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Tokolyse: Stellenwert Beim Vorzeitigen Blasensprung, Bei Gestörtem Intrauterinem Wachstum Und Bei Operativen Entbindungen by W. Künzel, S. Darda

Tokolyse: Stellenwert Beim Vorzeitigen Blasensprung, Bei Gestörtem Intrauterinem Wachstum Und Bei Operativen Entbindungen

by W. Künzel , S. Darda
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Book cover type: Paperback
  • ISBN13: 9783540137573
  • Binding: Paperback
  • Subject: N/A
  • Publisher: Springer
  • Publisher Imprint: Springer
  • Publication Date:
  • Pages: 88
  • Original Price: EUR 51.39
  • Language: German
  • Edition: N/A
  • Item Weight: 109 grams
  • BISAC Subject(s): Gynecology & Obstetrics

Die Einfiihrung -Rezeptoren-stimulierender Pharmaka in die Geburtshilfe vor etwa 15 lahren hat das geburtshilfliche Management ganz entscheidend gepriigt und beeinfluBt. Schnelle operative Ent- scheidungen bei fetalen Notsituationen wiihrend der Geburt sind sel- ten geworden. Vorzeitige Wehentiitigkeit mit der Gefahr der fruhen Beendigung der Schwangerschaft ist eine wesentliche Indikation fiir den Einsatz des Tokolytikums. Bei langer Anwendung uterusrelaxie- render Pharmaka bleibt es nicht aus, daB Nebenwirkungen unter- schiedlichen Schweregrades auftreten. Die in den einzelnen Publika- tionen berichteten Komplikationen und Gefahren der tokolytischen Therapie gilt es daher kritisch zu beleuchten und den Einsatz dieser Pharmaka in gewissen Bereichen neu zu uberdenken. Diese Aufgaben erfiillen die in diesem Buch zusammengefaBten Referate und Diskus- sionen einer Fortbildungstagung, die in Bad Nauheim 1983 stattfand. So bestehen grundsiitzliche Bedenken fiir eine tokolytische Therapie beim vorzeitigen Blasensprung, da die Ursache der When Ruptur der Membranen in niiherer Genese nicht gekliirt ist. Es ist denkbar, die Infektionsmorbiditiit des Fetus durch Verzogerung der Geburt zu erbOhen, obgleich das Ziel, eine bessere Ausreifung der fetalen Lunge durch die Tokolyse zu erreichen, sinnvoll erscheint. Hier ist es not- wendig, das Schwangerschaftsalter in die Entscheidungshilfe fUr das therapeutische Vorgehen einzubeziehen. Ungekliirt ist die Frage, welche Wirkungen die Tokolyse bei schwan- gerschaftsinduziertem Hochdruck entfaltet. Sie ist sicher bei der schweren Form der Gestose mit eingeschriinktem intrauterinem Wachstum nachteilig, da die Kontraktionen des Uterus fiir die Beur- teilung des fetalen Zustands notwendig sind. Auch Lungenkomplika- tionen sind beschrieben und in ihrer Genese jetzt weitgehend gekliirt.

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