Document Detail

Evidence-based investigations and treatments of recurrent pregnancy loss.
MedLine Citation:
PMID:  15820784     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To give an overview of currently used investigations and treatments offered to women with recurrent pregnancy loss (RPL) and, from an evidence-based point of view, to evaluate the usefulness of these interventions. DESIGN: Ten experts on epidemiologic, genetic, anatomic, endocrinologic, thrombophilic, immunologic, and immunogenetic aspects of RPL discussed methodologic problems threatening the validity of research in RPL during and after an international workshop on the evidence-based management of RPL. CONCLUSION(S): Most RPL patients have several risk factors for miscarriage, and an extensive investigation for all major factors should always be undertaken. There is an urgent need for agreement concerning the thresholds for detecting what is normal and abnormal, irrespective of whether laboratory tests or uterine abnormalities are concerned. A series of lifestyle factors should be reported in future studies of RPL because they might modify the effect of laboratory or anatomic risk factors. More and larger randomized controlled trials, including trials of surgical procedures, are urgently needed, and to achieve this objective multiple centers have to collaborate. Current meta-analyses evaluating the efficacy of treatments of RPL are generally pooling very heterogeneous patient populations and treatments. It is recommended that future meta-analyses look at subsets of patients and treatment protocols that are more combinable.
Ole B Christiansen; Anne-Marie Nybo Andersen; Ernesto Bosch; Salim Daya; Peter J Delves; Thomas V Hviid; William H Kutteh; Susan M Laird; Tin-Chiu Li; Katrin van der Ven
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Fertility and sterility     Volume:  83     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-04-11     Completed Date:  2005-06-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  821-39     Citation Subset:  IM    
Fertility Clinic 4071, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
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MeSH Terms
Abortion, Habitual / epidemiology,  etiology*,  therapy
Evidence-Based Medicine*
Comment In:
Fertil Steril. 2005 Sep;84(3):813; author reply 813-4   [PMID:  16169434 ]
Fertil Steril. 2006 Mar;85(3):812-3   [PMID:  16500376 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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