[Differential diagnostic considerations in the assessment of habitual abortion]

The nonviability of fertilized eggs or the death of the embryo is a frequent event (34 to 60%). They are called recurrent or habitual in the case of more than 2 consecutive abortions. Maternal etiologic factors are discussed: Endocrine disorders (sexual hormones, diabetes, thyroid function), uterine congenital anomalies (septale uterus), uterine tumors (fibromyoma) and uterine synechia formation, cervical incompetence, infections (i.e. mycoplasma infections, chlamydia infection, cytomegalovirus, herpes simplex virus) and autoimmune-disease with antinuclear antibodies. According to the etiology the diagnostic procedures in cases of recurrent abortions consist of hormone analysis, basal body temperature, oral glucose tolerance test, thyroid function and endometrial biopsy. Sonographic examination of the uterus, hysterosalpingography, search for local and systemic infections and cytologic examination for genetic disorders of both parents are obligatory. At the end of the diagnostic scheme HLA-analysis of the parents must be included.