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Die Gynäkologie
Erschienen in: Die Gynäkologie 5/2021

20.04.2021 | Pruritus | CME

Schwangerschaftscholestase

In Zusammenarbeit mit der AG Geburtshilfe und Pränatalmedizin in der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe – Sektion Maternale Erkrankungen

verfasst von: Dr. med. Carsten Hagenbeck, Ulrich Pecks, Frank Lammert, Matthias C. Hütten, Felix Borgmeier, Tanja Fehm, Ekkehard Schleußner, Holger Maul, Sven Kehl, Amr Hamza, Verena Keitel

Erschienen in: Die Gynäkologie | Ausgabe 5/2021

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Zusammenfassung

Die Schwangerschaftscholestase („intrahepatic cholestasis of pregnancy“, ICP) ist die häufigste schwangerschaftsspezifische Lebererkrankung. Das Leitsymptom Juckreiz sowie eine begleitende Serumkonzentrationserhöhung von Gallensäuren und/oder der Alaninaminotransferase (ALT) sind wegweisend in der Diagnosestellung. Die mütterliche Prognose ist gut. Das fetale Outcome ist abhängig von der Gallensäurenkonzentration. Die ICP ist dabei sowohl mit Frühgeburt als auch mit intrauterinem Fruchttod (IUFT) assoziiert. Dieser ist Folge einer akuten fetalen Asphyxie, nicht einer chronischen uteroplazentaren Dysfunktion. Ein prädiktives Monitoring, z. B. durch Kardiotokographie (CTG) oder Ultraschall gibt es nicht. Eine medikamentöse Therapie mit Ursodeoxycholsäure (UDCA) bessert den Juckreiz, aber beeinflusst das fetale Outcome nicht nachweislich. Eine Entbindungsindikation ist in Abhängigkeit von Gallensäurenkonzentration und Gestationsalter gegeben. In Folgeschwangerschaften besteht ein hohes Wiederholungsrisiko.
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Metadaten
Titel
Schwangerschaftscholestase
In Zusammenarbeit mit der AG Geburtshilfe und Pränatalmedizin in der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe – Sektion Maternale Erkrankungen
verfasst von
Dr. med. Carsten Hagenbeck
Ulrich Pecks
Frank Lammert
Matthias C. Hütten
Felix Borgmeier
Tanja Fehm
Ekkehard Schleußner
Holger Maul
Sven Kehl
Amr Hamza
Verena Keitel
Publikationsdatum
20.04.2021
Verlag
Springer Medizin
Erschienen in
Die Gynäkologie / Ausgabe 5/2021
Print ISSN: 2731-7102
Elektronische ISSN: 2731-7110
DOI
https://doi.org/10.1007/s00129-021-04787-4

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