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Gerinnung in der Schwangerschaft und peripartale Blutung

  • Chapter
Die geburtshilfliche Anästhesie

Zusammenfassung

Aufgrund der prokoagulatorischen Eigenschaften des Trophoblasten bzw. der Plazenta und der vermehrten Produktion von Gerinnungsfaktoren überwiegen zum Ende des dritten Trimenons prokoagulatorische Effekte bei gleichzeitig geminderter Fibrinolyse. Umgekehrt kann das Fibrinogen in Verbindung mit einer Messung des Blutverlustes im Falle einer schweren peripartalen Blutung (PPH; >500 ml bzw. 1000 ml Blutverlust) hinweisgebend für den Schweregrad der Blutung sein. In der Therapie der PPH sollten hämostaseologische, operative und ggf. interventionelle radiologische Therapieansätze ineinandergreifen. Sie umfassen u. a. die zügige Steigerung der Uteruskontraktion in Verbindung mit einer operativen Kompression, die frühzeitige Gabe von Tranexamsäure zur Vermeidung der Hyperfibrinolyse und die Wiederherstellung eines ausreichenden Gerinnungspotenzials. Alle Therapieschritte sollten in einem interdisziplinär abgestimmten Algorithmus auf Basis der aktuellen AWMF-Leitlinie trainiert werden.

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Authors and Affiliations

  1. Virchow-Klinikum Charité - Univers Med Berlin, Klinik für Anästhesiologie, Augustenburgerplatz 1, 13353, Berlin, Deutschland

    Dr. L. Kaufner

  2. Vivantes Klinikum im Friedrichshain, Klinik für Anästhesie, Landsberger Allee 49, 10249, Berlin, Deutschland

    Prof. Dr. C. v. Heymann

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  1. Dr. L. Kaufner
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  2. Prof. Dr. C. v. Heymann
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Correspondence to L. Kaufner or C. v. Heymann .

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Editors and Affiliations

  1. Universitätsklinikum Würzburg, Würzburg, Deutschland

    Peter Kranke

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Kaufner, L., v. Heymann, C. (2017). Gerinnung in der Schwangerschaft und peripartale Blutung. In: Kranke, P. (eds) Die geburtshilfliche Anästhesie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54375-7_22

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  • DOI: https://doi.org/10.1007/978-3-662-54375-7_22

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-54374-0

  • Online ISBN: 978-3-662-54375-7

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