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2018 | OriginalPaper | Buchkapitel

20. Geburtshilfliche Notfälle

verfasst von : Dr. med. C. Vonlanthen, Prof. Dr. O. Lapaire, Prof. Dr. T. Girard

Erschienen in: Die geburtshilfliche Anästhesie

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Bei vielen geburtshilflichen Notfällen ist eine reibungslose interdisziplinäre Zusammenarbeit wichtig. Somit ist es auch notwendig, dass Anästhesisten die geburtshilflichen Grundsätze dieser Notfälle kennen und wissen, was für die Geburtshelfer im Vordergrund steht. Bei einigen Notfällen ist es wichtig, nicht überstürzt zur Not-Sectio zu schreiten, sondern die Mutter zunächst zu stabilisieren. In vielen dieser Situationen muss jedoch zur Entbindung des Kindes rasch eine adäquate Anästhesie etabliert werden. Bei sorgfältiger Planung und entsprechender Struktur kann dies durchaus eine Regionalanästhesie sein. Das Kapitel umfasst geburtshilfliche Notfälle wie eklamptischer Anfall, Nabelschnurvorfall, Schulterdystokie, Plazentalösung oder Uterusruptur. Es werden aber ebenso allgemeinere Notfallsituationen wie Sepsis oder thromboembolische Ereignisse behandelt.
Literatur
Zurück zum Zitat Abenhaim HA, Azoulay L, Kramer MS, Leduc L (2008) Incidence and risk factors of amniotic fluid embolisms: a population-based study on 3 million births in the United States. Am J Obstet Gynecol 199:49.e1–8 Abenhaim HA, Azoulay L, Kramer MS, Leduc L (2008) Incidence and risk factors of amniotic fluid embolisms: a population-based study on 3 million births in the United States. Am J Obstet Gynecol 199:49.e1–8
Zurück zum Zitat American College of Obstetricians and Gynecologists (2015) Committee Opinion, Number 623, Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period 1–5 American College of Obstetricians and Gynecologists (2015) Committee Opinion, Number 623, Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period 1–5
Zurück zum Zitat American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy (2013) Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy. Obstet Gynecol 122:1122–1131 American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy (2013) Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy. Obstet Gynecol 122:1122–1131
Zurück zum Zitat Aşicioğlu O, Güngördük K, Yildirim G, Aslan H, Günay T (2014) Maternal and perinatal outcomes of eclampsia with and without HELLP syndrome in a teaching hospital in western Turkey. J Obstet Gynaecol 34:326–331 Aşicioğlu O, Güngördük K, Yildirim G, Aslan H, Günay T (2014) Maternal and perinatal outcomes of eclampsia with and without HELLP syndrome in a teaching hospital in western Turkey. J Obstet Gynaecol 34:326–331
Zurück zum Zitat Axemo P, Fu X, Lindberg B, Ulmsten U, Wessén A (1998) Intravenous nitroglycerin for rapid uterine relaxation. Acta Obstet Gynecol Scand 77:50–53 Axemo P, Fu X, Lindberg B, Ulmsten U, Wessén A (1998) Intravenous nitroglycerin for rapid uterine relaxation. Acta Obstet Gynecol Scand 77:50–53
Zurück zum Zitat Bates SM, Greer IA, Middeldorp S, Veenstra DL, Prabulos A-M, Vandvik PO, American College of Chest Physicians (2012) VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141:e691S–736S Bates SM, Greer IA, Middeldorp S, Veenstra DL, Prabulos A-M, Vandvik PO, American College of Chest Physicians (2012) VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141:e691S–736S
Zurück zum Zitat Bourjeily G, Paidas M, Khalil H, Rosene-Montella K, Rodger M (2010) Pulmonary embolism in pregnancy. Lancet 375:500–512 Bourjeily G, Paidas M, Khalil H, Rosene-Montella K, Rodger M (2010) Pulmonary embolism in pregnancy. Lancet 375:500–512
