Krebserkrankungen in der Schwangerschaft – Mammakarzinom

Die Gynäkologie - Brustkrebs ist eine der häufigsten Krebserkrankungen während der Schwangerschaft. Von schwangerschaftsassoziiertem Brustkrebs spricht man, wenn die Erkrankung...     

Blutgerinnungsstörungen in der Schwangerschaft

Volumenzufuhr wie z. B. bei der postpartalen Atonie, die Entwicklung einer disseminierten intravasalen Gerinnung (DIG) mit Verbrauchskoagulopathie bei vorzeitiger Plazental?sung, hypertensiver Schwangerschaftserkrankung, intrauterinem Fruchttod, septischen Zust?nde (z. B. Amnioninfektionssyndrom) oder Fruchtwasserembolie, sowie Thrombozytopenien und h?morrhagische Diathesen bei internistischen Erkrankungen.     

Sexualität in der Schwangerschaft

Sexuality during pregnancy is associated with a number of uncertainties and fears. In addition to contraindications which come into question, myths and false information often play a role. This article discusses these uncertainties and options are presented to promote dialogue between physicians and pregnant women in order to free the loving and attentive sexual and physical contact of the couple from fears and false impressions.     

EURAP-Register ? Antiepileptika in der Schwangerschaft

In Europe, approximately 0.5% of women suffer from epilepsy. Many of those women are unsure about the risks with antiepileptic treatment during pregnancy. The European Registry of Antiepileptic drugs in Pregnancy (EURAP) is an international project which collects prospective information about pregnancies with exposure to antiepileptic drugs. The aim is to gain more information about the safety and risks of different antiepileptic drugs and to compare them in terms of the frequency of major malformations or prenatal growth retardation. At present there are 7,555 pregnancies registered (May, 2011).The rate of major malformations is about 6% after exposure to antiepileptic drug (AED) monotherapy. Lamotrigine seems to have a relatively lower teratogenic risk and is therefore preferred as an antiepileptic medication during pregnancy. Levetiracetam showed a low malformation rate of 2.5% but the numbers are too low to give a final statement about the safety in pregnancy. Unfortunately, less than 20% of suitable women have been registered in EURAP. As EURAP is a global network, collaboration of the responsible physicians is essential for the growing success of the EURAP registry.     

H?matoonkologische Erkrankungen in der Schwangerschaft

The concomitant occurrence of cancer and pregnancy causes a dilemma for the woman and physicians alike. The requirement for maternal cure or lifetime prolongation and fetal protection against treatment-related adverse effects are ambitious aims. The tumor entity and stage, the prognosis and the gestational age are of utmost importance for the therapeutic strategy. The clinical care of these women requires multidisciplinary consultation. In the article we review the database for chemotherapy treatment standards and ??new substances?? given during pregnancy and their teratogenic risk. We also briefly evaluate the staging, diagnostic procedures and therapeutic strategies for hematological neoplasms and solid carcinomas as well as the complex emotional dilemma for the expectant mother, her family and physicians.     

Venöse Insuffizienz in der Schwangerschaft

Zusammenfassung Schwangerschaft und Geburt gehen mit einer erhöhten Rate an venösen Erkrankungen einher. Bereits in der ersten Schwangerschaft kommt es bei 34%, in der zweiten bei 60% und ab der dritten bei 70% der Frauen zur Ausbildung einer Varikosis. Die Veränderungen, die der venösen Insuffizienz zugrunde liegen, bestehen aus der Trias von venöser Dilatation, Klappeninsuffizienz und venöser Hypertension. Die schwangerschaftsbedingten Ursachen beinhalten zum einen anatomische Ursachen, wie die geänderte Lage des Uterus, als auch endokrine Faktoren, wie den Einfluss der hormonellen Umstellungen auf den Tonus der Gefäßmuskulatur. Sowohl für Varizen als auch für Hämorrhoiden sollte 6–12 Monate nach der Geburt eine Reevaluierung erfolgen, um ein stadiengerechtes therapeutisches Vorgehen einzuleiten.     

H?matologische Erkrankungen in der Schwangerschaft

The management of hematologic disorders in pregnancy presents diagnostic and therapeutic challenges requiring a multidisciplinary approach. Iron deficiency is the most common cause of anemia in pregnancy. Gestational thrombocytopenia is defined by mild, asymptomatic thrombocytopenia and usually requires no therapy. Autoantibody-induced idiopathic thrombocytopenia is treated with steroids and high-dose immunoglobulins in patients with platelet counts below 30,000/??l during pregnancy and below 50,000/??l before delivery. The most common hematologic neoplasias in pregnancy include Hodgkin??s disease, aggressive non-Hodgkin??s lymphomas, and acute leukemias. Cure for the mother depends on consistent intensive chemotherapy. Chemotherapy can be administered during the second and third trimester with reasonable safety, though there is an increased fetal risk. It is important to balance the potential fetal risk against the maternal risk of an untreated neoplasia.     

Parasitäre Erkrankungen in der Schwangerschaft

Parasitic diseases are not commonly found in Germany due to high hygienic standards; however, the incidence is rising. This article will give insight regarding first-line therapy options for the most common parasitic diseases in pregnancy and during the lactation period.