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Frauenheilkunde up2date 2016; 10(05): 380-387
DOI: 10.1055/s-0042-113794
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Georg Thieme Verlag KG Stuttgart · New York

Schwangerschaft bei Mukoviszidose – ein Überblick

Ruth. K. Michl   *
,
Saskia Mues   *
,
Jochen G. Mainz
,
Udo R. Markert
Further Information

Publication History

Publication Date:
26 October 2016 (online)

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Zusammenfassung

Die Lebenserwartung von Mukoviszidose-Patienten stieg dank intensiver Forschung und Therapie in den letzten 4 Jahrzehnten vom Vorschulalter auf heute über 40 Jahre. Entsprechend nimmt auch die Anzahl von Schwangerschaften an Mukoviszidose erkrankter Frauen zu. Häufig ist für Betroffene die Einschätzung der Konsequenzen einer Schwangerschaft auf ihre Erkrankung und die Auswirkung ihrer Erkrankung auf das heranwachsende Kind nicht möglich. Die Schwangerschaft einer an Mukoviszidose erkrankten Frau mit schlechter Lungenfunktion, reduziertem BMI und Komorbiditäten zeigt erwartungsgemäß mehr Komplikationen als eine Schwangerschaft von Patientinnen ohne entsprechende Risikofaktoren. Generell sind Verläufe mit bestem Outcome für Mutter und Kind unter exakter Planung und engmaschiger multidisziplinärer Betreuung zu erreichen.

* Die Autoren Michl und Mues haben gleichen Anteil an der Erstellung des Manuskripts.


 

