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Residiverende spontanaborter

Sist revidert:
Sist revidert av:
Definisjon:
Residiverende spontanaborter er tre eller flere påfølgende spontanaborter før 20. svangerskapsuke, med samme partner. Årsaken er multifaktoriell
Forekomst:
Tilstanden rammer rundt 1% av alle par
Symptomer:
Spontanaborter i 1. eller 2. trimester
Funn:
Graviditetstap/blødning i 1. eller 2. trimester
Diagnostikk:
Ingen spesielle tester eller prøver er påkrevet
Behandling:
Psykologisk støtte. Vanligvis ingen medikamentell behandling, unntatt ved underliggende antifosfolipidsyndrom
  1. Oldereid NB, Kierulf KH, Myklebust I, Renden M. Habituell abort - gjentatte spontanaborter. Norsk gynekologisk forening. Veileder i gynekologi 2015. legeforeningen.no  
  2. European Society of Human Reproduction and Embryology. Recurrent pregnancy loss. Guideline of the European Society of Human Reproduction and Embryology. ESHRE. Nov 2017. legeforeningen.no  
  3. Krog MC, Kolte AM, Husby K et al. Gentagne graviditetstab. Ugeskr Læger 2017;179:V11160834 Ugeskrift for Læger  
  4. Lund M, Kamper-Jørgensen M, Nielsen HS et al. Prognosis for livebirth in women with recurrent miscarriage: what is the best measure of success? Obstet Gynecol 2012;119:37-43. PubMed  
  5. Alfirevic Z, Stampalija T, Medley N. Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy. Cochrane Database of Systematic Reviews 2017, Issue 6. Art. No.: CD008991. The Cochrane Library  
  6. Rai R, Regan L. Recurrent miscarriage. Lancet 2006; 368: 601-11. PubMed  
  7. Brocklehurst P, Gordon A, Heatley E, Milan SJ. Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No.: CD000262. DOI: 10.1002/14651858.CD000262.pub4. DOI  
  8. Al-Biate MA. Effect of metformin on early pregnancy loss in women with polycystic ovary syndrome. Taiwan J Obstet Gynecol. 2015 Jun;54(3):266-9. PubMed  
  9. Hamulyák EN, Scheres LJJ, Marijnen MC, et al. Aspirin or heparin or both for improving pregnancy outcomes in women with persistent antiphospholipid antibodies and recurrent pregnancy loss. Cochrane Database of Systematic Reviews 2020, Issue 5. Art. No.: CD012852. The Cochrane Library  
  10. Kovalevsky G, Gracia CR, Berlin JA, Sammel MD and Barnhart KT. Evaluation of the association between hereditary thrombophilias and recurrent pregnancy loss: a meta-analysis. Arch Intern Med 2004; 164: 558-63. PubMed  
  11. Christiansen OB, Steffensen R, Nielsen HS, Varming K. Multifactorial etiology of recurrent miscarriage and its scientific and clinical implications.. Gynecol Obstet Invest 2008; 66: 257-67. PubMed  
  12. Sundermann AC, Velez Edwards DR, Slaughter JC, et al. Week-by-week alcohol consumption in early pregnancy and spontaneous abortion risk: a prospective cohort study. Am J Obstet Gynecol. 2021;224(1):97.e1-97.e16. PMID: 32673615. PubMed  
  13. Hu X, Miao M, Bai Y, Cheng N, Ren X. Reproductive Factors and Risk of Spontaneous Abortion in the Jinchang Cohort. Int J Environ Res Public Health. 2018 Nov 2;15(11):2444. PMID: 30400160 PubMed  
  14. Hahn KA, Wise LA, Rothman KJ et al.. Caffeine and caffeinated beverage consumption and risk of spontaneous abortion. Hum Reprod 2015; 30: 1246-55. pmid:25788567 PubMed  
  15. Cavalcante MB, Sarno M, Peixoto AB, Araujo Júnior E, Barini R. Obesity and recurrent miscarriage: A systematic review and meta-analysis. J Obstet Gynaecol Res. 2019 Jan;45(1):30-38. Epub 2018 Aug 28. PMID: 30156037.
  16. Practice Committee of American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss: a committee opinion. Fertil Steril. 2013;99:63. PubMed  
  17. Haas DM, Ramsey PS. Progestogen for preventing miscarriage. Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD003511. DOI: 10.1002/14651858.CD003511.pub3. DOI  
  18. Coomarasamy A, Williams H, Truchanowicz E, et al. PROMISE: first-trimester progesterone therapy in women with a history of unexplained recurrent miscarriages - a randomised, double-blind, placebo-controlled, international multicentre trial and economic evaluation. Health Technol Assess. 2016; 20:1-92. PMID: 27225013 PubMed  
  19. Kaandorp SP, et al. Aspirin plus heparin or aspirin alone in women with recurrent miscarriage. N Engl J Med 2010; 362: 1586. New England Journal of Medicine  
  20. Schisterman EF, Silver RM, Lesher LL, et al. Preconception low-dose aspirin and pregnancy outcomes: results from the EAGeR randomised trial . Lancet 2014; 384: 29-36. doi:10.1016/S0140-6736(14)60157-4 DOI  
  21. Ahrens KA, Silver RM, Mumford SL, et al. Complications and Safety of Preconception Low-Dose Aspirin Among Women With Prior Pregnancy Losses. Obstet Gynecol 2016; 127: 689-98. pmid:26959198 PubMed  
  22. Lockwood CJ, Lockshin MD. Antiphospholipid syndrome: Pregnancy implications and management in pregnant women. UpToDate, last updated Feb 24, 2021. UpToDate  
  23. Lockwood CJ, Bauer KA. Inherited thrombophilias in pregnancy. UpToDate, last updated Mar 31, 2020. UpToDate  
  24. Badawy AM, Khiary M, Sherif LS, Hassan M, Ragab A, Abdelall I. Low-molecular weight heparin in patients with recurrent early miscarriages of unknown aetiology.. J Obstet Gynaecol 2008; 28: 280-4. PubMed  
  25. Larsen EC, Christiansen OB. Årsager, udredning og behandling af abortus habitualis. Ugeskr Læger 2012; 174: 2448. Ugeskrift for Læger  
  26. Jivraj S, Anstrie B, Cheong YC et al. Obstetric and neonatal outcome in women with a history of recurrent miscarriage: a cohort study. Hum Reprod 2011;16:102-6. PubMed  
  • Ingard Løge, spesialist allmennmedisin, redaktør NEL