Skip to main content

Risikoschwangerschaft, Schwangerschaftserkrankungen und pathologische Geburt

  • Chapter
Die geburtshilfliche Anästhesie

Zusammenfassung

Bei einer Risikoschwangerschaft besteht ein erhöhtes Risiko für das Leben und die Gesundheit von Mutter oder Kind. Ein Großteil der Risikoschwangerschaften ist Folge schwerer mütterlicher Erkrankungen. Genaue Kenntnisse der wechselseitigen Beeinflussung von Schwangerschaft und Erkrankung sind unabdingbar. Es muss geklärt werden, ob das Risiko, eine Schwangerschaft auszutragen, vertretbar ist. Ebenso sollten mögliche Therapienebenwirkungen auf den Fetus eruiert werden, vielfach sind Umstellungen oder Dosisanpassungen bei medikamentösen Therapien notwendig. Bei Risikoschwangerschaften ist es darüber hinaus erforderlich, den Entbindungsmodus, den Entbindungszeitpunkt und die geeignete Entbindungsklinik festzulegen, um für Mutter und Kind die bestmögliche Betreuung zu gewährleisten. Auch bei zuvor unauffälligen Schwangerschaftsverläufen kann es unter der Geburt zu Pathologien kommen, teils mit dramatischen Folgen.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Literatur

  • Abdul Sultan A, West J, Tata LJ et al. (2013) Risk of first venous thromboembolism in pregnant women in hospital: population based cohort study from England. BMJ 347:f6099

    Google Scholar 

  • Aggarwal N, Chopra S, Suri V, Sikka P et al. (2011) Pregnancy outcome in women with autoimmune hepatitis. Arch Gynecol Obstet 284(1):19–23

    Google Scholar 

  • Alsuwaida A, Mousa D, Al-Harbi A et al. (2011) Impact of early chronic kidney disease on maternal and fetal outcomes of pregnancy. J Matern Fetal Neonatal Med 24(12):1432–6

    Google Scholar 

  • Andersgaard AB, Herbst A, Johansen M et al. (2006) Eclampsia in Scandinavia: incidence, substandard care, and potentially preventable cases.Acta Obstet Gynecol Scand 85(8):929–36

    Google Scholar 

  • Antony C, Rossaint R, Schaelte G (2010) Von Willebrand disease: diagnosis and management. Internist 51(9): 1118–1126

    Google Scholar 

  • AQUA-Institut (Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH) (2014) Bundesauswertung zum Erfassungsjahr 2014, https://www.sqg.de/downloads/Bundesauswertungen/2014/bu_Gesamt_16N1-GEBH_2014.pdf. Zugriff: 15.06.2017

  • Arakawa H, Lötvall J, Kawikova I et al. (1993) Leukotriene D4- and prostaglandin F2 alpha-induced airflow obstruction and airway plasma exudation in guinea-pig: role of thromboxane and its receptor. Br J Pharmacol 110(1):127–32

    Google Scholar 

  • Barnes-Powell LL (2007) Infants of diabetic mothers: the effects of hyperglycemia on the fetus and neonate. Neonatal Netw 26(5):283–90

    Google Scholar 

  • Bates SM, Greer IA, Middeldorp S, Veenstra DL et al. (2012) VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141(2 Suppl):e691S–736S

    Google Scholar 

  • Bergmann F, Rath W (2015) Differenzialdiagnose der Thrombozytopenie in der Schwangerschaft. Eine interdisziplinäre Herausforderung. Dtsch Arztebl Int 112: 795–802

    Google Scholar 

  • Callaghan WM, Creanga AA, Jamieson DJ (2015) Pregnancy-related mortality resulting from influenza in the United States during the 2009–2010 pandemic. Obstet Gynecol 126(3):486–90

    Google Scholar 

  • Chan WS, Rey E, Kent NE et al. (2014) Venous thromboembolism and antithrombotic therapy in pregnancy. J Obstet Gynaecol Can 36(6):527–53

    Google Scholar 

  • Chang J, Elam-Evans LD, Berg CJ et al. (2003) Pregnancy-related mortality surveillance – United States, 1991–1999. MMWR Surveill Summ 52(2):1–8

    Google Scholar 

  • Coyle PK (2016) Management of women with multiple sclerosis through pregnancy and after childbirth. Ther Adv Neurol Disord 9(3):198–210

    Google Scholar 

  • Cunningham FG, Leveno KJ, Bloom SL et al. (2014) Williams Obstetrics. 24th ed. McGraw-Hill Education, New-York