Zurück zum Zitat Buddeberg BS, Aveling W (2015) Puerperal sepsis in the 21st century: progress, new challenges and the situation worldwide. Postgrad Med J 91:572–578 Buddeberg BS, Aveling W (2015) Puerperal sepsis in the 21st century: progress, new challenges and the situation worldwide. Postgrad Med J 91:572–578
Zurück zum Zitat Chestnut DH, Wong CA, Tsen LC, Ngan Kee WD, Beilin Y, Mhyre J (2014) Chestnut’s Obstetric Anesthesia: Principles and Practice. Elsevier Health Sciences, Amsterdam Chestnut DH, Wong CA, Tsen LC, Ngan Kee WD, Beilin Y, Mhyre J (2014) Chestnut’s Obstetric Anesthesia: Principles and Practice. Elsevier Health Sciences, Amsterdam
Zurück zum Zitat Clark SL, Hankins GD, Dudley DA, Dildy GA, Porter TF (1995) Amniotic fluid embolism: analysis of the national registry. Am J Obstet Gynecol 172:1158–67 Clark SL, Hankins GD, Dudley DA, Dildy GA, Porter TF (1995) Amniotic fluid embolism: analysis of the national registry. Am J Obstet Gynecol 172:1158–67
Zurück zum Zitat Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, Sevransky JE, Sprung CL, Douglas IS, Jaeschke R, Osborn TM, Nunnally ME, Townsend SR, Reinhart K, Kleinpell RM, Angus DC, Deutschman CS, Machado FR, Rubenfeld GD, Webb SA, Beale RJ, Vincent J-L, Moreno R, Surviving Sepsis Campaign Guidelines Committee including the Pediatric Subgroup (2013) Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med 41:580–637 Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, Sevransky JE, Sprung CL, Douglas IS, Jaeschke R, Osborn TM, Nunnally ME, Townsend SR, Reinhart K, Kleinpell RM, Angus DC, Deutschman CS, Machado FR, Rubenfeld GD, Webb SA, Beale RJ, Vincent J-L, Moreno R, Surviving Sepsis Campaign Guidelines Committee including the Pediatric Subgroup (2013) Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med 41:580–637
Zurück zum Zitat Dennis AT (2012) Management of pre-eclampsia: issues for anaesthetists. Anaesthesia 67:1009–1020 Dennis AT (2012) Management of pre-eclampsia: issues for anaesthetists. Anaesthesia 67:1009–1020
Zurück zum Zitat Dennis AT, Chambers E, Serang K (2015) Blood pressure assessment and first-line pharmacological agents in women with eclampsia. Int J Obstet Anesth 24:247–251 Dennis AT, Chambers E, Serang K (2015) Blood pressure assessment and first-line pharmacological agents in women with eclampsia. Int J Obstet Anesth 24:247–251
Zurück zum Zitat DGAI (2009) Durchführung von Analgesie- und Anästhesieverfahren in der Geburtshilfe. Anaesthesiol Intensivmed S490–S495 DGAI (2009) Durchführung von Analgesie- und Anästhesieverfahren in der Geburtshilfe. Anaesthesiol Intensivmed S490–S495
Zurück zum Zitat Duley L, Duley L, Gülmezoglu AM, Henderson-Smart DJ, Chou D (2010) Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane Database Syst Rev CD000025 Duley L, Duley L, Gülmezoglu AM, Henderson-Smart DJ, Chou D (2010) Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane Database Syst Rev CD000025
Zurück zum Zitat Einav SS, Kaufman NN, Sela HYH (2012) Maternal cardiac arrest and perimortem caesarean delivery: Evidence or expert-based? Resuscitation 83:1191–1200 Einav SS, Kaufman NN, Sela HYH (2012) Maternal cardiac arrest and perimortem caesarean delivery: Evidence or expert-based? Resuscitation 83:1191–1200
