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Endokrine Notfälle in der Schwangerschaft

Endocrine emergencies during pregnancy

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Zusammenfassung

Eine Schwangerschaft geht mit diversen physiologischen Veränderungen hormoneller Regelkreise einher. Akute Entgleisungen können sowohl die Mutter als auch das Kind vital gefährden. Neben Endokrinopathien, die im Rahmen der Schwangerschaft entstehen, stellen chronische endokrinologische Erkrankungen, wie z. B. Typ-1-Diabetes oder Morbus Basedow, in der Schwangerschaft eine besondere Herausforderung dar. Sowohl klinische Symptome, als auch die laborchemischen Referenzbereiche endokrinologischer Parameter werden durch die Schwangerschaft beeinflusst und können z. T. deutlich von denen außerhalb einer Schwangerschaft variieren. Zudem wird die Therapie durch eingeschränkte medikamentöse Optionen bei zugleich engeren Zielkorridoren erschwert. Diagnostik und therapeutisches Management erfordern daher insbesondere im Akutfall besondere Aufmerksamkeit. Diese Übersichtsarbeit fasst notfallrelevante endokrinologische Erkrankungen und Hintergrundinformationen zu Physiologie und Management zusammen.

Abstract

Endocrine emergencies during pregnancy can become life-threatening for both mother and fetus. In addition to some pregnancy-linked endocrine disorders, several pre-existing forms of endocrinopathy, such as Grave’s disease, type 1 diabetes and adrenal insufficiency might deteriorate acutely during pregnancy. Early diagnosis and management are challenging because the classical symptoms are often modified by pregnancy. Laboratory tests are subject to altered physiological ranges and pharmacological options are limited while therapeutic goals are stricter than in the non-pregnant patient. This article focuses on endocrine emergencies complicating pregnancy.

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Harbeck, B., Schütt, M. & Sayk, F. Endokrine Notfälle in der Schwangerschaft. Med Klin Intensivmed Notfmed 107, 110–117 (2012). https://doi.org/10.1007/s00063-011-0035-4

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