    Google Scholar 

  • De Groot L, Abalovich M, Alexander EK et al. (2012) Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 97(8):2543–65

    Google Scholar 

  • Deutsche Diabetes-Gesellschaft (2014) S3-Leitlinie: Diabetes und Schwangerschaft 12/2014. Registernummer 057-023

    Google Scholar 

  • Deutsche Diabetes-Gesellschaft (DDG) und Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) (2011) S3-Leitlinie: Gestationsdiabetes mellitus (GDM). Evidenzbasierte Leitlinie zu Diagnostik, Therapie und Nachsorge. Registernummer 057-008

    Google Scholar 

  • Deutsche Gesellschaft für Angiologie – Gesellschaft für Gefäßmedizin (2015) S2 Leitlinie Venenthrombose und Lungenembolie: Diagnostik und Therapie. Registernummer 065-002

    Google Scholar 

  • Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) (2012) S1-Leitlinie Vaginal-operative Entbindungen

    Google Scholar 

  • Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) (2013) S1-Leitlinie Hypertensive Schwangerschaftserkrankungen: Diagnostik und Therapie. Registernummer 015-018

    Google Scholar 

  • Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin (2016) S3-Leitlinie Behandlung von erwachsenen Patienten mit ambulant erworbener Pneumonie und Prävention – Update 2016. Registernummer 020-020

    Google Scholar 

  • Diedrich K, Holzgreve W, Jonat W et al. (Hrsg.) (2006) Gynäkologie und Geburtshilfe, 2. Aufl. Springer, Berlin Heidelberg New York

    Google Scholar 

  • Dudenhausen JW, Pschyrembel W (2001) Praktische Geburtshilfe mit Geburtshilflichen Operationen, 19. Aufl. Walter de Gruyter, Berlin New York

    Google Scholar 

  • Duley L, Henderson-Smart DJ, Walker GJ et al. (2010) Magnesium sulphate versus diazepam for eclampsia. Cochrane Database Syst Rev 8(12):CD000127

    Google Scholar 

  • Ersbøll AS, Damm P, Gustafsson F et al. (2016) Peripartum cardiomyopathy: a systematic literature review. Acta Obstet Gynecol Scand 95(11):1205–1219

    Google Scholar 

  • European Society of Gynecology (ESG); Association for European Paediatric Cardiology (AEPC); German Society for Gender Medicine (DGesGM) et al. (2011) ESC Guidelines on the management of cardiovascular diseases during pregnancy. European Heart Journal 32: 3147–3197

    Google Scholar 

  • Ferrero S, Esposito F, Biamonti M et al. (2008) Myasthenia gravis during pregnancy. Expert Rev Neurother 8(6):979–88

    Google Scholar 

  • Fishman EB, Connors JM, Camann WR (2009) Anesthetic management of seven deliveries in three sisters with the May-Hegglin anomaly. Anesth Analg 108(5):1603–1605

    Google Scholar 

  • Führer D, Mann K, Feldkamp J et al. (2014) Thyroid dysfunction in pregnancy. Dtsch Med Wochenschr 139(42):2148–52

    Google Scholar 

  • Gernsheimer T, James AH, Stasi R (2013) How I treat thrombocytopenia in pregnancy. Blood 121(1):38–47

    Google Scholar 

  • Gillet D, de Braekeleer M, Bellis G et al. (2002) Cystic fibrosis and pregnancy. Report from French data (1980–1999) BJOG 109(8):912–8

    Google Scholar 

  • Goerke K, Steller J, Valet A (2008) Klinikleitfaden Gynäkologie und Geburtshilfe, 7. Aufl. Elsevier, München

    Google Scholar 

  • Goldenberg RL, Culhane JF, Iams JD et al.(2008) Epidemiology and causes of preterm birth. Lancet 371(9606):75–84

    Google Scholar 

  • HAPO Study Cooperative Research Group et al. (2008) Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 358(19):1991–2002

    Google Scholar 

  • Haram K, Svendsen E, Abildgaard U (2009) The HELLP syndrome: clinical issues and management. A Review. BMC Pregnancy Childbirth 26(9):8

    Google Scholar 

  • Huq FY, Kadir RA (2011) Management of pregnancy, labour and delivery in women with inherited bleeding disorders. Haemophilia 17 Suppl 1:20–30

    Google Scholar 

  • James AH (2009) Venous thromboembolism in pregnancy. Arterioscler Thromb Vasc Biol 29(3):326–31

