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Myome in der Schwangerschaft

Häufigkeit, Komplikationen und Behandlung

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Weiterbildung Gynäkologie und Geburtshilfe

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Zussamenfassung

Symptomatische Myome des Uterus sind ein häufiger und bedeutsamer Morbiditätsgrund für Frauen in der reproduktiven Lebensphase. Die Rate myomassoziierter Komplikationen in der Schwangerschaft wird mit etwa 10-30% angegeben, doch die Studienlage ist noch unzureichend. In der frühen Schwangerschaft können Uterusmyome mit einer erhöhten Spontanabortrate einhergehen und sind gehäuft mit Blutungen assoziiert, insbesondere wenn die Plazentation nahe am Myom stattgefunden hat. Im Verlauf der Schwangerschaft sind Schmerzen die häufigsten myomassoziierten Komplikationen, insbesondere bei Vorliegen von Myomen mit einem Größenwachstum über 5 cm im 2. und 3. Trimenon. Des Weiteren kann das Risiko in der Schwangerschaft u. a. für vorzeitige Wehen, vorzeitige Plazentalösung, Placenta praevia und Lageanomalien sowie seltener für kindliche Fehlbildungen erhöht sein. Eine Behandlung erfolgt in der Regel konservativ: Bettruhe, Flüssigkeitszufuhr, Analgesie und ggf. antibiotische Therapie. In seltenen Fällen ist jedoch operatives Vorgehen erforderlich; dann steht die Myomenukleation als Ultima Ratio im Vordergrund.

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Author information

Authors and Affiliations

  1. Universitäts-Frauenklinik, Heidelberg

    M. Wallwiener, S. Gawlik & W. Janni

Authors
  1. M. Wallwiener
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  2. S. Gawlik
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  3. W. Janni
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Editor information

Editors and Affiliations

  1. Klinikum Kassel, Frauenklinik, Kassel, Deutschland

    Thomas Dimpfl

  2. Universitätsklinik Ulm, Frauenklinik, Ulm, Deutschland

    Wolfgang Janni

  3. Landshut, Deutschland

    Rolf Kreienberg

  4. Klinik für Gynäkologie und Geburtshilfe, Universitätsklinik Kiel, Kiel, Deutschland

    Nicolai Maass

  5. Klinik für Frauenheilkunde und Geburtshilfe, Caritas-Krankenhaus St. Josef, Regensburg, Deutschland

    Olaf Ortmann

  6. Frauenklinik, Universitätsklinik Heidelberg, Heidelberg, Deutschland

    Thomas Strowitzki

  7. Klinik für Frauenheilkunde, Vivantes Klinikum Neuköln, Berlin, Deutschland

    Klaus Vetter

  8. Klinik für Geburtshilfe, Universitätsspital Zürich, USZ, Zürich, Schweiz

    Roland Zimmermann

  9. Pränatale Medizin, Endokrinologie und Osteologie, amedes experts Hamburg Facharzt-Zentrum für Kinderwunsch, Hamburg, Deutschland

    Barbara Sonntag

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Wallwiener, M., Gawlik, S., Janni, W. (2017). Myome in der Schwangerschaft. In: Dimpfl, T., et al. Weiterbildung Gynäkologie und Geburtshilfe. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49480-6_4

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  • DOI: https://doi.org/10.1007/978-3-662-49480-6_4

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-49479-0

  • Online ISBN: 978-3-662-49480-6

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