Versorgungsrealität von Frauen nach hypertensiver Schwangerschaftserkrankung – eine monozentrische fragebogenbasierte Analyse

Zusammenfassung

Einleitung Frauen nach einer hypertensiven Schwangerschaftserkrankung wird aufgrund ihres signifikant erhöhten kardiovaskulären Risikos zu Screeninguntersuchungen und primärer Prävention geraten. Diese Studie soll einen Beitrag zur Ermittlung der aktuellen Nachsorgepraxis leisten und aufzeigen, wie viele Frauen an den empfohlenen Nachsorgeuntersuchungen mit Beratung zur Reduktion von Risikofaktoren teilnehmen.

Material und Methoden Monozentrische Patientinnenbefragung von 113 Frauen, welche im Zeitraum von 2014 bis 2019 von einer hypertensiven Schwangerschaftserkrankung betroffen waren. Es erfolgte eine deskriptive statistische Auswertung.

Ergebnisse Eine Nachsorgeuntersuchung erfolgte bei 54% der Frauen. Es wurden 47% der Patientinnen im persönlichen Gespräch über ihre Erkrankung informiert und auf mögliche langfristige gesundheitliche Konsequenzen hingewiesen. Von 67 übergewichtigen Frauen (BMI≥25 kg/m²) erhielten 23% eine Empfehlung zur Steigerung der körperlichen Aktivität und 13% wurde zur Gewichtsreduktion geraten. Es stellten sich signifikant mehr Frauen mit höherer Krankheitslast (BMI, p=0,027; arterieller Hypertonus, p=0,016) und gravierender Ausprägung der Erkrankung (Eklampsie, Aufenthalt auf einer Intensivstation, jeweils p=0,049) zu weiteren Untersuchungen vor.

Schlussfolgerung Die vorliegenden Ergebnisse legen nahe, dass die Maßnahmen zur Prävention und Früherkennung von kardiovaskulären Erkrankungen in unserem Patientinnenkollektiv nicht ausgeschöpft wurden. Unabhängig des Ausprägungsgrades der Erkrankung sollten alle Frauen eine Empfehlung zur Teilnahme an Nachsorgeuntersuchung erhalten.

Abstract

Introduction Women with a history of a hypertensive disorders of pregnancy have a significantly higher risk of future cardiovascular diseases and are therefore recommended to participate in screening examinations and counseling on primary prevention. To understand the current routine of postpartum care, we examined how many women engage in follow-up examinations and whether counseling takes place.

Methodology Single-center, survey-based study of 113 women affected by hypertensive disorders of pregnancy between 2014 and 2019. Descriptive analysis was used to analyze the responses.

Results A total of 54% of the women engaged in follow-up. Of the participants, 47% were informed about their diagnosis in a personal conversation and possible consequences were pointed out. Of the 67 women with a BMI≥25 kg/m², 23% received a recommendation to increase physical activity, and 13% of these women were advised to reduce their weight. Significantly more women with a higher burden of disease (BMI, p=0.027; arterial hypertension, p=0.016) and a severe form of hypertensive pregnancy disorder (eclampsia, intensive care treatment, each p=0.016) engaged in follow-up care.

Conclusions The present results suggest that the strategies to prevent cardiovascular diseases and detect cardiovascular risk factors have not been consistently pursued. After a hypertensive disorder of pregnancy, every woman should receive a recommendation to engage in follow-up examinations.

Schlüsselwörter

Schwangerschaft - Präeklampsie - Kardiovaskuläre Erkrankungen - Hypertensive Schwangerschaftserkrankung

Key words

pregnancy - preeclampsia - cardiovascular diseases - hypertensive disorders of pregnancy

Publication History

Received: 22 August 2022

Accepted after revision: 04 October 2022

Article published online:
27 October 2022

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