DerAnaesthesist.50440395.ger.abstr-passage-0
abstract
Im Verlauf der Schwangerschaft kommt es zu wesentlichen haemodynamischen Veraenderungen . So steigt das Herzminutenvolumen um 40-50% der periphere Gefaesswiderstand ist deutlich vermindert und der arterielle Mitteldruck erniedrigt . Es vergroessern sich der Extrazellulaerraum um 5-6 l und das intravasale Volumen um 40-50% . Oestrogen und Progesteron aktivieren das Renin-Angiotensinsystem , das wiederum eine vermehrte Aldosteron- , und Prostaglandinsynthese induziert . Gleichzeitig nimmt die Sensibilitaet der glatten Gefaessmuskulatur fuer Angiotension und Katecholamine ab , so dass die Vasodilatation der Prostaglandine im Vordergrund steht . Die haeufigsten angeborenen Herzerkrankungen wie Vorhofseptumdefekt vom Sekundumtyp und offener Ductus Botalli erhoehen das Risiko fuer Mutter und Kind in der Regel nicht . Dagegen gefaehrden alle angeborenen Vitien mit Rechts-/links-Shunt und pulmonaler Hypertonie ( Eisenmengenkomplex , Fallotsche Tetralogie ) die Schwangere auf das Hoechste . Die haeufigste erworbene Herzerkrankung waehrend der Schwangerschaft ist das rheumatische Mitralvitium . Durch die schwangerschaftsspezifischen haemodynamischen Veraenderungen wird die klinische Symptomatik bei der Mitralstenose deutlich verschlechtert . Patientinnen mit einer hypertrophischen Kardiomyopathie tolerieren eine Schwangerschaft erstaunlich gut , so dass vaginale Entbindungen durchaus moeglich sind . Die arterielle Hypertonie waehrend der Schwangerschaft laesst sich in 3 Erscheinungsformen unterteilen : die chronische , die transitorische und praeeklamptische arterielle Hypertension . Die ersten beiden Formen erhoehen das Risiko fuer Mutter und Kind nur unwesentlich ; dagegen ist die praeeklamptische Hypertonie ein ernstes Krankheitsbild . Bei der praeeklamptischen Schwangeren ist das Renin-Angiotension-Aldosteron-System supprimiert und die Angiotensinrezeptoren sind offensichtlich up regulated " . " Das Herzminutenvolumen ist vermindert und der periphere Gefaesswiderstand erhoeht . Trotz bestehender Oedeme ist das Plasmavolumen reduziert . Die wesentlichen Aspekte , die sich fuer eine Narkose und eine rueckenmarknahe Leitungsanaesthesie im Kreissaal ergeben , werden dargestellt .
DerAnaesthesist.50440395.ger.abstr-s2-r1-t3.1-t2.1
measurement_of
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s2-r2-t1.1-t2.1
measurement_of
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s2-r3-t1.1-t3.1
measures
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s2-r4-t1.1-t2.1
measures
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s4-r1-t3.1-t4.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s4-r2-t4.1-t2.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s4-r3-t1.1-t2.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s4-r4-t4.1-t1.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s4-r5-t2.1-t4.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s4-r6-t3.1-t2.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s4-r7-t2.1-t3.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s4-r8-t3.1-t1.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s4-r9-t1.1-t4.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s4-r10-t4.1-t3.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s4-r11-t2.1-t1.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s4-r12-t1.1-t3.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s5-r1-t1.1-t2.1
affects
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s5-r2-t1.1-t4.1
disrupts
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s5-r3-t2.1-t1.1
produces
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s5-r4-t3.1-t2.1
affects
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s5-r5-t4.1-t3.1
produces
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s5-r6-t3.1-t1.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s5-r7-t4.1-t1.1
produces
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s5-r8-t4.1-t2.1
location_of
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s5-r9-t1.1-t3.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s6-r1-t5.1-t4.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s6-t5
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s6-r2-t4.1-t5.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s6-t5
DerAnaesthesist.50440395.ger.abstr-s7-r1-t3.1-t1.1
affects
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s7-r2-t4.1-t1.1
associated_with
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s7-r3-t3.1-t4.1
affects
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s7-r4-t4.1-t3.1
produces
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s7-r5-t1.1-t4.1
associated_with
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s7-r6-t1.1-t3.1
produces
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s8-r1-t1.1-t2.1
location_of
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s10-r1-t3.1-t4.1
associated_with
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s10-r2-t2.1-t4.1
result_of
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s10-r3-t4.1-t1.1
result_of
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s10-r4-t3.1-t1.1
associated_with
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s10-r5-t3.1-t2.1
affects
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s10-r6-t2.1-t1.1
result_of
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s10-r7-t4.1-t2.1
result_of
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s10-r8-t1.1-t4.1
result_of
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s10-r9-t1.1-t2.1
result_of
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s10-r10-t1.1-t3.1
associated_with
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s10-r11-t4.1-t3.1
associated_with
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s11-r1-t3.1-t2.1
result_of
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s11-r2-t1.1-t2.1
evaluation_of
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s11-r3-t3.1-t1.1
associated_with
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s11-r4-t2.1-t3.1
result_of
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s11-r5-t2.1-t1.1
result_of
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s11-r6-t3.1-t2.1
evaluation_of
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s11-r7-t1.1-t2.1
result_of
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s11-r8-t1.1-t3.1
associated_with
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s12-r1-t4.1-t3.1
occurs_in
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s12-r2-t3.1-t2.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s12-r3-t4.1-t2.1
occurs_in
DerAnaesthesist.50440395.ger.abstr-s12-t4
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s12-r4-t2.1-t3.1
interacts_with
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s12-t3
DerAnaesthesist.50440395.ger.abstr-s14-r1-t1.1-t2.1
measurement_of
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s14-r2-t1.1-t2.1
measures
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s15-r1-t1.1-t2.1
co-occurs_with
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s15-r2-t2.1-t1.1
associated_with
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s15-r3-t1.1-t2.1
associated_with
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s15-r4-t2.1-t1.1
co-occurs_with
DerAnaesthesist.50440395.ger.abstr-s16-t2
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s16-r1-t1.1-t2.1
location_of
DerAnaesthesist.50440395.ger.abstr-s16-t1
DerAnaesthesist.50440395.ger.abstr-s16-t2