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Morphologische Ursachen als Faktor beim habituellen Abort

Morphologic uterine disorders in association with recurrent pregnancy loss

  • Leitthema
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Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Unter den morphologischen Ursachen habitueller Aborte, deren Prävalenz bei 10–15% liegt, stehen an erster Stelle uterine Fehlbildungen. In den meisten Fällen handelt es sich dabei um Reabsorptionsstörungen des Septum uteri. In diesen Fällen ist die hysteroskopisch durchgeführte Metroplastik eine effektive Therapie, die zu einer deutlichen Verbesserung der Schwangerschafts- und Geburtenrate führt. Weitere angeborene Fehlbildungen wie Uterus bicornis, didelphys (duplex) oder unicornis können in der Frühschwangerschaft ebenfalls Probleme verursachen, die meisten Komplikationen betreffen jedoch den geburtshilflichen Bereich. Nicht zuletzt können auch andere morphologische Veränderungen wie cavumnahe Leiomyome des Uterus, Endometriumpolypen oder Synechien im Sinne eines Asherman-Syndroms mit habituellem Abortgeschehen einhergehen. Eine kausale Therapie dieser Fehlbildungen kann die Prognose für nachfolgende Schwangerschaften signifikant verbessern.

Abstract

Morphologic reasons for recurrent pregnancy loss have a prevalence of 10–15%. Congenital uterine anomalies range in first place. A non-reabsorbed uterine septum is the most frequently discovered malformation with a high impact on pregnancy loss. Hysteroscopic metroplasty is an effective procedure, which subsequently improves the obstetrical course. Other malformations such as unicornuate, bicornuate or didelphic uterus are more frequently associated with obstetrical impairment rather than with complications in early pregnancy. Furthermore, acquired uterine malformations distorting the cavum uteri can be associated with pregnancy loss. Implantation at the site of benign tumours such as submucous fibroids or in a cavum uteri malformed by polyps or synechiae of Asherman’s syndrome is often doomed to failure or accompanied by obstetrical complications. Surgical therapy has proven to be beneficial for the obstetrical outcome.

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Authors and Affiliations

  1. Universitätsfrauenklinik Aachen

    M. M. Wölfler & S. Rimbach

  2. Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der RWTH Aachen, Pauwelsstraße 30, 52057 , Aachen

    S. Rimbach

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  1. M. M. Wölfler
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Correspondence to S. Rimbach.

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Wölfler, M.M., Rimbach, S. Morphologische Ursachen als Faktor beim habituellen Abort. Gynäkologische Endokrinologie 3, 18–24 (2005). https://doi.org/10.1007/s10304-004-0097-y

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