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Schwangerschafts- und Geburtsrisiken

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Die geburtshilfliche Anästhesie

Zusammenfassung

Trotz aller Anstrengungen, die weltweite mütterliche Mortalitätsrate nachhaltig zu senken, stieg diese 2015 laut WHO wieder leicht an. Weiterhin sterben weltweit täglich über 830 Frauen an schwangerschafts- oder geburtsassoziierten Komplikationen, wobei die überwiegende Zahl der Fälle vermeidbar wäre. Verschiedene Projekte haben sich bisher mit der Erfassung mütterlicher Mortalität und Morbidität im Rahmen der Narkose beschäftigt. Laut Centers for Disease Control and Prevention (CDC) betrug der anästhesiebedingte Anteil im Jahr 2015 0,7% aller mütterlichen Sterbefälle. Während die Anzahl der unmittelbar anästhesiebedingten Todesfälle in den Confidential Enquiry into Maternal Deaths (CEMD) seit 1985 abgenommen hat, blieb die Zahl der anästhesieassoziierten Todesfälle auf einem nahezu unveränderten Niveau. Atemwegsprobleme sowie die Aspiration von Mageninhalt hatten zuletzt insgesamt weniger fatale klinische Endergebnisse zur Folge.

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Literatur

  • Acosta CD, Kurinczuk JJ, Lucas DN et al. (2014) Severe maternal sepsis in the UK, 2011–2012: a national case-control study. PLoS Medicine 11:e1001672

    Google Scholar 

  • Alkema L, Chou D, Hogan D et al. (2015) Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. The Lancet 387 (10017): 462–474

    Google Scholar 

  • ASA (2016) Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology 124:270–300

    Google Scholar 

  • Bateman BT, Berman MF, Riley LE et al. (2010) The epidemiology of postpartum hemorrhage in a large, nationwide sample of deliveries. Anesthesia and Analgesia 110: 1368–1373

    Google Scholar 

  • Bose P, Regan F, Paterson-Brown S (2006) Improving the accuracy of estimated blood loss at obstetric haemorrhage using clinical reconstructions. BJOG 113:919–924

    Google Scholar 

  • Bundesinstitut Für Bevölkerungsforschung (2015) Glossareintrag »Müttersterblichkeit«. http://www.bib-demografie.de/SharedDocs/Glossareintraege/DE/M/muettersterblichkeit.html. Zugriff: 11.12.2015

  • Callaghan WM, Kuklina EV, Berg CJ (2010) Trends in postpartum hemorrhage: United States, 1994–2006. American Journal of Obstetrics and Gynecology 202:353.e351–356

    Google Scholar 

  • Creanga AA, Berg CJ, Ko JY et al. (2014) Maternal mortality and morbidity in the United States: where are we now? Journal of Women’s Health (2002) 23:3–9

    Google Scholar 

  • Crofts JF, Draycott TJ, Winter C et al. (2007) Change in knowledge of midwives and obstetricians following obstetric emergency training: a randomised controlled trial of local hospital, simulation centre and teamwork training. BJOG: an International Journal of Obstetrics and Gynaecology 114:1534–1541

    Google Scholar 

  • D’Angelo R, Smiley RM, Riley ET et al. (2014) Serious complications related to obstetric anesthesia: the serious complication repository project of the Society for Obstetric Anesthesia and Perinatology. Anesthesiology 120:1505–1512

    Google Scholar 

  • Davies JM, Posner KL, Lee LA et al. (2009) Liability associated with obstetric anesthesia: a closed claims analysis. Anesthesiology 110:131–139

    Google Scholar 

  • DGGG, DGAI, BDA et al. (2016) Zur Frage der postoperativen Überwachung von Kaiserschnittpatientinnen. Anästh Intensivmed 57:47–50

    Google Scholar 

  • Drife J (2005) Why mothers die. J R Coll Physicians Edinb 35:332–336

    Google Scholar 

  • Geschäftsstelle Qualitätssicherung Im Krankenhaus (2014) Weiterführende Datenerhebung zu mütterlichen Sterbefällen im stationären Bereich der Geburtshilfe im Rahmen der Qualitätssicherung (Strukturierter Dialog). http://www.geqik.de/index.php?eID=tx_dvssecurefiles&gid=0&enc=1&file=dXBsb2Fkcy9tZWRpYS9GcmFnZWJvZ2VuX011ZXR0ZXJsaWNoZV9TdGVyYmVmYWVsbGVfMjAxNC5wZGY=. Zugriff: 29.11.2015

