Thrombophile Gerinnungsstörungen als Risikofaktoren für habituelle Aborte

Recurrent spontaneous abortions - three or more consecutive miscarriages of the same couple - are traditionally associated with genetic, anatomic, immunologic, endocrine, and questionable infectious factors. However, there is growing evidence that changes in the haemostaseologic maternal pathway may play a role in the development of pregnancy complications. Maternal thrombophilic disorders, whether hereditary or acquired, can be associated with a significantly elevated risk for miscarriage. Besides hereditary changes of the coagulation system (e.g. factor V Leiden mutation, prothrombin mutation, protein S deficiency), it is the acquired thrombophilic disorder of the antiphospholipid syndrome that especially symbolizes a major risk factor for recurrent miscarriages; however, it can be treated adequately with combination anticoagulant therapy. This review summarizes the current knowledge concerning the diagnosis and therapeutic options in patients with recurrent abortions and maternal thrombophilic disorders.