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30.01.2018 | Fertilität und Kinderwunsch | Übersichten

Neuromyelitis-optica-Spektrum-Erkrankung und Schwangerschaft

verfasst von: Dr. N. Borisow, K. Hellwig, F. Paul

Erschienen in: Der Nervenarzt | Ausgabe 6/2018

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Zusammenfassung

Hintergrund

Neuromyelitis-optica-Spektrum-Erkrankungen (NMOSD) sind autoimmun-entzündliche Erkrankungen des Zentralnervensystems (ZNS), die vorrangig Frauen betreffen. Ein Teil dieser Patientinnen erkrankt im gebärfähigen Alter, sodass Beratungsbedarf bezüglich Familienplanung und Schwangerschaften bestehen kann.

Ziel

Die aktuelle Publikation liefert einen Überblick zu den Themen Fertilität, Schwangerschaftskomplikationen und den Einfluss einer Schwangerschaft auf den NMOSD-Krankheitsverlauf. Darüber hinaus werden Therapieoptionen während der Schwangerschaft dargestellt.

Material und Methoden

Mithilfe der Datenbank PubMed erfolgte eine Recherche der aktuellen Literatur.

Ergebnisse und Diskussion

Tierexperimentelle Studien weisen auf Einschränkungen der Fertilität bei NMOSD hin, zur Fertilität von NMOSD-Patientinnen existieren bislang jedoch keine ausreichenden Daten. Eine Schwangerschaft bei NMOSD-Patientinnen geht mit einer erhöhten postpartalen Krankheitsaktivität sowie einem höheren Grad der Behinderung nach einer Schwangerschaft einher. Es liegen Hinweise auf ein erhöhtes Risiko für Schwangerschaftskomplikationen wie Spontanaborte und eine Präeklampsie vor. Zur Therapie eines akuten Schubs während einer Schwangerschaft können Methylprednisolon und/oder Plasmapherese/Immunadsorption eingesetzt werden. Das Absetzen bzw. die Fortführung einer immunsuppressiven Therapie mit Azathioprin oder Rituximab sollte kritisch unter Berücksichtigung der bisherigen Krankheitsaktivität abgewogen werden. Daher ist eine Mitbetreuung von NMOSD-Patienten, insbesondere in besonderen Situationen wie einer Schwangerschaft, durch spezialisierte Zentren empfehlenswert.

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Titel: Neuromyelitis-optica-Spektrum-Erkrankung und Schwangerschaft
verfasst von: Dr. N. Borisow
K. Hellwig
F. Paul
Publikationsdatum: 30.01.2018
Verlag: Springer Medizin
Schlagwörter: Fertilität und Kinderwunsch
Präeklampsie
Azathioprin
Rituximab
Neuromyelitis-optica-Spektrum-Erkrankung
Rituximab
Azathioprin
Erschienen in: Der Nervenarzt / Ausgabe 6/2018
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI: https://doi.org/10.1007/s00115-018-0486-4

Neu in den Fachgebieten Neurologie und Psychiatrie

25.04.2024 | Hypotonie | Nachrichten

Springer Medizin

Neuromyelitis-optica-Spektrum-Erkrankung und Schwangerschaft

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Hintergrund

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Ergebnisse und Diskussion

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Material und Methoden

Ergebnisse und Diskussion

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