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Treatment efficacy ...
Treatment efficacy for idiopathic recurrent pregnancy loss - a systematic review and meta-analyses
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- Rasmark Roepke, Emma (författare)
- Lund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Hellgren, Margareta, 1947 (författare)
- Gothenburg University,Göteborgs universitet,University of Gothenburg,Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi,Institute of Clinical Sciences, Department of Obstetrics and Gynecology
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- Hjertberg, Ragnhild (författare)
- Ultragyn AB
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- Blomqvist, Lennart, 1947 (författare)
- South Elfsborg Hospital
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- Matthiesen, Leif (författare)
- Lund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Helsingborg Hospital
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- Henic, Emir (författare)
- Skåne University Hospital
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- Lalitkumar, Sujata (författare)
- Karolinska University Hospital
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- Strandell, Annika, 1956 (författare)
- Gothenburg University,Göteborgs universitet,University of Gothenburg,Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi,Institute of Clinical Sciences, Department of Obstetrics and Gynecology
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(creator_code:org_t)
- 2018-04-26
- 2018
- Engelska.
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 97:8, s. 921-941
- Relaterad länk:
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http://dx.doi.org/10...
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https://obgyn.online...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Introduction: Medical treatment of women with idiopathic recurrent pregnancy loss is controversial. The objective was to assess the effects of different treatments on live birth rates and complications in women with unexplained recurrent pregnancy loss. Material and methods: We searched MEDLINE, Embase and the Cochrane Library, and identified 1415 publications. This systematic review included 21 randomized controlled trials regarding acetylsalicylic acid, low-molecular-weight heparin, progesterone, intravenous immunoglobulin or leukocyte immune therapy in women with three or more consecutive miscarriages of unknown cause. The study quality was assessed and data was extracted independently by at least two authors. Results: No significant difference in live birth rate was found when acetylsalicylic acid was compared with low-molecular-weight heparin or with placebo. Meta-analyses of low-molecular-weight heparin vs. control found no significant differences in live birth rate [risk ratio (RR) 1.47, 95% CI 0.83-2.61]. Treatment with progesterone starting in the luteal phase seemed effective in increasing live birth rate (RR 1.18, 95% CI 1.09-1.27) but not when started after conception. Intravenous immunoglobulin showed no effect on live birth rate compared with placebo (RR 1.07, 95% CI 0.91-1.26). Paternal immunization compared with autologous immunization showed a significant difference in outcome (RR 1.8, 95% CI 1.34-2.41), although the studies were small and at high risk of bias. Conclusion: The literature does not allow advice on any specific treatment for idiopathic recurrent pregnancy loss, with the exception of progesterone starting from ovulation. We suggest that any treatment for recurrent pregnancy loss should be used within the context of a randomized controlled trial.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Nyckelord
- Acetylsalicylic acid
- Corticosteroids
- Intravenous immunoglobulin
- Leukocyte immune therapy
- Low-molecular-weight heparin
- Progesterone
- Recurrent pregnancy loss
- Tender loving care
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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