Very early HELLP-Syndrom – vergeblicher Aktionismus oder geordneter Rückzug?

Jan Pauluschke-Fröhlich; Karl-Oliver Kagan; Manuela Bihler; Harald Abele

doi:10.1055/a-0589-4227

Geburtshilfe und Frauenheilkunde, Table of Contents

Geburtshilfe Frauenheilkd 2018; 78(07): 671-676
DOI: 10.1055/a-0589-4227

GebFra Magazin

Der interessante Fall

Georg Thieme Verlag KG Stuttgart · New York

Very early HELLP-Syndrom – vergeblicher Aktionismus oder geordneter Rückzug?

Authors

Jan Pauluschke-Fröhlich
Karl-Oliver Kagan
Manuela Bihler
Harald Abele

Abstract

Das „Very early HELLP-Syndrom“ stellt die Geburtsmedizin vor besondere Herausforderungen. Es handelt sich dabei um die für ein HELLP-Syndrom typische auftretende Trias aus Hämolyse, ansteigender Leberwerte und einer Thrombozytopenie zu einem Zeitpunkt, an dem die Lebensfähigkeit des Kindes außerhalb des Mutterleibes noch nicht gegeben ist. Es sind vor allem die mütterlichen Risiken, die zu einer raschen Beendigung der Schwangerschaft drängen und demgegenüber der erklärte Wunsch betroffener Paare, das Ungeborene – unter Ausschöpfung aller medizinischer Möglichkeiten – in ein Gestationsalter zu begleiten, zu dem eine Maximalversorgung außerhalb des Mutterleibes möglich wird. Dabei darf nicht allein auf die Grenze der extrauterinen Lebensfähigkeit geschaut werden, sondern es muss zukunftsweisend abgewogen werden, unter welchen Voraussetzungen der Neonatologe eine Maximaltherapie bzw. Unterstützung des Kindes postpartal beginnen soll.

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References

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