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Erschienen in: Der Anaesthesist 4/2016

05.04.2016 | Allgemeinanästhesie | Fehler und Gefahren

„Why mothers die“

Was wir von der Analyse anästhesiebedingter mütterlicher Sterbefälle (1985–2013) gelernt haben

verfasst von: Dr. S. Neuhaus, C. Neuhaus, H. Fluhr, S. Hofer, R. Schreckenberger, M. A. Weigand, D. Bremerich

Erschienen in: Die Anaesthesiologie | Ausgabe 4/2016

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Zusammenfassung

Täglich sterben weltweit über 800 Frauen an schwangerschafts- oder geburtsassoziierten Komplikationen. In den Confidential Enquiry of Maternal Deaths Reports (CEMD) wird seit 1952 die Müttersterblichkeit im Vereinigten Königreich Großbritannien und Irland erfasst und aufgearbeitet. Die vorliegende Arbeit analysiert die CEMD der Jahre 1985–2013 hinsichtlich anästhesie- und analgesiebedingter mütterlicher Todesursachen in der Schwangerschaft, peripartal und im Wochenbett. Im untersuchten Zeitraum zeichnete sich eine Abnahme direkt anästhesiebedingter mütterlicher Sterbefälle auf aktuell 4,3 % ab. Jedoch kam es zu einer Zunahme anästhesieassoziierter mütterlicher Sterbefälle. Die Rate an tödlichen Komplikationen im Rahmen einer geburtshilflichen Regionalanästhesie hat sich in den letzten Jahren verdoppelt, während das Risiko im Rahmen einer geburtshilflichen Vollnarkose zu sterben rückläufig ist.
Viele der geschilderten mütterlichen Sterbefälle wären möglicherweise vermeidbar gewesen. Jeder geburtshilflich tätige Anästhesist sollte sich mit dem schwangerschaftsspezifischen Vorgehen, peripartal und auch im Wochenbett vertraut machen, bestenfalls mithilfe der geforderten Simulationsübungen. Das Monitoring von Patientinnen nach geburtshilflichen Eingriffen muss dem nicht geburtshilflicher Patienten entsprechen, sogenannte Modified Early Obstetric Warning Scores sollten hierbei zur Anwendung kommen. Im Rahmen der Regionalanästhesie sind aktuelle Hygienestandards strikt einzuhalten und Postpunktionskontrollen durchzuführen. Interdisziplinäre Kommunikation und Zusammenarbeit sind essenziell, jedoch weiterhin verbesserungswürdig. Für Risikopatientinnen sollte bereits im Schwangerschaftsverlauf ein interdisziplinärer Geburtsplan erarbeitet werden.
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Metadaten
Titel
„Why mothers die“
Was wir von der Analyse anästhesiebedingter mütterlicher Sterbefälle (1985–2013) gelernt haben
verfasst von
Dr. S. Neuhaus
C. Neuhaus
H. Fluhr
S. Hofer
R. Schreckenberger
M. A. Weigand
D. Bremerich
Publikationsdatum
05.04.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Anaesthesiologie / Ausgabe 4/2016
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI
https://doi.org/10.1007/s00101-016-0155-6

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