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HPV-Infektion in der Schwangerschaft

HPV infection during pregnancy

  • Leitthema
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Der Gynäkologe Aims and scope

Zusammenfassung

Infektionen mit dem humanen Papillomavirus (HPV) sind häufig. Durch die höchste Prävalenz um das 20. bis 30. Lebensjahr ist die Wahrscheinlichkeit hoch, schwangere Patientinnen mit HPV-Läsionen zu betreuen. Der Beitrag gibt eine Übersicht über die häufigsten HPV-assoziierten Krankheitsbilder und nennt Therapiemöglichkeiten in der Schwangerschaft. Die meisten Empfehlungen basieren auf retrospektiven Erhebungen mit kleineren Fallzahlen, Studien mit nichtschwangeren Frauen und Expertenmeinungen. Kondylome in der Schwangerschaft können behandelt werden. Da eine Progression einer zervikalen intraepithelialen Neoplasie (CIN) in ein invasives Karzinom im Verlauf der Schwangerschaft extrem selten ist, gilt für die CIN in der Schwangerschaft ein exspektatives Vorgehen. Die Behandlung eines Zervixkarzinoms bedarf immer einer individuellen, interdisziplinär zu treffenden Entscheidung. Im Sinne der Prävention sollte eine HPV-Impfung nahegelegt werden.

Abstract

Infection with human papillomavirus (HPV) is very common. With peak prevalence at the age of 20–30 there is a great chance to counsel a pregnant woman with HPV lesions. This report provides information on the most common HPV diseases and offers treatment options in pregnancy. Management guidelines in pregnancy are not well defined and are derived from small retrospective series of pregnant women, data of non-pregnant women and expert opinion. Genital condylomata can be treated in pregnancy. As the progression from cervical intraepithelial neoplasia to invasive cervical carcinoma during the course of pregnancy is very rare, preferred management is follow-up with treatment deferred until postpartum. The treatment of invasive cervical carcinoma is based on an individual multidisciplinary decision. To prevent clinical disease prophylactic HPV vaccination should be offered.

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Authors and Affiliations

  1. Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe Großhadern, LMU Klinikum der Universität München, Marchioninistr. 15, 81377, München, Deutschland

    S. Rückert, N. Ditsch, J. Gallwas & C. Dannecker

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  1. S. Rückert
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  2. N. Ditsch
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  4. C. Dannecker
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Correspondence to S. Rückert.

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Rückert, S., Ditsch, N., Gallwas, J. et al. HPV-Infektion in der Schwangerschaft. Gynäkologe 44, 630–636 (2011). https://doi.org/10.1007/s00129-011-2774-y

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