Skip to main content

2016 | OriginalPaper | Buchkapitel

12. Schwangerschaftsvorsorge

verfasst von : Ralf Schild

Erschienen in: Die Geburtshilfe

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Vorsorgeuntersuchungen sind essenzieller Bestandteil der Schwangerenbetreuung und Geburtsplanung. Ziele der modernen Schwangerenvorsorge sind die Sicherstellung der mütterlichen Gesundheit vor und nach der Geburt und die frühzeitige Diagnose und Therapie maternaler und fetaler Erkrankungen, um einen optimalen Schwangerschaftsausgang zu erreichen. Neben der ausführlichen Anamneseerhebung ist die möglichst exakte Bestimmung des Gestationsalters mittels hochauflösender Sonographie von Bedeutung. Die Beratung zum Lifestyle soll wesentliche Aspekte der optimalen Lebensführung in der Schwangerschaft beinhalten. Von zunehmender Bedeutung ist das Ultraschallscreening, das gemäß den Mutterschafts-Richtlinien zu 3 Zeitpunkten in der Schwangerschaft angeboten wird. Das Screening auf Schwangerschaftsdiabetes ist mittlerweile gut etabliert. Die Screeninguntersuchungen auf Zytomegalie, Streptokokken der Gruppe B und Toxoplasmose werden mangels eindeutiger Datenlage kontrovers diskutiert.
Literatur
Zurück zum Zitat Adler SP, Finney JW et al (1996) Prevention of child-to-mother transmission of cytomegalovirus by changing behaviors: a randomized controlled trial. Pediatr Infect Dis J 15(3):240–246CrossRefPubMed Adler SP, Finney JW et al (1996) Prevention of child-to-mother transmission of cytomegalovirus by changing behaviors: a randomized controlled trial. Pediatr Infect Dis J 15(3):240–246CrossRefPubMed
Zurück zum Zitat Benitz WE, Gould JB et al (1999) Preventing early-onset group B streptococcal sepsis: strategy development using decision analysis. Pediatrics 103(6):e76CrossRefPubMed Benitz WE, Gould JB et al (1999) Preventing early-onset group B streptococcal sepsis: strategy development using decision analysis. Pediatrics 103(6):e76CrossRefPubMed
Zurück zum Zitat Bricker L, Neilson JP (2000) Routine ultrasound in late pregnancy (after 24 weeks gestation). Cochrane Database Syst Rev (2):CD001451 Bricker L, Neilson JP (2000) Routine ultrasound in late pregnancy (after 24 weeks gestation). Cochrane Database Syst Rev (2):CD001451
Zurück zum Zitat Brocklehurst P, Rooney G (2000) Interventions for treating genital Chlamydia trachomatis infection in pregnancy. Cochrane Database Syst Rev (2):CD000054 Brocklehurst P, Rooney G (2000) Interventions for treating genital Chlamydia trachomatis infection in pregnancy. Cochrane Database Syst Rev (2):CD000054
Zurück zum Zitat Buekens P, Alexander S et al (1994) Randomised controlled trial of routine cervical examinations in pregnancy. European Community Collaborative Study Group on Prenatal Screening. Lancet 344(8926):841–844CrossRefPubMed Buekens P, Alexander S et al (1994) Randomised controlled trial of routine cervical examinations in pregnancy. European Community Collaborative Study Group on Prenatal Screening. Lancet 344(8926):841–844CrossRefPubMed
