Präeklampsie – Signatur und Pathophysiologie

Carmen Eppel, Bodo Grahlke, Angelika Maaser, Tatjana Mijic, Angela Kuck, Peter Zimmermann
Article-ID: DMS-20585-DE

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Die Präeklampsie ist trotz ihrer denkbar einfachen Definition als Symptomkomplex von erhöhtem Blutdruck und Proteinurie in der Schwangerschaft ein höchst komplexes Krankheitsbild mit einer hohen Morbidität und Mortalität von Mutter und Kind. In ihrer klassischen Form mit einem Auftreten vor der 34. Schwangerschaftswoche ist die zentrale pathophysiologische Signatur eine Störung des Plazenta- Gefäßbettes mit fehlender Umwandlung des – außerhalb der Schwangerschaft physiologischen – uterinen Hoch-Widerstand-Strömungsbildes in ein Nieder-Widerstand-Strömungsbild. Die alleinige Kausaltherapie ist die Trennung von Mutter und Kind mit der Entfernung der Plazenta. Eine wirksame Prophylaxe gibt es bisher nicht. Die vorliegende Arbeit, entstanden aus einer Initiative während der frauenärztlichen Fortbildung in Kassel im Juni 2014, soll neben einer Übersicht zum gegenwärtigen Stand der Forschung Gedanken anregen, das Krankheitsbild der Präeklampsie geisteswissenschaftlich weiter zu verstehen.

Preeclampsia – signature and pathophysiology

In spite of a truly simple definition as the combined symptoms of elevated blood pressure and proteinuria during pregnancy, preeclampsia is a highly complex syndrome with high morbidity and mortality for mother and child. In the classic form, onset is before the 34th week, and the central pathophysiological signature is uteroplacental disorder, with failure to transform the uterine high-resistance flow image (physiological if outside pregnancy) into a low-resistance flow image. The only causal treatment is to separate mother and child and remove the placenta. So far there is no effective prophylaxis. The paper, resulting from an initiative during the gynaecological further training course in Kassel in June 2014, offers an overview of current research findings and is intended to encourage efforts to gain further spiritual-scientific insight into the conditions.

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