,
Blackshaw Road, London SW17 0QT; United Kingdom.
Title:
Recurrent spontaneous miscarriage - Current trends and management (1996-1663).
Source:
Contemporary Reviews in Obstetrics and Gynaecology. Vol 8(4) (pp17-222),
1996.
Abstract:
Ideally, the modern preventive treatment of recurrent spontaneous miscarriage (RSM) should encompass the unequivocal identification of the cause, and the administration of therapy of proven efficacy. Such practice of evidence-based medicine is far from reality in RSM. It is convenient to divide the causes of recurrent miscarriage into six broad groups: anatomical, infective, genetic, endocrine, autoimmune and idiopathic, the last accounting for 30-40 per cent of cases. In recent years, it has been speculated that lack or failure of an ill-defined protective alloimmune response might be responsible for the miscarriages in the idiopathic group. It is for this group that the most controversial therapy, leukocyte immunization or immunotherapy, has been advocated and, without a tenable scientific basis and despite lack of clinical evidence for its efficacy, continues to be widely practised. Claims for the efficacy of any therapy for RSM must always be interpreted against a background spontaneous success rate of 40-60 per cent when no specific treatment is given, even after four miscarriages, and especially in the idiopathic group. Thus, on the one hand there is need for caution in interpreting data, while on the other there is good cause for an optimistic approach.
Please click on the required question.
- 1 What is a miscarriage?
- 2 What are the different types of miscarriage?
- 3 How accurate are pregnancy tests?
- 4 What is a blighted ovum?
- 5 I have had a hydatidiform mole. What is this?
- 6 Why did I have a spontaneous miscarriage?
- 7 How frequently do miscarriages occur?
- 8 I am miscarrying. How should this be treated?
- 8a Can miscarriage result in anxiety and depression?
- 9 What is meant by recurrent miscarriage?
- 10 I have a problem with recurrent miscarriage. What is the chance of my next pregnancy being successful?
- Q 12.11 Recurrent Miscarriage I have miscarried again. Why does this keep happening?
- 12 What congenital problems might be associated with recurrent miscarriage and how could they be treated?
- 13 What traumatic conditions can cause recurrent miscarriage and how can they be treated?
- 14 Can infection cause recurrent miscarriage and would treatment help?
- 15 Could a metabolic disorder cause recurrent miscarriage?
- 16 Could a hormonal problem account for recurrent miscarriage and would hormone treatment help me?
- 17 Could an autoimmune problem cause recurrent miscarriage and how could this be treated?
- 18 Could a tumour cause recurrent miscarriage?
- 19 What degenerative processes may be associated with recurrent miscarriage?
- 20 After every miscarriage I become more depressed. Could this account for the problem?
- 21 Is it always possible to explain recurrent miscarriage?
- 22 I have a problem with recurrent miscarriage. What treatment is available to ensure that this does not happen again?
- 23 What is an ectopic pregnancy?
- 24 How frequently do ectopic pregnancies occur?
- 25 Why do ectopic pregnancies occur?
- 26 How can an ectopic pregnancy be diagnosed?
- 27 How can an ectopic pregnancy be treated?
- 28 Where can I obtain more information?
- 29 Support Groups.
Thank you for choosing to visit us.
This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
