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Anämie in der Schwangerschaft

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Die Geburtshilfe

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Zusammenfassung

Anämien gehören zu den häufigsten Risikofaktoren in der Geburtshilfe und Perinatalmedizin. Die meisten internationalen Leitlinien empfehlen die zusätzliche Einnahme von 15–30 mg/Tag Eisen, um den im Verlauf der Schwangerschaft zunehmenden Eisenbedarf zu kompensieren.

Voraussetzung für die Abklärung einer Schwangerschaftsanämie ist die Festlegung des richtigen Cut-off-Werts für einen zu niedrigen Hämoglobin(Hb)-Wert in Abhängigkeit des Gestationsalters; ein Hb-Wert <10,5 g/dl kann zu jedem Zeitpunkt der Schwangerschaft als diagnostischer Hinweis für eine Anämie gewertet werden und bedarf der Abklärung. Weiteres wichtiges Diagnostikum ist die Bestimmung des Ferritinwerts. Die Therapie richtet sich nach der Ursache und Schwere der Anämie. Auch leichtere Formen müssen konsequent behandelt werden, um einer Aggravation und peripartalen Komplikationen bei hohen Blutverlusten vorzubeugen.

  • Eisenmangel in der Schwangerschaft ist häufig und kann mittels Screening des Serumferritins im 1. Trimester diagnostiziert werden (Grenzwert <30 μg/l). Regelmäßige Hb-Kontrollen zumindest 1-mal pro Trimester sind generell empfohlen.

  • Bei Eisenmangel mit oder ohne Anämie sollte in der Schwangerschaft primär eine Therapie mit oralen Eisenpräparaten erfolgen. Bei schwerer Eisenmangelanämie, Unverträglichkeit von oralem Eisen, fehlendem Ansprechen auf orales Eisen oder bei klinischer Notwendigkeit der raschen und effizienten Anämiekorrektur sollte eine intravenöse Eisentherapie durchgeführt werden.

  • Postparatal sollte bei leichter Eisenmangelanämie (Blutungsanämie) eine Therapie mit oralem Eisen und bei mittelschwerer bis schwerer Anämie (Hb <95 g/l) eine intravenöse Eisentherapie erfolgen.

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Authors and Affiliations

  1. Gyn & Perinatal Zürich/Hirslanden Clinic, Zürich, Schweiz

    Christian Breymann

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  1. Christian Breymann
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Correspondence to Christian Breymann .

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Editors and Affiliations

  1. Frauenklinik, Medizinische Hochschule Hannover, Hannover, Niedersachsen, Deutschland

    Constantin von Kaisenberg

  2. Klinische Abteilung für Geburtshilfe, Medizinische Universität Graz, Graz, Steiermark, Österreich

    Philipp Klaritsch

  3. Geburtshilfe, Universitätsspital Basel, Basel Universitätsspital, Basel Stadt, Schweiz

    Irene Hösli-Krais

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Breymann, C. (2023). Anämie in der Schwangerschaft. In: von Kaisenberg, C., Klaritsch, P., Hösli-Krais, I. (eds) Die Geburtshilfe. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44369-9_23-2

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  • DOI: https://doi.org/10.1007/978-3-662-44369-9_23-2

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Chapter history

  1. Latest

    Anämie in der Schwangerschaft
    Published:
    09 December 2023

    DOI: https://doi.org/10.1007/978-3-662-44369-9_23-2

  2. Original

    Anämie in der Schwangerschaft
    Published:
    17 July 2015

    DOI: https://doi.org/10.1007/978-3-662-44369-9_23-1

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