Zurück zum Zitat Fitzpatrick KE, Kurinczuk JJ, Alfirevic Z, Spark P, Brocklehurst P, Knight M (2012) Uterine rupture by intended mode of delivery in the UK: a national case-control study. PLoS Med 9:e1001184 Fitzpatrick KE, Kurinczuk JJ, Alfirevic Z, Spark P, Brocklehurst P, Knight M (2012) Uterine rupture by intended mode of delivery in the UK: a national case-control study. PLoS Med 9:e1001184
Zurück zum Zitat Gogarten W (2009) Preeclampsia and anaesthesia. Curr Opin Anaesthesiol 22:347–351 Gogarten W (2009) Preeclampsia and anaesthesia. Curr Opin Anaesthesiol 22:347–351
Zurück zum Zitat Grady K, Howell C, Cox C (2007) Managing obstetric emergencies and trauma: the MOET Course Manual. Royal College of Obstetricians and Gynaecologists Grady K, Howell C, Cox C (2007) Managing obstetric emergencies and trauma: the MOET Course Manual. Royal College of Obstetricians and Gynaecologists
Zurück zum Zitat Guntupalli KK, Karnad DR, Bandi V, Hall N, Belfort M (2015) Critical Illness in Pregnancy: Part II: Common Medical Conditions Complicating Pregnancy and Puerperium. Chest 148:1333–1345 Guntupalli KK, Karnad DR, Bandi V, Hall N, Belfort M (2015) Critical Illness in Pregnancy: Part II: Common Medical Conditions Complicating Pregnancy and Puerperium. Chest 148:1333–1345
Zurück zum Zitat Henke VG, Bateman BT, Leffert LR (2013) Focused review: spinal anesthesia in severe preeclampsia. Anesth Analg 117:686–693 Henke VG, Bateman BT, Leffert LR (2013) Focused review: spinal anesthesia in severe preeclampsia. Anesth Analg 117:686–693
Zurück zum Zitat Hsieh YY, Chang CC, Li PC, Tsai HD, Tsai CH (2000) Successful application of extracorporeal membrane oxygenation and intra-aortic balloon counterpulsation as lifesaving therapy for a patient with amniotic fluid embolism. Am J Obstet Gynecol 183:496–497 Hsieh YY, Chang CC, Li PC, Tsai HD, Tsai CH (2000) Successful application of extracorporeal membrane oxygenation and intra-aortic balloon counterpulsation as lifesaving therapy for a patient with amniotic fluid embolism. Am J Obstet Gynecol 183:496–497
Zurück zum Zitat James A, Committee on Practice Bulletins – Obstetrics (2011) Practice bulletin no. 123: thromboembolism in pregnancy. Obstet Gynecol 118:718–729 James A, Committee on Practice Bulletins – Obstetrics (2011) Practice bulletin no. 123: thromboembolism in pregnancy. Obstet Gynecol 118:718–729
Zurück zum Zitat Kaneko Y, Ogihara T, Tajima H, Mochimaru F (2001) Continuous hemodiafiltration for disseminated intravascular coagulation and shock due to amniotic fluid embolism: report of a dramatic response. Intern Med 40:945–947 Kaneko Y, Ogihara T, Tajima H, Mochimaru F (2001) Continuous hemodiafiltration for disseminated intravascular coagulation and shock due to amniotic fluid embolism: report of a dramatic response. Intern Med 40:945–947
Zurück zum Zitat Katz D, Beilin Y (2015) Disorders of coagulation in pregnancy. Br J Anaesth 115:ii75–ii88 Katz D, Beilin Y (2015) Disorders of coagulation in pregnancy. Br J Anaesth 115:ii75–ii88
Zurück zum Zitat Kinsella SM, Girgirah K, Scrutton MJL (2010) Rapid sequence spinal anaesthesia for category-1 urgency caesarean section: a case series. Anaesthesia 65:664–669 Kinsella SM, Girgirah K, Scrutton MJL (2010) Rapid sequence spinal anaesthesia for category-1 urgency caesarean section: a case series. Anaesthesia 65:664–669
Zurück zum Zitat Knight M, Kenyon S, Brocklehurst P, Neilson J, Shakespeare J, Kurinczuk JJ, kurinc (2014) Saving Lives, Improving Mothers’ Care. Oxford Knight M, Kenyon S, Brocklehurst P, Neilson J, Shakespeare J, Kurinczuk JJ, kurinc (2014) Saving Lives, Improving Mothers’ Care. Oxford