    Google Scholar 

  • James AH, Jamison MG, Brancazio LR et al. (2006) Venous thromboembolism during pregnancy and the postpartum period: incidence, risk factors, and mortality. Am J Obstet Gynecol 194(5):1311–5

    Google Scholar 

  • Jones DC, Hayslett JP (1996) Outcome of pregnancy in women with moderate or severe renal insufficiency., N Engl J Med 335(4):226–32

    Google Scholar 

  • Kainer F (2016) Facharztwissen Geburtsmedizin, 3. Aufl. Elsevier, München

    Google Scholar 

  • Kamyar M, Varner M (2013) Epilepsy in pregnancy. Clin Obstet Gynecol 56(2):330–41

    Google Scholar 

  • Kc K, Shakya S, Zhang H (2015) Gestational diabetes mellitus and macrosomia: a literature review. Ann Nutr Metab 66 (Suppl 2):14–20

    Google Scholar 

  • Khan K, Wojdyla D, Say L et al. (2006) WHO analysis of causes of maternal death: a systematic review. Lancet 367(9516):1066–74

    Google Scholar 

  • Konstantinides SV, Torbicki A, Agnelli G et al. (2014) ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 35(43) :3033–69

    Google Scholar 

  • Lee CA, Chi C, Pavord SR et al. (2006) The obstetric and gynaecological management of women with inherited bleeding disorders – review with guidelines produced by a taskforce of UK Haemophilia Centre Doctors’ Organization. Haemophilia 12(4):301–36

    Google Scholar 

  • Lipe BC, Dumas MA, Ornstein DL (2011) Von Willebrand disease in pregnancy. Hematol Oncol Clin North Am 25(2):335–58

    Google Scholar 

  • Lison S, Spannagl M. (2014) Perioperatives Management bei Patienten mit Hämophilie. Anaesthesist 63(1):6–15

    Google Scholar 

  • Lockwood C, Wendel G; Committee on Practice Bulletins – Obstetrics. (2011) Inherited thrombophilias in pregnancy. Obstet Gynecol 118(3): 730–740 ( Practice bulletin no. 124)

    Google Scholar 

  • Loustau V, Debouverie O, Canoui-Poitrine F et al. (2014) Effect of pregnancy on the course of immune thrombocytopenia: a retrospective study of 118 pregnancies in 82 women. Br J Haematol 166(6):929–35

    Google Scholar 

  • MacDonald SC, Bateman BT, McElrath TF et al. (2015) Mortality and morbidity during delivery hospitalization among pregnant women with epilepsy in the United States. JAMA Neurol 72(9):981–8

    Google Scholar 

  • Mannucci PM (2001) How I treat patients with von Willebrand disease. Blood 97(7):1915–9

    Google Scholar 

  • Matzdorf A, Eberl W, Giagounidis A, Imbach P et al. (2013) Immunthrombozytpenie (ITP). www.dgho-onkopedia/guidelines/immunthrombozytopenie-itp. Zugriff: 15.06.2017

  • Minerbi-Codish I, Fraser D, Avnun L et al.(1998) Influence of asthma in pregnancy on labor and the newborn. Respiration 65(2):130–5

    Google Scholar 

  • Patel S, Pennell PB (2016) Management of epilepsy during pregnancy: an update. Ther Adv Neurol Disord 9(2): 118–29

    Google Scholar 

  • Pomp ER, Lenselink AM, Rosendaal FR et al. (2008) Pregnancy, the postpartum period and prothrombotic defects: risk of venous thrombosis in the MEGA study. J Thromb Haemost 6(4):632–7

    Google Scholar 

  • Pozzilli C, Pugliatti M (2015) An overview of pregnancy-related issues in patients with multiple sclerosis. Eur J Neurol 22 (Suppl 2):34–9

    Google Scholar 

  • Rath W, Gembruch U, Schmidt S (Hrsg.) (2010) Geburtshilfe und Perinatalmedizin: Pränataldiagnostik – Erkrankungen – Entbindung, 2. Aufl. Thieme, Stuttgart

    Google Scholar 

  • Regitz-Zagrosek V, Gohlke-Bärwolf C, Geibel-Zehender A et al. (2008) Heart diseases in pregnancy. Clin Res Cardiol 97(9):630–665