  • Haeri S, Dildy GaR (2012) Maternal mortality from hemorrhage. Seminars in Perinatology 36:48–55

    Google Scholar 

  • Hawkins JL, Chang J, Palmer SK et al. (2011) Anesthesia-related maternal mortality in the United States: 1979–2002. Obstetrics and Gynecology 117:69–74

    Google Scholar 

  • Isaacs RA, Wee MY, Bick DE et al. (2014) A national survey of obstetric early warning systems in the United Kingdom: five years on. Anaesthesia 69:687–692

    Google Scholar 

  • Jenkins JG (2005) Some immediate serious complications of obstetric epidural analgesia and anaesthesia: a prospective study of 145,550 epidurals. International Journal of Obstetric Anesthesia 14:37–42

    Google Scholar 

  • Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS et al. (2014) Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet 384:980–1004

    Google Scholar 

  • Kerwat, Schulz-Stuebner, Steinfeldt et al. (2015) Überarbeitete Handlungsempfehlung: Hygieneempfehlungen für die Regionalanästhesie. Anästh Intensivmed 56:34–40

    Google Scholar 

  • Kinsella SM, Winton AL, Mushambi MC et al. (2015) Failed tracheal intubation during obstetric general anaesthesia: a literature review. International Journal of Obstetric Anesthesia 24:356–374

    Google Scholar 

  • Knight M, Kurinczuk JJ, Tuffnell D et al. (2005) The UK Obstetric Surveillance System for rare disorders of pregnancy. BJOG: an International Journal of Obstetrics and Gynaecology 112:263–265

    Google Scholar 

  • Knight M, Callaghan WM, Berg C et al. (2009) Trends in postpartum hemorrhage in high resource countries: a review and recommendations from the International Postpartum Hemorrhage Collaborative Group. BMC Pregnancy Childbirth 9:55–65

    Google Scholar 

  • Knight M, Kenyon S, Brocklehurst P et al. (2014) on behalf of MBRRACE- UK. University of Oxford: Saving Lives, Improving Mothers’ Care – Lessons learned to inform future maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–12

    Google Scholar 

  • Knight M, Tuffnell D, Kenyon S et al. (2015) Saving Lives, Improving Mothers’ Care – Surveillance of maternal deaths in the UK 2011–13 and lessons learned to inform maternity care from the UK and Ireland. National Perinatal Epidemiology Unit, University of Oxford

    Google Scholar 

  • Lockhart EM, Baysinger CL (2007) Intracranial venous thrombosis in the parturient. Anesthesiology 107:652–658; quiz 687–658

    Google Scholar 

  • Main EK, Menard MK (2013) Maternal mortality: time for national action. Obstetrics and Gynecology 122:735–736

    Google Scholar 

  • Merién AE, Van De Ven J, Mol BW et al. (2010) Multidisciplinary team training in a simulation setting for acute obstetric emergencies: a systematic review. Obstetrics and Gynecology 115:1021–1031

    Google Scholar 

  • Morin AM, Kerwat KM, Klotz M et al. (2005) Risk factors for bacterial catheter colonization in regional anaesthesia. BMC Anesthesiology 5:1

    Google Scholar 

  • Murphy JD, Togioka BM (2011) Aspiration in early pregnancy: risk factors revisited. Journal of clinical anesthesia 23:435–436

    Google Scholar 

  • Mushambi MC, Kinsella SM, Popat M et al. (2015) Obstetric Anaesthetists’ Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics. Anaesthesia 70: 1286–1306

    Google Scholar 

  • Pattinson R (2009) Near miss audit in obstetrics. Best practice & research. Clinical Obstetrics and Gynaecology 23:285–286

    Google Scholar 

  • Pattinson R, Say L, Souza JP et al. (2009) WHO maternal death and near-miss classifications. Bulletin of the World Health Organization 87:734

    Google Scholar 

  • Royal College of Obstetricians and Gynaecologists (2011) Maternal Collapse in Pregnancy and the Puerperium. Green-top Guideline No. 56

