Präeklampsie/Eklampsie

CME
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Zusammenfassung

Die Präeklampsie/Eklampsie ist ein für Mutter und Fetus potenziell lebensbedrohliches Krankheitsbild. Sie ist durch eine neu aufgetretene Hypertonie von mehr als 140/90 mmHg (Gestationshypertonie) und eine Proteinurie von mehr als 300 mg/24 h nach Beendigung der 20. Schwangerschaftswoche (SSW) charakterisiert. Bei schwerem Krankheitsverlauf kann es zu generalisierten Krampfanfällen, Nierenfunktionsstörungen, Lungenödem oder fetaler Wachstumsretardierung kommen. Aktuell ist die Entbindung die einzige kausale Therapie bei schwerer Präeklampsie. Die Präeklampsie wurde kürzlich als unabhängiger kardiovaskulärer Risikofaktor für die Mutter identifiziert. In den letzten Jahren konnte als Ursache der Präeklampsie eine Imbalance von angiogenen und antiangiogenen Faktoren beschrieben werden, die für die vorliegende generalisierte endotheliale Dysfunktion mitverantwortlich ist. Die Identifizierung von an diesen Prozessen beteiligten Faktoren eröffnet neue Ansätze für die Behandlung der Präeklampsie.

Schlüsselwörter

Gestationshypertonie Endotheliale Dysfunktion Schwangerschaft VEGF Proteinurie 

Preeclampsia/eclampsia

Abstract

Preeclampsia/eclampsia is a potentially life-threatening disorder for mother and fetus. Hallmarks of the disease are a newly diagnosed hypertension >140/90 mmHg (gestational hypertension) and proteinuria >300 mg/24 h after completion of the 20th week of gestation. A severe course of the disease can lead to generalized seizures, kidney failure, HELLP syndrome, pulmonary edema and fetal growth retardation. In this situation, to date, prompt delivery is the only therapeutic option. Preeclampsia has recently been identified as an independent cardiovascular risk factor for the mother. In recent years exciting evidence has revealed an imbalance of angiogenic and anti-angiogenic factors to be partly responsible for the development of generalized endothelial dysfunction. The identification of these factors opens up new avenues for treatment of preeclampsia.

Keywords

Gestational hypertension Endothelial dysfunction  Pregnancy Vascular endothelial growth factor Proteinuria 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

H. Hagmann, T. Benzing und C. Kurschat geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Klinik II für Innere Medizin, Nephrologie, Rheumatologie, Diabetologie und Allgemeine Innere MedizinUniklinik KölnKölnDeutschland

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