Zurück zum Zitat Bukowski R, Malone FD et al (2009) Preconceptional folate supplementation and the risk of spontaneous preterm birth: a cohort study. PLoS Med 6(5):e1000061CrossRefPubMedPubMedCentral Bukowski R, Malone FD et al (2009) Preconceptional folate supplementation and the risk of spontaneous preterm birth: a cohort study. PLoS Med 6(5):e1000061CrossRefPubMedPubMedCentral
Zurück zum Zitat Cook RL, Hutchison SL et al (2005) Systematic review: noninvasive testing for Chlamydia trachomatis and Neisseria gonorrhoeae. Ann Intern Med 142(11):914–925CrossRefPubMed Cook RL, Hutchison SL et al (2005) Systematic review: noninvasive testing for Chlamydia trachomatis and Neisseria gonorrhoeae. Ann Intern Med 142(11):914–925CrossRefPubMed
Zurück zum Zitat Crowley P (2000) Interventions for preventing or improving the outcome of delivery at or beyond term. Cochrane Database Syst Rev (2):CD000170 Crowley P (2000) Interventions for preventing or improving the outcome of delivery at or beyond term. Cochrane Database Syst Rev (2):CD000170
Zurück zum Zitat Crowther CA, Kornman L et al (1999) Is an ultrasound assessment of gestational age at the first antenatal visit of value? A randomised clinical trial. Br J Obstet Gynaecol 106(12):1273–1279CrossRefPubMed Crowther CA, Kornman L et al (1999) Is an ultrasound assessment of gestational age at the first antenatal visit of value? A randomised clinical trial. Br J Obstet Gynaecol 106(12):1273–1279CrossRefPubMed
Zurück zum Zitat Dawes MG, Grudzinskas JG (1991) Repeated measurement of maternal weight during pregnancy. Is this a useful practice? Br J Obstet Gynaecol 98(2):189–194CrossRefPubMed Dawes MG, Grudzinskas JG (1991) Repeated measurement of maternal weight during pregnancy. Is this a useful practice? Br J Obstet Gynaecol 98(2):189–194CrossRefPubMed
Zurück zum Zitat Enders G, Bader U et al (2001) Prenatal diagnosis of congenital cytomegalovirus infection in 189 pregnancies with known outcome. Prenat Diagn 21(5):362–377CrossRefPubMed Enders G, Bader U et al (2001) Prenatal diagnosis of congenital cytomegalovirus infection in 189 pregnancies with known outcome. Prenat Diagn 21(5):362–377CrossRefPubMed
Zurück zum Zitat Figueras F, Martinez JM et al (2003) Contraction stress test versus ductus venosus Doppler evaluation for the prediction of adverse perinatal outcome in growth-restricted fetuses with non-reassuring non-stress test. Ultrasound Obstet Gynecol 21(3):250–255CrossRefPubMed Figueras F, Martinez JM et al (2003) Contraction stress test versus ductus venosus Doppler evaluation for the prediction of adverse perinatal outcome in growth-restricted fetuses with non-reassuring non-stress test. Ultrasound Obstet Gynecol 21(3):250–255CrossRefPubMed
Zurück zum Zitat Gemeinsamer Bundesausschuss (2012) Richtlinien über die ärztliche Betreuung während der Schwangerschaft und nach der Entbindung (Mutterschafts-Richtlinien) Bundesanzeiger (36):914 ff. Gemeinsamer Bundesausschuss (2012) Richtlinien über die ärztliche Betreuung während der Schwangerschaft und nach der Entbindung (Mutterschafts-Richtlinien) Bundesanzeiger (36):914 ff.
