Hypertensive Erkrankungen in der Schwangerschaft

Abstract

Hypertensive disorders occur in up to 10 % of pregnancies and increase both maternal and fetal morbidity and mortality. The most important differential diagnoses comprise pre-existing chronic hypertension, pregnancy-associated hypertension, and preeclampsia with simultaneous proteinuria. Antihypertensive therapy during pregnancy should be initiated when blood pressure is 150–160/100–110 mmHg. With regard to an earlier initiation of therapy, the data situation is not clear. Pre-eclampsia is defined as new or pre-existing elevated blood pressure ≥ 140/90 mmHg in pregnancy with at least one new organ manifestation, usually proteinuria ≥ 300 mg/day or ≥ 30 mg/mmol in the protein-creatinine ratio. Thrombotic microangiopathies TTP and aHUS are altogether rare but potentially life-threatening diseases that should be clarified in case of severe or atypical courses.

Hypertensive Erkrankungen treten bei bis zu 10 % der Schwangerschaften auf und können zur gesteigerten maternalen und fetalen Morbidität und Mortalität führen. Wichtige Differenzialdiagnosen sind vorbestehende chronische Hypertonie, schwangerschaftsassoziierte Hypertonie und Präeklampsie bei gleichzeitigem Auftreten einer Proteinurie. Seltene, aber potenziell lebensbedrohliche Erkrankungen wie TTP oder aHUS sind bei atypischen Verläufen zu bedenken.

Schlüsselwörter

Hypertonie - Schwangerschaft - Präeklampsie - thrombotische Mikroangiopathie

Key words

hypertension - pregnancy - preeclampsia - thrombotic microangiopathy

Publication History

Article published online:
16 February 2021

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