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Erschienen in: Der Gynäkologe 10/2014

01.10.2014 | CME Zertifizierte Fortbildung

Myome in der Schwangerschaft

Häufigkeit, Komplikationen und Behandlung

verfasst von: PD Dr. M. Wallwiener, MHBA, S. Gawlik

Erschienen in: Die Gynäkologie | Ausgabe 10/2014

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Zusammenfassung

Symptomatische Myome des Uterus sind ein häufiger und bedeutsamer Morbiditätsgrund für Frauen in der reproduktiven Lebensphase. Die Rate myomassoziierter Komplikationen in der Schwangerschaft wird mit etwa 10–30 % angegeben, doch die Studienlage ist noch unzureichend. In der frühen Schwangerschaft können Uterusmyome mit einer erhöhten Spontanabortrate einhergehen und sind gehäuft mit Blutungen assoziiert, insbesondere wenn die Plazentation nahe am Myom stattgefunden hat. Im Verlauf der Schwangerschaft sind Schmerzen die häufigsten myomassoziierten Komplikationen, insbesondere bei Vorliegen von Myomen mit einem Größenwachstum über 5 cm im 2. und 3. Trimenon. Des Weiteren kann das Risiko in der Schwangerschaft u. a. für vorzeitige Wehen, vorzeitige Plazentalösung, Placenta praevia und Lageanomalien sowie seltener für kindliche Fehlbildungen erhöht sein. Eine Behandlung erfolgt in der Regel konservativ: Bettruhe, Flüssigkeitszufuhr, Analgesie und ggf. antibiotische Therapie. In seltenen Fällen ist jedoch operatives Vorgehen erforderlich; dann steht die Myomenukleation als Ultima Ratio im Vordergrund.
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Metadaten
Titel
Myome in der Schwangerschaft
Häufigkeit, Komplikationen und Behandlung
verfasst von
PD Dr. M. Wallwiener, MHBA
S. Gawlik
Publikationsdatum
01.10.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Gynäkologie / Ausgabe 10/2014
Print ISSN: 2731-7102
Elektronische ISSN: 2731-7110
DOI
https://doi.org/10.1007/s00129-014-3438-5

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