Zurück zum Zitat Goh BT, van Voorst Vader PC (2001) European guideline for the management of syphilis. Int J STD AIDS 12(Suppl 3):14–26CrossRefPubMed Goh BT, van Voorst Vader PC (2001) European guideline for the management of syphilis. Int J STD AIDS 12(Suppl 3):14–26CrossRefPubMed
Zurück zum Zitat Hohlfeld P, Daffos F et al (1989) Fetal toxoplasmosis: outcome of pregnancy and infant follow-up after in utero treatment. J Pediatr 115(5 Pt 1):765–769CrossRefPubMed Hohlfeld P, Daffos F et al (1989) Fetal toxoplasmosis: outcome of pregnancy and infant follow-up after in utero treatment. J Pediatr 115(5 Pt 1):765–769CrossRefPubMed
Zurück zum Zitat Kiss H, Petricevic L et al (2004) Prospective randomised controlled trial of an infection screening programme to reduce the rate of preterm delivery. BMJ 329(7462):371CrossRefPubMedPubMedCentral Kiss H, Petricevic L et al (2004) Prospective randomised controlled trial of an infection screening programme to reduce the rate of preterm delivery. BMJ 329(7462):371CrossRefPubMedPubMedCentral
Zurück zum Zitat Langer B, Caneva MP et al (1999) Routine prenatal care in Europe: the comparative experience of nine departments of gynaecology and obstetrics in eight different countries. Eur J Obstet Gynecol Reprod Biol 85(2):191–198CrossRefPubMed Langer B, Caneva MP et al (1999) Routine prenatal care in Europe: the comparative experience of nine departments of gynaecology and obstetrics in eight different countries. Eur J Obstet Gynecol Reprod Biol 85(2):191–198CrossRefPubMed
Zurück zum Zitat Lebech M, Andersen O et al (1999) Feasibility of neonatal screening for toxoplasma infection in the absence of prenatal treatment. Danish Congenital Toxoplasmosis Study Group. Lancet 353(9167):1834–1837CrossRefPubMed Lebech M, Andersen O et al (1999) Feasibility of neonatal screening for toxoplasma infection in the absence of prenatal treatment. Danish Congenital Toxoplasmosis Study Group. Lancet 353(9167):1834–1837CrossRefPubMed
Zurück zum Zitat Levran D, Shoham Z et al (1988) The value of amnioscopy in surveillance of postdate pregnancy. Aust N Z J Obstet Gynaecol 28(4):271–274CrossRefPubMed Levran D, Shoham Z et al (1988) The value of amnioscopy in surveillance of postdate pregnancy. Aust N Z J Obstet Gynaecol 28(4):271–274CrossRefPubMed
Zurück zum Zitat Lumley J, Watson L et al (2001) Periconceptional supplementation with folate and/or multivitamins for preventing neural tube defects. Cochrane Database Syst Rev (3):CD001056 Lumley J, Watson L et al (2001) Periconceptional supplementation with folate and/or multivitamins for preventing neural tube defects. Cochrane Database Syst Rev (3):CD001056
Zurück zum Zitat Mahomed K (2000) Folate supplementation in pregnancy. Cochrane Database Syst Rev (2):CD000183 Mahomed K (2000) Folate supplementation in pregnancy. Cochrane Database Syst Rev (2):CD000183
Zurück zum Zitat McDonald H, Brocklehurst P et al (2005) Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database Syst Rev (1):CD000262 McDonald H, Brocklehurst P et al (2005) Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database Syst Rev (1):CD000262
Zurück zum Zitat Moro PL, Tepper NK et al (2012) Safety of seasonal influenza and influenza A (H1N1) 2009 monovalent vaccines in pregnancy. Expert Rev Vaccines 11(8):911–921CrossRefPubMed Moro PL, Tepper NK et al (2012) Safety of seasonal influenza and influenza A (H1N1) 2009 monovalent vaccines in pregnancy. Expert Rev Vaccines 11(8):911–921CrossRefPubMed
Zurück zum Zitat National Collaborating Centre for Women’s and Children’s Health (2008) Antenatal care: routine care for the healthy pregnant woman. National Institute for Health and Clinical Excellence (NICE), London. http://www.rcog.org.uk: > Guidelines > National Evidence-Based Clinical Guidelines > Antenatal Care Routine for the Healthy Pregnant Woman.pdf. Zugegriffen im Oct 2013 National Collaborating Centre for Women’s and Children’s Health (2008) Antenatal care: routine care for the healthy pregnant woman. National Institute for Health and Clinical Excellence (NICE), London. http://​www.​rcog.​org.​uk: > Guidelines > National Evidence-Based Clinical Guidelines > Antenatal Care Routine for the Healthy Pregnant Woman.pdf. Zugegriffen im Oct 2013