    Google Scholar 

  • Say L, Souza JP, Pattinson RC (2009) Maternal near miss – towards a standard tool for monitoring quality of maternal health care. Best practice & research. Clinical Obstetrics and Gynaecology 23:287–296

    Google Scholar 

  • Schlembach D, Mortl MG, Girard T et al. (2014) Management of postpartum hemorrhage (PPH): algorithm of the interdisciplinary D-A-CH consensus group PPH (Germany – Austria – Switzerland). Der Anaesthesist 63:234–242

    Google Scholar 

  • Soar J, Pumphrey R, Cant A et al. (2008) Emergency treatment of anaphylactic reactions--guidelines for healthcare providers. Resuscitation 77:157–169

    Google Scholar 

  • Souza JP, Cecatti JG, Haddad SM et al. (2012) The WHO maternal near-miss approach and the maternal severity index model (MSI): tools for assessing the management of severe maternal morbidity. PloS one 7:e44129

    Google Scholar 

  • Souza JP, Gulmezoglu AM, Vogel J et al. (2013) Moving beyond essential interventions for reduction of maternal mortality (the WHO Multicountry Survey on Maternal and Newborn Health): a cross-sectional study. The Lancet 381:1747–1755

    Google Scholar 

  • Stabille DM, Diogo Filho A, Mandim BL et al. (2015) Frequency of colonization and isolated bacteria from the tip of epidural catheter implanted for postoperative analgesia. Brazilian Journal of Anesthesiology (Elsevier) 65: 200–206

    Google Scholar 

  • Tamma PD, Ault KA, Del Rio C et al. (2009) Safety of influenza vaccination during pregnancy. Am J Obstet Gynecol 201:547–552

    Google Scholar 

  • Thomas TA (1991) Anaesthesia and Maternal Mortality. In: Current Anaesthesia and Critical Care. Longman Group UK, p 85–91

    Google Scholar 

  • Thompson MG, Li DK, Shifflett P et al. (2014) Effectiveness of seasonal trivalent influenza vaccine for preventing influenza virus illness among pregnant women: a population-based case-control study during the 2010–2011 and 2011–2012 influenza seasons. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America 58:449–457

    Google Scholar 

  • United Nations (2000) 55/2. United Nations Millennium Declaration

    Google Scholar 

  • Volk T, Engelhardt L, Spies C et al. (2009) Incidence of infection from catheter procedures for regional anesthesia: first results from the network of DGAI and BDA. Der Anaesthesist 58:1107–1112

    Google Scholar 

  • Walker E, Moore P (2005) Obstetric recovery practice: a survey of UK obstetric anaesthetists. International Journal of Obstetric Anesthesia 14:193–199

    Google Scholar 

  • Waterstone M, Bewley S, Wolfe C (2001) Incidence and predictors of severe obstetric morbidity: case–control study. BMJ (Clinical research ed.) 322:1089–1093

    Google Scholar 

  • Wilkins KK, Greenfield ML, Polley LS et al. (2009) A survey of obstetric perianesthesia care unit standards. Anesthesia and Analgesia 108:1869–1875

    Google Scholar 

  • World Health Organization (2010) Accelerating progress towards the health-related Millennium Development Goals

    Google Scholar 

  • World Health Organization (2014) Trends in Maternal Mortality: 1990 to 2013- Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division. p 56

    Google Scholar 

  • World Health Organization (2015) Maternal mortality Fact sheet N°348. http://www.who.int/mediacentre/factsheets/fs348/en. Zugriff: 11.12.2015

  • Zeidan A, Farhat O, Maaliki H et al. (2006) Does postdural puncture headache left untreated lead to subdural hematoma? Case report and review of the literature. International Journal of Obstetric Anesthesia 15:50–58

    Google Scholar 

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Correspondence to S. T. Neuhaus or D. Bremerich .

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Neuhaus, S.T., Bremerich, D. (2017). Schwangerschafts- und Geburtsrisiken. In: Kranke, P. (eds) Die geburtshilfliche Anästhesie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54375-7_3

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  • DOI: https://doi.org/10.1007/978-3-662-54375-7_3

  • Publisher Name: Springer, Berlin, Heidelberg

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