ABORSI PART 2

RECURRENT MISCARRIAGE

a. Definisi
Aborsi yang terjadi tiga kali atau lebih secara berturut-turut pada minggu sebelum 20
minggu atau dengan berat kurang dari sama dengan 500 grams
b. Etiologi
1. Prenatal chromosomal abnormalitiea
2. Anatomical factors
3. Immunological factor
4. Inherited thrombophilias
5. Endocrinological factor
6. Infection
7. Evaluation and management
c. Sign and Symptom
 Vaginal bleeding
 Rasa nyeri
 Cramping
 Terjadi setiap kehmilan
d. Management berdasarkan etiology
1. Prenatal chromosomal abnormalitiea
Implantation genetic counseling
2. Anatomical factors
Septate uterus : hysteroscopic metroplasty
Uterine synechiae : hysteroscopic lysis
Intracavity fibroids : excised
3. Immunological factor
Autoimmune: aspirin 81mg oral sekali sehari dan unfractionated heparin 5000 units SC
dua kali sehari

Alloimmune: Paternal cell immunization, donor leukocyte pihak ketiga, infusi membran
tropoblast, intravenous immunoglobulin
4. Inherited thrombophilias
(-)
5. Endocrinological factor
Progesterone Deficiency: Corpus luteum diremoved lalu dilakukan penggamtian
Progesteron
Polycistic Ovarium : Metformin sebelum dan selama kehamilan
Diabetes Mellitus : Menjaga pola makan dan mengontrol gula darah
Hypothiroidism : TSH screening
6. Infection
(-)
7. Evaluation and management
Paternal karyotyping, uterine cavity evaluation, testing for antiphospolipid antibody
syndrome, dll.