Zurück zum Zitat Nigro G, Anceschi MM et al (2003) Clinical manifestations and abnormal laboratory findings in pregnant women with primary cytomegalovirus infection. BJOG 110(6):572–577CrossRefPubMed Nigro G, Anceschi MM et al (2003) Clinical manifestations and abnormal laboratory findings in pregnant women with primary cytomegalovirus infection. BJOG 110(6):572–577CrossRefPubMed
Zurück zum Zitat Pattison N, McCowan L (2000) Cardiotocography for antepartum fetal assessment. Cochrane Database Syst Rev (2):CD001068 Pattison N, McCowan L (2000) Cardiotocography for antepartum fetal assessment. Cochrane Database Syst Rev (2):CD001068
Zurück zum Zitat Peyron F, Wallon M et al (2000) Treatments for toxoplasmosis in pregnancy. Cochrane Database Syst Rev (2):CD001684 Peyron F, Wallon M et al (2000) Treatments for toxoplasmosis in pregnancy. Cochrane Database Syst Rev (2):CD001684
Zurück zum Zitat Schild RL, Wacker J (2013) Schwangerenvorsorge. In: Wacker J, Bastert G, Beckmann MW (Hrsg) Therapiehandbuch Gynäkologie und Geburtshilfe. Springer, Berlin/Heidelberg/New York, S 31–42CrossRef Schild RL, Wacker J (2013) Schwangerenvorsorge. In: Wacker J, Bastert G, Beckmann MW (Hrsg) Therapiehandbuch Gynäkologie und Geburtshilfe. Springer, Berlin/Heidelberg/New York, S 31–42CrossRef
Zurück zum Zitat Siemer J, Schild RL et al (2013) Neuerungen im Mutterpass und pränatalen Ultraschallscreening. Geburtsh Frauenheilkd 73:R49–R62CrossRef Siemer J, Schild RL et al (2013) Neuerungen im Mutterpass und pränatalen Ultraschallscreening. Geburtsh Frauenheilkd 73:R49–R62CrossRef
Zurück zum Zitat Smaill F (2000) Intrapartum antibiotics for group B streptococcal colonisation. Cochrane Database Syst Rev (2):CD000115 Smaill F (2000) Intrapartum antibiotics for group B streptococcal colonisation. Cochrane Database Syst Rev (2):CD000115
Zurück zum Zitat Smaill F (2001) Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Database Syst Rev (2):CD000490 Smaill F (2001) Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Database Syst Rev (2):CD000490
Zurück zum Zitat Voigt M, Briese V, Jorch G, Henrich W, Schneider KT, Straube S (2009) The influence of smoking during pregnancy on fetal growth. Considering daily cigarette consumption and the SGA rate according to length of gestation. Z Geburtshilfe Neonatol 213(5):194–200CrossRefPubMed Voigt M, Briese V, Jorch G, Henrich W, Schneider KT, Straube S (2009) The influence of smoking during pregnancy on fetal growth. Considering daily cigarette consumption and the SGA rate according to length of gestation. Z Geburtshilfe Neonatol 213(5):194–200CrossRefPubMed
Zurück zum Zitat Wong VC, Ip HM et al (1984) Prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carriers of HBsAg and HBeAg by administration of hepatitis-B vaccine and hepatitis-B immunoglobulin. Double-blind randomised placebo-controlled study. Lancet 1(8383):921–926CrossRefPubMed Wong VC, Ip HM et al (1984) Prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carriers of HBsAg and HBeAg by administration of hepatitis-B vaccine and hepatitis-B immunoglobulin. Double-blind randomised placebo-controlled study. Lancet 1(8383):921–926CrossRefPubMed
Zurück zum Zitat Yow MD, Demmler GJ (1992) Congenital cytomegalovirus disease – 20 years is long enough. N Engl J Med 326(10):702–703CrossRefPubMed Yow MD, Demmler GJ (1992) Congenital cytomegalovirus disease – 20 years is long enough. N Engl J Med 326(10):702–703CrossRefPubMed
Metadaten
Titel
Schwangerschaftsvorsorge
verfasst von
Ralf Schild
Copyright-Jahr
2016
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-45064-2_12