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Dtsch Med Wochenschr 2016; 141(18): 1287-1294
DOI: 10.1055/s-0042-111583
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Schwangere beim Internisten
© Georg Thieme Verlag KG Stuttgart · New York

Hypertensive Schwangerschaftserkrankungen

Hypertensive Disorders in Pregnancy
Martin Middeke
1   Hypertoniezentrum München
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Publication History

Publication Date:
06 September 2016 (online)

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Zusammenfassung

In der Schwangerschaft profitieren Mutter und Fetus von einem Blutdruck in normalen Grenzen. Internationale Leitlinien definieren die Blutdruckgrenzen und die Schwellenwerte für eine antihypertensive Therapie in der Schwangerschaft unterschiedlich. Die systolischen und diastolischen Blutdruckwerte, die bei normalem Schwangerschaftsverlauf beobachtet werden, sind deutlich niedriger als die empfohlenen Interventionsgrenzen für eine antihypertensive Therapie. Eine strenge Blutdruckeinstellung (< 85 mmHg diastolisch) ist sicher und kann die Entwicklung einer schweren Hypertonie der Mutter verhindern, wie die Daten von CHIPS zeigen.

Eine engmaschige Blutdruckkontrolle mit den modernsten Messmethoden inklusive Telemonitoring ist geeignet, eine Risikoentwicklung frühzeitig zu erkennen und die Therapiesteuerung optimal zu gestalten – beginnend in der frühen Schwangerschaft. Für die antihypertensive Medikation kommen nur wenige Substanzen zur Auswahl.

Abstract

In pregnancy, both mother and fetus benefit from blood pressure in normal ranges. There is discrepancy in the normenclature and thresholds for classification of hypertension in pregnancy and for initiation of antihypertensive treatment in different international guidelines. Systolic and diastolic blood pressure values that are associated with normal outcome are notably lower than any recommended treatment threshold in pregnancy. Tight blood pressure control under 85 mmHg diastolic is save and significantly prevents severe maternal hypertension as could be demonstrated in CHIPS. Close blood pressure monitoring comprising modern methods and devices including telemonitoring allows early recognition of risk developments and optimal guidance of antihypertensive therapy starting early in pregnancy. Only a few pharmacological substances are suitable for antihypertensive treatment in pregnancy.

Schlüsselwörter

hypertensive Schwangerschaftserkrankungen - antihypertensive Therapie - Präeklampsie

Keywords

hypertension in pregnancy - antihypertensive therapy - pre-eclampsia
 

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