  • Literatur

  • 1 Riordan JR, Rommens JM, Kerem B et al. Identification of the cystic fibrosis gene: cloning and characterization of complementary DNA. Science 1989; 245: 1066-1073
    CrossrefGoogle Scholar
  • 2 Poulou M, Fylaktou I, Fotoulaki M et al. Cystic fibrosis genetic counseling difficulties due to the identification of novel mutations in the CFTR gene. J Cystic Fibrosis 2012; DOI: 10.1016/j.jcf.2012.01.004.
    Google Scholar
  • 3 Ballmann M, Smaczny C, Ammon M Hrsg. CF Manual. 2nd. ed. Bremen: UNI-MED; 2008: 192
    Google Scholar
  • 4 Dinwiddie R. Anti-inflammatory therapy in cystic fibrosis. J Cystic Fibrosis 2005; 4 (Suppl. 02) 45-48
    CrossrefGoogle Scholar
  • 5 Edenborough FP. Women with cystic fibrosis and their potential for reproduction. Thorax 2001; 56: 649-655
    CrossrefGoogle Scholar
  • 6 Umlawska W, Sands D, Zielinska A. Age of menarche in girls with cystic fibrosis. Folia histochemica et cytobiologica/Polish Academy of Sciences, Polish Histochemical and Cytochemical Society 2010; 48: 185-190
    Google Scholar
  • 7 Johannesson M, Gottlieb C, Hjelte L. Delayed puberty in girls with cystic fibrosis despite good clinical status. Pediatrics 1997; 99: 29-34
    CrossrefGoogle Scholar
  • 8 Neinstein LS, Stewart D, Wang CI et al. Menstrual dysfunction in cystic fibrosis. J Adolescent Health Care: 1983; 4: 153-157
    CrossrefGoogle Scholar
  • 9 Stead RJ, Hodson ME, Batten JC et al. Amenorrhoea in cystic fibrosis. Clinical Endocrinol 1987; 26: 187-195
    CrossrefGoogle Scholar
  • 10 Lyon A, Bilton D. Fertility issues in cystic fibrosis. Paediatric Resp Rev 2002; 3: 236-240
    Google Scholar
  • 11 Oppenheimer EA, Case AL, Esterly JR et al. Cervical mucus in cystic fibrosis: a possible cause of infertility. Am J Obstet Gynecol 1970; 108: 673-674
    CrossrefGoogle Scholar
  • 12 Schram CA, Stephenson AL, Hannam TG et al. Cystic fibrosis (cf) and ovarian reserve: A cross-sectional study examining serum anti-mullerian hormone (amh) in young women. J Cystic Fibrosis 2014; DOI: 10.1016/j.jcf.2014.09.008.
    Google Scholar
  • 13 Lissens W, Liebaers I. The genetics of male infertility in relation to cystic fibrosis. Bailliereʼs Clin Obstet Gynaecol 1997; 11: 797-817
    Google Scholar
  • 14 Tsang A, Moriarty C, Towns S. Contraception, communication and counseling for sexuality and reproductive health in adolescents and young adults with CF. Paediatric Resp Rev 2010; 11: 84-89
    Google Scholar
  • 15 Zentler-Munro PL. Cystic fibrosis – a gastroenterological cornucopia. Gut 1987; 28: 1531-1547
    CrossrefGoogle Scholar
  • 16 Dowsett J. An overview of nutritional issues for the adult with cystic fibrosis. Nutrition 2000; 16: 566-570
    CrossrefGoogle Scholar
  • 17 Wilson DC, Pencharz PB. Nutrition and cystic fibrosis. Nutrition 1998; 14: 792-795
    CrossrefGoogle Scholar
  • 18 Whitty JE. Cystic fibrosis in pregnancy. Clin Obstet Gynecol 2010; 53: 369-376
    CrossrefGoogle Scholar
  • 19 Matel JL. Nutritional management of cystic fibrosis. J Parenteral Enteral Nutr 2012; 36: 60S-67S
    CrossrefGoogle Scholar
  • 20 Kondo A, Kamihira O, Ozawa H. Neural tube defects: prevalence, etiology and prevention. Int J Urol 2009; 16: 49-57
    CrossrefGoogle Scholar
  • 21 Bailey LB. New standard for dietary folate intake in pregnant women. Am J Clin Nutr 2000; 71: 1304S-1307S
    Google Scholar
  • 22 Borowitz D, Robinson KA, Rosenfeld M et al. Cystic Fibrosis Foundation evidence-based guidelines for management of infants with cystic fibrosis. J Pediatrics 2009; 155: S73-S93
    CrossrefGoogle Scholar
  • 23 Edenborough FP, Borgo G, Knoop C et al. Guidelines for the management of pregnancy in women with cystic fibrosis. J Cystic Fibrosis 2008; 7 (Suppl. 01) S2-S32
    Google Scholar
  • 24 Stephenson A, Brotherwood M, Robert R et al. Increased vitamin A and E levels in adult cystic fibrosis patients after lung transplantation. Transplantation 2005; 79: 613-615
    CrossrefGoogle Scholar
  • 25 Sitrin MD, Lieberman F, Jensen WE et al. Vitamin E deficiency and neurologic disease in adults with cystic fibrosis. Ann Intern Med 1987; 107: 51-54
    CrossrefGoogle Scholar
  • 26 Bye AM, Muller DP, Wilson J et al. Symptomatic vitamin E deficiency in cystic fibrosis. Archives of disease in childhood 1985; 60: 162-164
    Google Scholar
  • 27 Carr SB, McBratney J. The role of vitamins in cystic fibrosis. J Royal Soc Med 2000; 93 (Suppl. 38) 14-19
    Google Scholar
  • 28 Davis PB, di SantʼAgnese PA. Diagnosis and treatment of cystic fibrosis. An update. Chest 1984; 85: 802-809
    CrossrefGoogle Scholar
  • 29 Hubert D. [Cystic fibrosis in adults]. La Revue du Praticien 2003; 53: 158-162
    Google Scholar
  • 30 Corey M, Gaskin K, Durie P et al. Improved prognosis in CF patients with normal fat absorption. J Pediatric Gastroenterol Nutr 1984; 3 (Suppl. 01) S99-S105
    CrossrefGoogle Scholar
  • 31 Folkesson A, Jelsbak L, Yang L et al. Adaptation of Pseudomonas aeruginosa to the cystic fibrosis airway: an evolutionary perspective. Nature Rev Microbiol 2012; 10: 841-851
    CrossrefGoogle Scholar
  • 32 Porter LA, Goldberg JB. Influence of Neutrophil Defects on Burkholderia cepacia Complex Pathogenesis. Frontiers Cellular Infection Microbiol 2011; 1: 9
    Google Scholar
  • 33 Govan JR, Hughes JE, Vandamme P. Burkholderia cepacia: medical, taxonomic and ecological issues. J Med Microbiol 1996; 45: 395-407
    CrossrefGoogle Scholar
