Kardiovaskuläre Erkrankungen in der Schwangerschaft

Herz-Kreislauf-Erkrankungen sind die Hauptursache für schwangerschaftsbedingte Todesfälle, deren Häufigkeit in den letzten Jahrzehnten zugenommen hat [1]. Die Betreuung von Hochrisikopatientinnen erfordert ein kardiologisch-geburtshilfliches Expertenteam. Die folgende Übersicht adressiert die wichtigsten Aspekte beim Management von Herz-Kreislauf-Erkrankungen in der Schwangerschaft.

Kernaussagen

• Herz-Kreislauf-Erkrankungen sind die Hauptursache für schwangerschaftsbedingte Todesfälle, deren Häufigkeit in westlichen Ländern in den letzten Jahrzehnten zugenommen hat.

• Angeborene Herzfehler sind am häufigsten für Komplikationen in der Schwangerschaft verantwortlich.

• Die Risikoeinschätzung der herzkranken, schwangeren Patientinnen erfolgt nach mWHO (modified WHO Classification of maternal cardiovascular Risk).

• Die ESC-Leitlinie spricht sich bei manchen Konstellationen explizit gegen eine Schwangerschaft aus.

• Medikamentöse Therapien müssen sorgfältig auf etwaige Kontraindikationen während der Schwangerschaft und Stillzeit geprüft werden und bei vorbekannten kardiovaskulären Erkrankungen sollten Therapiekonzepte bereits vor einer Schwangerschaft evaluiert werden.

• Idealerweise werden Therapieentscheidungen bei Schwangeren mit kardiovaskulären Erkrankungen in einem multidisziplinären Team gefällt.

Schlüsselwörter

kardiovaskulär - Erkrankungen - Schwangerschaft - angeborenen Herzfehler - Hypertonie - Herzklappe - Insuffizienz - Ischämie - Kardiomyopathie

Publication History

Article published online:
14 October 2024

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