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Der Gynäkologe

, Volume 51, Issue 10, pp 816–827 | Cite as

Monitoring bei Präeklampsie und kardiovaskulären Erkrankungen in der Schwangerschaft

  • Tanja Groten
Leitthema
  • 106 Downloads

Zusammenfassung

Die Schwangerschaft stellt für Frauen mit kardiovaskulären Vorerkrankungen und Frauen, die in der Schwangerschaft eine schwere Präeklampsie entwickeln, eine potenziell lebensbedrohliche Gefährdung dar. Die Entbindung aus mütterlicher Indikation ist oft die einzige Möglichkeit, die Mutter vor bleibenden Schäden zu bewahren. Eine Verlängerung der Schwangerschaft zugunsten des Kindes erfordert in dieser Situation ein engmaschiges Monitoring. Während die maternale Gefährdung bei der Präeklampsie erst in der Schwangerschaft entsteht, ist sie bei Frauen mit vorbestehenden Herzerkrankungen bereits präkonzeptionell bekannt. Diese Frauen sollen deshalb bereits präkonzeptionell einer besonderen Beratung und Betreuung zugeführt werden. Die WHO (World Health Organisation) empfiehlt unterschiedlich intensive Betreuungsregime in Abhängigkeit von der Schwere der Vorerkrankung. Frauen der Risikoklasse IV sollte von einer Schwangerschaft abgeraten werden. Im Rahmen der Präeklampsie sind die Schwangeren insbesondere durch schwere Hochdruckkrisen gefährdet, die zu Hirnblutungen und eklamptischen Anfällen führen können. Eine konsequente Blutdruckeinstellung ist deshalb essenziell.

Schlüsselwörter

Schwangerschaft bei angeborenem Herzfehler Herzkranke Schwangere Bluthochdruck Entbindung bei maternalem Herzfehler Schwangerschaftsinduizierte Hypertonie 

Monitoring of preeclempsia and cardiovascular diseases during pregnancy

Abstract

Women with preexisting cardiovascular diseases and women with severe preeclampsia are severely endangered by and during pregnancy. The delivery of the baby—ending the pregnancy—is often the only way to save the mother’s life. If pregnancy is continued to protect the child from very early preterm birth, the pregnant women has to be closely monitored. For women with preexisting heart disease, World Health Organization (WHO) offers distinct management recommendations depending of the kind and severity of the underlying disease. Women with a WHO risk classification IV should be advised not to become pregnant. In women with severe hypertension in pregnancy, the main threat are cerebral bleeding and eclampsia. Therefor close monitoring of blood pressure is essential in these cases.

Keywords

Pregnancy in women with congenital heart disease Pregnant women with heart disease High blood pressure Maternal heart disease and childbirth Gestational hypertension 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

T. Groten gibt 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 für GeburtsmedizinUniversitätsklinikum JenaJenaDeutschland

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