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Fall 22: Schwangerschaft – 30 Jahre, ♀, schwanger, DM Typ 1, Blutdruckspitzen

  • Aikaterini Valkanou
Chapter

Zusammenfassung

Eine 30-jährige schwangere Patientin mit Typ-1-Diabetes seit der Kindheit, einer Albuminurie, einem systolischen Blutdruck von 150 mm Hg vor Schwangerschaft, jetzt Spitzen bis zu 170 mm Hg und einem HbA1c von 7,3 %. Welche Medikamente sind sinnvoll?

Literatur

  1. Abalos E, Duley L, Steyn DW, Henderson-Smart DJ (2007) Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev 1:CD002252Google Scholar
  2. Bortolus R, Ricci E, Chatenoud L, Parazzini F (2000) Nifedipine administered in pregnancy: effect on the development of children at 18 months. BJOG 107(6):792–794.  https://doi.org/10.1111/j.1471-0528.2000.tb13342CrossRefPubMedGoogle Scholar
  3. Bujold E, Roberge S, Lacasse Y, Bureau M, Audibert F, Marcoux S, Forest JC, Giguère Y (2010) Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: a meta-analysis. Obstet Gynecol 116(2 Pt 1):402–414.  https://doi.org/10.1097/AOG.0b013e3181e9322aCrossRefPubMedGoogle Scholar
  4. Cooper W, Hernandez-Diaz S, Arbogast P, Dudley J, Dyer S, Gideon P, Hall K, Ray W (2006) Major congenital malformations after first-trimester exposure to ACE inhibitors. N Engl J Med 354:2443–2451CrossRefGoogle Scholar
  5. Hiilesmaa V, Suhonen L, Teramo K (2000) Glycaemic control is associated with pre-eclampsia but not with pregnancy-induced hypertension in women with type I diabetes mellitus. Diabetologia 43(12):1534–1539.  https://doi.org/10.1007/s001250051565CrossRefPubMedGoogle Scholar
  6. Houtzager BA, Hogendoorn SM, Papatsonis DN, Samsom JF, van Geijn HP, Bleker OP, van Wassenaer AG (2006) Long-term follow up of children exposed in utero to nifedipine or ritodrine for the management of preterm labour. BJOG 113(3):324–331CrossRefGoogle Scholar
  7. Magee L, von Dadelszen P et al (2015) Do labetalol and methyldopa have different effects on pregnancy outcome? Analysis of data from the Control of Hypertension In Pregnancy Study (CHIPS) trial. N Engl J Med 372:407–417. https://doi.org/10.1056/NEJMoa1404595CrossRefPubMedGoogle Scholar
  8. Montan S, Anandakumar C, Arulkumaran S et al (1993) Effects of methyldopa on uteroplacental and fetal hemodynamics in pregnancy-induced hypertension. Am J Obstet Gynecol 168(1):152–156. https://doi.org/org/10.1016/S0002-9378(12)90905-9CrossRefGoogle Scholar
  9. Nielsen LR, Müller C, Damm P, Mathiesen ER (2006) Reduced prevalence of early preterm delivery in women with Type 1 diabetes and microalbuminuria − Possible effect of early antihypertensive treatment during pregnancy. Diabet Med 23(4):426–431CrossRefGoogle Scholar
  10. Nielsen LR, Damm P, Mathiesen E (2009) Improved pregnancy outcome in type 1 diabetic women with microalbuminuria or diabetic nephropathy, effect of intensified antihypertensive therapy? Diabetes Care 32(1):38–44. https://doi.org/10.2337/dc08-1526CrossRefPubMedPubMedCentralGoogle Scholar
  11. Regitz-Zagrosek V, Gohlke-Bärwolf C, Haass M, Nienaber C, RybakK Seeland U (2011) “ESC Guidelines on the management of cardiovascular diseases during pregnancy“ European Society of Cardiology. Eur Heart J 32:3147–3197.  https://doi.org/10.1093/eurheartj/ehr218CrossRefPubMedGoogle Scholar
  12. Rüster C, Hasslacher C, Wolf G (2016) Diabetische Nephropathie, Leitlinien Deutsch Diabetes Gesellschaft. Diabetologie 11(S02):S93–S98.  https://doi.org/10.1055/s-0042-113138CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Abteilung Innere Medizin IMedizinische UniversitätsklinikHeidelbergDeutschland

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