Zurück zum Zitat Knight M, Tuffnell D, Brocklehurst P, Spark P, Kurinczuk JJ, UK Obstetric Surveillance System (2010) Incidence and risk factors for amniotic-fluid embolism. Obstet Gynecol 115:910–917 Knight M, Tuffnell D, Brocklehurst P, Spark P, Kurinczuk JJ, UK Obstetric Surveillance System (2010) Incidence and risk factors for amniotic-fluid embolism. Obstet Gynecol 115:910–917
Zurück zum Zitat Kramer MS, Rouleau J, Baskett TF, Joseph KS, Maternal Health Study Group of the Canadian Perinatal Surveillance System (2006) Amniotic-fluid embolism and medical induction of labour: a retrospective, population-based cohort study. Lancet 368:1444–1448 Kramer MS, Rouleau J, Baskett TF, Joseph KS, Maternal Health Study Group of the Canadian Perinatal Surveillance System (2006) Amniotic-fluid embolism and medical induction of labour: a retrospective, population-based cohort study. Lancet 368:1444–1448
Zurück zum Zitat Kramer S, Schröder T, Schuster M, Stangl V, Correns I, Sanad W, Volk T (2011) Management bei kardialer Hochrisikoschwangerschaft. Sectio bei einer I. Gravida mit zyanotischem Vitium. Anaesthesist 60:57–62 Kramer S, Schröder T, Schuster M, Stangl V, Correns I, Sanad W, Volk T (2011) Management bei kardialer Hochrisikoschwangerschaft. Sectio bei einer I. Gravida mit zyanotischem Vitium. Anaesthesist 60:57–62
Zurück zum Zitat Kurinczuk JJ, Draper ES, Field DJ (2014) Experiences with maternal and perinatal death reviews in the UK MBRRACE-UK programme. Brit J Obstet Gynaec 121 Suppl 4:41–6 Kurinczuk JJ, Draper ES, Field DJ (2014) Experiences with maternal and perinatal death reviews in the UK MBRRACE-UK programme. Brit J Obstet Gynaec 121 Suppl 4:41–6
Zurück zum Zitat Leffert LR (2015) What’s new in obstetric anesthesia? Focus on preeclampsia. Int J Obstet Anesth 24:264–271 Leffert LR (2015) What’s new in obstetric anesthesia? Focus on preeclampsia. Int J Obstet Anesth 24:264–271
Zurück zum Zitat Leung AN, Bull TM, Jaeschke R; ATS/STR Committee on Pulmonary Embolism in Pregnancy (2012) American Thoracic Society documents: an official American Thoracic Society/Society of Thoracic Radiology Clinical Practice Guideline--Evaluation of Suspected Pulmonary Embolism in Pregnancy. Radiology. 2012;262:635–646 Leung AN, Bull TM, Jaeschke R; ATS/STR Committee on Pulmonary Embolism in Pregnancy (2012) American Thoracic Society documents: an official American Thoracic Society/Society of Thoracic Radiology Clinical Practice Guideline--Evaluation of Suspected Pulmonary Embolism in Pregnancy. Radiology. 2012;262:635–646
Zurück zum Zitat Martin JN, Thigpen BD, Moore RC, Rose CH, Cushman J, May W (2005) Stroke and severe preeclampsia and eclampsia: a paradigm shift focusing on systolic blood pressure. Obstet Gynecol 105:246–254 Martin JN, Thigpen BD, Moore RC, Rose CH, Cushman J, May W (2005) Stroke and severe preeclampsia and eclampsia: a paradigm shift focusing on systolic blood pressure. Obstet Gynecol 105:246–254
Zurück zum Zitat McClure JH, Cooper GM, Clutton-Brock TH, on behalf of the Centre for Maternal and Child Enquiries (2011) Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer: 2006–8: a review. Br J Anaesth 107:127–132 McClure JH, Cooper GM, Clutton-Brock TH, on behalf of the Centre for Maternal and Child Enquiries (2011) Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer: 2006–8: a review. Br J Anaesth 107:127–132
Zurück zum Zitat McDonnell NJ, Chan BO, Frengley RW (2007) Rapid reversal of critical haemodynamic compromise with nitric oxide in a parturient with amniotic fluid embolism. Int J Obstet Anesth 16:269–273 McDonnell NJ, Chan BO, Frengley RW (2007) Rapid reversal of critical haemodynamic compromise with nitric oxide in a parturient with amniotic fluid embolism. Int J Obstet Anesth 16:269–273