  • 34 Horsley A, Jones AM. Antibiotic treatment for Burkholderia cepacia complex in people with cystic fibrosis experiencing a pulmonary exacerbation. Cochrane Database Syst Rev 2012; (10) CD009529
    Google Scholar
  • 35 Smyth A. Prophylactic antibiotics in cystic fibrosis: a conviction without evidence?. Pediatric Pulmonology 2005; 40: 471-476
    CrossrefGoogle Scholar
  • 36 Ewald N, Kaufmann C, Raspe A et al. Prevalence of diabetes mellitus secondary to pancreatic diseases (type 3c). Diabetes/Metabolism Res Rev 2012; 28: 338-342
    Google Scholar
  • 37 Moran A, Brunzell C, Cohen RC et al. Clinical care guidelines for cystic fibrosis-related diabetes: a position statement of the American Diabetes Association and a clinical practice guideline of the Cystic Fibrosis Foundation, endorsed by the Pediatric Endocrine Society. Diabetes Care 2010; 33: 2697-2708
    CrossrefGoogle Scholar
  • 38 OʼRiordan SM, Dattani MT, Hindmarsh PC. Cystic fibrosis-related diabetes in childhood. Hormone Res Paediatrics 2010; 73: 15-24
    Google Scholar
  • 39 Lanng S. Glucose intolerance in cystic fibrosis patients. Paediatric Resp Rev 2001; 2: 253-259
    Google Scholar
  • 40 Brennan AL, Geddes DM, Gyi KM et al. Clinical importance of cystic fibrosis-related diabetes. J Cystic Fibrosis 2004; 3: 209-222
    CrossrefGoogle Scholar
  • 41 Curran DR, McArdle JR, Talwalkar JS. Diabetes mellitus and bone disease in cystic fibrosis. Seminars Resp Crit Care Med 2009; 30: 514-530
    Google Scholar
  • 42 Alicandro G, Battezzati PM, Battezzati A et al. Insulin secretion, nutritional status and respiratory function in cystic fibrosis patients with normal glucose tolerance. Clin Nutr 2012; 31: 118-123
    CrossrefPubMedGoogle Scholar
  • 43 Lanng S, Thorsteinsson B, Nerup J et al. Influence of the development of diabetes mellitus on clinical status in patients with cystic fibrosis. Eur J Pediatrics 1992; 151: 684-687
    CrossrefGoogle Scholar
  • 44 Moran A, Pekow P, Grover P et al. Insulin therapy to improve BMI in cystic fibrosis-related diabetes without fasting hyperglycemia: results of the cystic fibrosis related diabetes therapy trial. Diabetes Care 2009; 32: 1783-1788
    CrossrefPubMedGoogle Scholar
  • 45 Bismuth E, Laborde K, Taupin P et al. Glucose tolerance and insulin secretion, morbidity, and death in patients with cystic fibrosis. J Pediatrics 2008; 152: 540-545 545.e1
    CrossrefGoogle Scholar
  • 46 Koch C, Rainisio M, Madessani U et al. Presence of cystic fibrosis-related diabetes mellitus is tightly linked to poor lung function in patients with cystic fibrosis: data from the European Epidemiologic Registry of Cystic Fibrosis. Pediatric Pulmonology 2001; 32: 343-350
    CrossrefGoogle Scholar
  • 47 Hardin DS, Rice J, Cohen RC et al. The metabolic effects of pregnancy in cystic fibrosis. Obstet Gynecol 2005; 106: 367-375
    CrossrefGoogle Scholar
  • 48 Metzger BE, Lowe LP, Dyer AR et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 2008; 358: 1991-2002
    CrossrefPubMedGoogle Scholar
  • 49 Kleinwechter H, Schafer-Graf U, Buhrer C et al. Gestational diabetes mellitus (GDM) diagnosis, therapy and follow-up care: Practice Guideline of the German Diabetes Association (DDG) and the German Association for Gynaecology and Obstetrics (DGGG). Experimental Clin Endocrinol & Diabetes 2014; 122: 395-405
    Google Scholar
  • 50 Braun AT, Merlo CA. Cystic fibrosis lung transplantation. Curr Op Pulmonary Med 2011; 17: 467-472
    Google Scholar
  • 51 Budev MM, Arroliga AC, Emery S. Exacerbation of underlying pulmonary disease in pregnancy. Crit Care Med 2005; 33: S313-S318
    CrossrefGoogle Scholar
  • 52 Gyi KM, Hodson ME, Yacoub MY. Pregnancy in cystic fibrosis lung transplant recipients: case series and review. J Cystic Fibrosis 2006; 5: 171-175
    CrossrefGoogle Scholar
  • 53 Kulak CA, Borba VZ, Kulak Jr. J et al. Osteoporosis after transplantation. Curr Osteoporos Rep 2012; 10: 48-55
    CrossrefGoogle Scholar
  • 54 Aris RM, Neuringer IP, Weiner MA et al. Severe osteoporosis before and after lung transplantation. Chest 1996; 109: 1176-1183
    CrossrefGoogle Scholar
  • 55 Kotloff RM, FitzSimmons SC, Fiel SB. Fertility and pregnancy in patients with cystic fibrosis. Clinics Chest Med 1992; 13: 623-635
    Google Scholar
  • 56 Larsen Jr JW. Cystic fibrosis and pregnancy. Obstet Gynecol 1972; 39: 880-883
    Google Scholar
  • 57 Burden C, Ion R, Chung Y et al. Current pregnancy outcomes in women with cystic fibrosis. Eur J Obstet Gynecol Reprod Biol 2012; 164: 142-145
    CrossrefGoogle Scholar
  • 58 Edenborough FP, Mackenzie WE, Stableforth DE. The outcome of 72 pregnancies in 55 women with cystic fibrosis in the United Kingdom 1977–1996. Br J Obstet Gyneacol 2000; 107: 254-261
    CrossrefGoogle Scholar
  • 59 Odegaard I, Stray-Pedersen B, Hallberg K et al. Maternal and fetal morbidity in pregnancies of Norwegian and Swedish women with cystic fibrosis. Acta Obstet Gynaecol Scandinavica 2002; 81: 698-705
    Google Scholar
  • 60 Huffmyer JL, Littlewood KE, Nemergut EC. Perioperative management of the adult with cystic fibrosis. Anesthesia Analgesia 2009; 109: 1949-1961
    CrossrefGoogle Scholar
  • 61 Faden Y, Gruslin A. Vaginal delivery of a patient with severe cystic fibrosis. Int J Gynaecol Obstet 2005; 91: 256-257
    CrossrefGoogle Scholar
  • 62 NIH Consensus conference. Optimal calcium intake. NIH Consensus Development Panel on Optimal Calcium Intake. J Am Med Assoc 1994; 272: 1942-1948
    CrossrefGoogle Scholar