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[No consensus on the definition, diagnosis and treatment of habitual abortion in the Netherlands]
M Goddijn1, F van der Veen, W M Ankum
1Afd. Verloskunde en Gynaecologie, Academisch Medisch Centrum, Amsterdam.
Objective:
To review the current policy in diagnosis and treatment of recurrent miscarriage in the Netherlands.
Design:
Cross-sectional survey.
Method:
A printed questionnaire was sent in 1996 to all 125 departments of gynaecology in the Netherlands with questions about definition, investigation and therapy of recurrent miscarriage.
Results:
The response rate was 90% (n = 112). Twenty-nine per cent of the respondents defined recurrent miscarriage as having two or more abortions and 71% as three or more abortions. In 42% of the departments a diagnostic protocol for recurrent miscarriage was present. Diagnostic investigations most frequently performed were vaginal ultrasound (79%), parental chromosome analysis (78%), thyroid-stimulating hormone (72%), lupus anticoagulant (69%), blood glucose (65%), hysterosalpingography (56%) and anticardiolipin antibodies (IgG, IgM) (56%). Therapy most frequently applied was prescription of folic acid (53%).
Conclusion:
The definition of recurrent miscarriage differed. Uncertainty about a rational diagnostic approach was evident from the large number of tests requested by 20-50% of the respondents. Some diagnostic tests like immunological investigation and search for infectious factors were not followed by a therapeutical intervention.
