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Was erwartet der Geburtshelfer bei der Schwangerenbetreuung vom Internisten?

What does the obstetrician expect from the internist during prenatal care?

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Zusammenfassung

Die Kooperation zwischen Internisten und Geburtshelfern ist insbesondere bei häufiger auftretenden bzw. komplexen internistischen Erkrankungen gefordert. Am Beispiel des Medikamenteneinsatzes in der Frühschwangerschaft, kardiologischer Erkrankungen, der schwangerschaftsinduzierten Hypertonie, dem HELLP-Syndrom, Gestationsdiabetes und Typ-I-Diabetes, der Thrombose, pulmonalen Erkrankungen, Infektionskrankheiten sowie der Behandlung von Malignomen wird in dem vorliegenden Beitrag auf die Besonderheiten der maternalen Behandlung unter Berücksichtigung der fetalen Interessen aufmerksam gemacht. Besondere Wünsche des Geburtshelfers an den Internisten sind hierbei im Wesentlichen die intensive Kontaktaufnahme, die Vermeidung eines vorfixierten Entbindungsmodus, die Vermeidung der Übertherapie bei hypertensiven Schwangerschaftserkrankungen sowie die Intensivierung der internistischen Überwachung mit Einschleusung in Präventivprogramme bei Schwangeren mit höherem Risiko für die spätere Entwicklung eines metabolischen Syndroms.

Abstract

Cooperation between the obstetrician and the physician for internal medicine is especially needed when a pregnant woman suffers from complex medical diseases. This contribution focuses on the special circumstances of maternal treatment also considering the fetal state with the following examples: drugs in the first trimester, cardiac diseases, pregnancy-induced hypertension, HELLP syndrome, gestational and type I diabetes, thrombosis, pulmonary diseases, infections, and treatment of cancer during pregnancy. Special obstetric requests to the physician are: keeping in close contact, avoiding recommendations for the mode of delivery, avoiding overtreatment of hypertensive disorders as well as intensifying the surveillance including the creation of preventive schedules for pregnant women with an increased risk of developing metabolic syndrome in their later life.

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Literatur

  1. Bo S, Menato G, Botto C et al. (2006) Mild gestational hyperglycemia and the metabolic syndrome in later life. Metab Syndr Relat Disord 4: 113–121

    Article  PubMed  Google Scholar 

  2. Boggess KA (2005) Pathophysiology of preterm birth: emerging concepts of maternal infection. Clin Perinatol 32: 561–569

    Article  PubMed  Google Scholar 

  3. Carpenter MW (2007) Gestational diabetes, pregnancy hypertension and late vascular disease. Diabetes Care 30 (Suppl 2): 246–250

    Article  Google Scholar 

  4. Cheng YW, Caughey AB (2008) Glucose tolerance test: varying diagnostic strategies for gestational diabetes mellitus. J Perinatol 28: 1–2

    Article  PubMed  CAS  Google Scholar 

  5. Dombrowski MP, Schatz M, ACOG Committee on Practice Bulletins – Obstetrics (2008) ACOG practice bulletin: clinical management guidelines for obstetrician-gynecologists number 90, February 2008: asthma in pregnancy. Obstet Gynecol 111: 457–464

    PubMed  Google Scholar 

  6. Garovic VD, Hayman SR (2007) Hypertension in pregnancy: an emerging risk factor for cardiovascular disease. Nat Clin Pract Nephrol (11): 613–622

    Article  Google Scholar 

  7. Giagrande PL (2001) Air travel and thrombosis. Int J Clin Pract 55(10): 690–693

    Google Scholar 

  8. Hach-Wunderle V, Präve F, Düx M et al. (2008) Diagnose und Therapie venöser Thrombosen in der Schwangerschaft. Dtsch Med Wochenschr 133: 521–526

    Article  PubMed  CAS  Google Scholar 

  9. Koopmans CM, Bijlenga D, Aarnoudse JG et al. (2007) Induction of labour versus expectant monitoring in women with pregnancy induced hypertension or mild preeclampsia at term: the HYPITAT trial. BMC Pregnancy Childbirth 27: 7–14

    Google Scholar 

  10. Kovavisarach E, Nualplot P (2007) Outcome of pregnancy among parturients complicated with heart disease in Rajavithi Hospital. J Med Assoc Thai 90: 2253–2259

    PubMed  Google Scholar 

  11. Lacasse A, Rey E, Ferreira E et al. (2008) Validity of a modified Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) scoring index to assess severity of nausea and vomiting of pregnancy. Am J Obstet Gynecol 198: 1–7

    Article  Google Scholar 

  12. Pereg D, Lishner M (2008) Maternal and fetal effects of systematic therapy in the pregnant woman with cancer. Recent Results Cancer Res 178: 21–38

    Article  PubMed  CAS  Google Scholar 

  13. Rath W, Fischer T, Klockenbusch W et al. (2007) Diagnostik und Therapie hypertensiver Schwangerschaftserkrankungen. Leitlinie der Arbeitsgemeinschaft Schwangerschaftshochdruck / Gestose der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe e.V. (DGGG), http://www.uni-duesseldorf.de/awmf/ll/015-018.htm

  14. Schaefer C, Spielmann H, Vetter K (2006) Arzneiverordnung in Schwangerschaft und Stillzeit, 7. Aufl. Elsevier/Urban & Fischer, München

  15. Schneider H, Husslein P, Schneider KTM (2007) Die Geburtshilfe, 3. Aufl. Thieme, Stuttgart

  16. Schneider KT, Bung P, Weber S et al. (1993) An orthostatic uterovascular syndrome – a prospective, longitudinal study. Am J Obstet Gynecol 169: 183–188

    PubMed  CAS  Google Scholar 

  17. Sezik M, Ozkaya O, Sezik HT, Yapar EG (2007) Expectant management of severe preeclampsia presenting before 25 weeks of gestation. Med Sci Monit 13: 523–527

    Google Scholar 

  18. Sibai BM, Ramadan MK, Chari RS, Friedman SA (1995) Pregnancies complicated by HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets): subsequent pregnancy outcome and long-term prognosis. Am J Obstet Gynecol 172: 125–129

    Article  PubMed  CAS  Google Scholar 

  19. Suzuki H, Watanabe Y, Arima H et al. (2008) Short- and long-term prognosis of blood pressure and kidney disease in women with a past history of preeclampsia. Clin Exp Nephrol 12: 102–109

    Article  PubMed  Google Scholar 

  20. Tamás P, Szilágyi A, Jeges S et al. (2007) Effects of maternal central hemodynamics on fetal heart rate patterns. Acta Obstet Gynecol Scand: 711–714

    Article  Google Scholar 

  21. Vidaeff AC, Yeomans ER (2007) Corticosteroids for the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP): what evidence? Minerva Ginecol: 183–190

    Google Scholar 

  22. Winer N, Tsasaris V (2008) Latest developments: management and treatment of preeclampsia. J Gynecol Obstet Biol Reprod (Paris) 37: 5–15

    Google Scholar 

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  1. Abteilung für Perinatalmedizin, Technische Universität München, Ismaningerstraße 22, 81675, München, Deutschland

    K.T.M. Schneider

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Schneider, K. Was erwartet der Geburtshelfer bei der Schwangerenbetreuung vom Internisten?. Internist 49, 799–804 (2008). https://doi.org/10.1007/s00108-008-2068-1

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