Zurück zum Zitat McDonnell NJ, Percival V, Paech MJ (2013) Amniotic fluid embolism: a leading cause of maternal death yet still a medical conundrum. Int J Obstet Anesth 22:329–336 McDonnell NJ, Percival V, Paech MJ (2013) Amniotic fluid embolism: a leading cause of maternal death yet still a medical conundrum. Int J Obstet Anesth 22:329–336
Zurück zum Zitat Melchiorre K, Sharma R, Thilaganathan B (2014) Cardiovascular implications in preeclampsia: an overview. Circulation 130:703–714 Melchiorre K, Sharma R, Thilaganathan B (2014) Cardiovascular implications in preeclampsia: an overview. Circulation 130:703–714
Zurück zum Zitat Nagarsheth NP, Pinney S, Bassily-Marcus A, Anyanwu A, Friedman L, Beilin Y (2008) Successful placement of a right ventricular assist device for treatment of a presumed amniotic fluid embolism. Anesth Analg 107:962–964 Nagarsheth NP, Pinney S, Bassily-Marcus A, Anyanwu A, Friedman L, Beilin Y (2008) Successful placement of a right ventricular assist device for treatment of a presumed amniotic fluid embolism. Anesth Analg 107:962–964
Zurück zum Zitat Nelson-Piercy C (2015) Handbook of Obstetric Medicine, 5th ed. CRC Press Nelson-Piercy C (2015) Handbook of Obstetric Medicine, 5th ed. CRC Press
Zurück zum Zitat Palanisamy A (2014) What’s New in Obstetric Anesthesia? The 2013 Gerard W. Ostheimer Lecture. Anesth Analg 118:360–366 Palanisamy A (2014) What’s New in Obstetric Anesthesia? The 2013 Gerard W. Ostheimer Lecture. Anesth Analg 118:360–366
Zurück zum Zitat Pant M, Fong R, Scavone B (2014) Prevention of Peri-Induction Hypertension in Preeclamptic Patients. Anesth Analg 119:1350–1356 Pant M, Fong R, Scavone B (2014) Prevention of Peri-Induction Hypertension in Preeclamptic Patients. Anesth Analg 119:1350–1356
Zurück zum Zitat Schneider H, Husslein PW, Schneider K-T (2010) Die Geburtshilfe. Springer, Berlin Heidelberg Schneider H, Husslein PW, Schneider K-T (2010) Die Geburtshilfe. Springer, Berlin Heidelberg
Zurück zum Zitat Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. (2016) The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 315:801–10 Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. (2016) The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 315:801–10
Zurück zum Zitat Stanten RD, Iverson LIG, Daugharty TM, Lovett SM, Terry C, Blumenstock E (2003) Amniotic fluid embolism causing catastrophic pulmonary vasoconstriction: diagnosis by transesophageal echocardiogram and treatment by cardiopulmonary bypass. Obstet Gynecol 102:496–498 Stanten RD, Iverson LIG, Daugharty TM, Lovett SM, Terry C, Blumenstock E (2003) Amniotic fluid embolism causing catastrophic pulmonary vasoconstriction: diagnosis by transesophageal echocardiogram and treatment by cardiopulmonary bypass. Obstet Gynecol 102:496–498
Zurück zum Zitat Strauss A (2006) Geburtshilfe Basics. Springer, Berlin Heidelberg New York Strauss A (2006) Geburtshilfe Basics. Springer, Berlin Heidelberg New York
Zurück zum Zitat Yentis S, Malhotra S (2012) Analgesia, Anaesthesia and Pregnancy. Cambridge University Press, Cambridge Yentis S, Malhotra S (2012) Analgesia, Anaesthesia and Pregnancy. Cambridge University Press, Cambridge
Metadaten
Titel
Geburtshilfliche Notfälle
verfasst von
Dr. med. C. Vonlanthen
Prof. Dr. O. Lapaire
Prof. Dr. T. Girard
Copyright-Jahr
2018
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-54375-7_20

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