    Google Scholar 

  • Romero R, Oyarzun E, Mazor M et al. (1989) Meta-analysis of the relationship between asymptomatic bacteriuria and preterm delivery/low birth weight. Obstet Gynecol 73(4):576–582

    Google Scholar 

  • Rosenn B, Miodovnik M, Combs CA et al. (1994) Glycemic thresholds for spontaneous abortion and congenital malformations in insulin-dependent diabetes mellitus. Obstet Gynecol 84(4):515–20

    Google Scholar 

  • Sacks DA, Black MH, Li X et al. (2015) Adverse pregnancy outcomes using the international association of the diabetes and pregnancy study groups criteria: Glycemic thresholds and associated risks. Obstet Gynecol 126(1):67–73

    Google Scholar 

  • Scheepers HC, de Jong PA, Essed GG et al. (2001) Fetal and maternal energy metabolism during labor in relation to the available caloric substrate. J Perinat Med 29(6):457–64

    Google Scholar 

  • Schneider H, Husslein PW, Schneider K (2010) Die Geburtshilfe, 4. Aufl. Springer, Berlin Heidelberg New York

    Google Scholar 

  • Simpson LL (2012) Maternal cardiac disease: update for the clinician. Obstet Gynecol 119(2 Pt 1):345–59

    Google Scholar 

  • Smallridge RC, Glinoer D, Hollowell JG et al. (2005) Thyroid function inside and outside of pregnancy: what do we know and what don’t we know? Thyroid 15(1):54–9

    Google Scholar 

  • Stagnaro-Green A, Abalovich M, Alexander E et al. (2011) Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 21(10):1081–125

    Google Scholar 

  • Stoll BJ, Hansen NI, Bell EF et al.; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (2015) Trends in Care Practices, Morbidity, and Mortality of Extremely Preterm Neonates, 1993–2012. JAMA 314(10):1039–51

    Google Scholar 

  • Strauss A (2006) Geburtshilfe Basics. Springer, Berlin Heidelberg

    Google Scholar 

  • Tan J, Surti B, Saab S (2008) Pregnancy and cirrhosis. Liver Transpl 14(8):1081–91

    Google Scholar 

  • Thompson M, Towers CV, Howard BC et al. (2015) The use of prostaglandin E1 in peripartum patients with asthma. Am J Obstet Gynecol 212(3):392. e1–3

    Google Scholar 

  • Towers CV, Briggs GG, Rojas JA (2004) The use of prostaglandin E2 in pregnant patients with asthma. Am J Obstet Gynecol 190(6):1777–80

    Google Scholar 

  • Varner M (2013) Myasthenia gravis and pregnancy. Clin Obstet Gynecol 56(2):372–81

    Google Scholar 

  • Vatti RR, Teuber SS (2012) Asthma and pregnancy. Clin Rev Allergy Immunol 43(1–2):45–56

    Google Scholar 

  • Widmer M, Villar J, Benigni A et al. (2007) Mapping the theories of preeclampsia and the role of angiogenic factors: a systematic review. Obstet Gynecol 109(1):168–80

    Google Scholar 

  • Wood SL, Jick H, Sauve R (2003) The risk of stillbirth in pregnancies before and after the onset of diabetes. Diabet Med 20(9):703–7

    Google Scholar 

  • Yang J, Cummings EA, O’Connell C et al. (2006) Fetal and neonatal outcomes of diabetic pregnancies. Obstet Gynecol 108(3 Pt 1):644–50

    Google Scholar 

  • Yanit KE, Snowden JM, Cheng YW et al. (2012) The impact of chronic hypertension and pregestational diabetes on pregnancy outcomes. Am J Obstet Gynecol 207(4):333

    Google Scholar 

  • Zhang J, Merialdi M, Platt LD et al. (2010) Defining normal and abnormal fetal growth: promises and challenges. Am J Obstet Gynecol 202(6):522–8

    Google Scholar 

  • Zimmer EZ, Divon MY (1992) Sonographic diagnosis of IUGR-macrosomia. Clin Obstet Gynecol 35(1):172–84

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to M. Papsdorf , A. Wöckel or P. Kranke .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer-Verlag GmbH Deutschland

About this chapter

Cite this chapter

Papsdorf, M., Wöckel, A., Kranke, P. (2017). Risikoschwangerschaft, Schwangerschaftserkrankungen und pathologische Geburt. In: Kranke, P. (eds) Die geburtshilfliche Anästhesie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54375-7_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-54375-7_12

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-54374-0

  • Online ISBN: 978-3-662-54375-7

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics