Geburtshilfe Frauenheilkd 2018; 78(04): 327-338
DOI: 10.1055/a-0590-4931
GebFra Magazin
Aufklärung in der Frauenheilkunde
Georg Thieme Verlag KG Stuttgart · New York

Aufklärungspflichten in der Gynäkologie und Geburtshilfe

Teil 5b: Aufklärungspflichten in der Geburtshilfe – Beratung und Aufklärungspflichten bei der Geburtsplanung
Further Information

Publication History

Publication Date:
27 April 2018 (online)

In Deutschland kommt jedes 3. Kind per Kaiserschnitt zur Welt. Damit ist die Sectio caesarea zur häufigsten Operation in der Frauenheilkunde geworden. Der nachfolgende Artikel erklärt anschaulich, warum die Zahl der Kaiserschnitte in den letzten 2 Jahrzehnten so stark angestiegen ist und warum jetzt ein Umdenken stattfindet.

 
  • Literatur

  • 1 Kainer F. Facharztwissen Geburtsmedizin. 3. Aufl.. München: Urban & Fischer Verlag/Elsevier GmbH; 2016
  • 2 Schneider H. Die Geburtshilfe. 5. Aufl.. Heidelberg: Springer; 2016
  • 3 Stark M. Der Kaiserschnitt: Indikationen. Hintergründe. Operatives Management der Misgav-Ladach-Methode. München, Jena: Urban & Fischer; 2008
  • 4 Schütz F, Sohn C, Wallwiener M. et al. Aufklärungspflichten in der Gynäkologie und Geburtshilfe. Teil 1: Allgemeine Aspekte medizinischer Aufklärungen. Geburtsh Frauenheilk 2017; 77: 592-597
  • 5 Gupta JK, Hofmeyr GJ, Shehmar M. Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database Syst Rev 2012; (05) CD002006
  • 6 Priddis H, Dahlen H, Schmied V. What are the facilitators, inhibitors, and implications of birth positioning? A review of the literature. Women Birth 2012; 25: 100-106
  • 7 Reitter A, Daviss BA, Bisits A. et al. Does pregnancy and/or shifting positions create more room in a womanʼs pelvis?. Am J Obstet Gynecol 2014; 211: 662.e1-662.e9
  • 8 Institut für Qualitätssicherung und Transparenz im Gesundheitswesen. Bundesauswertung zum Erfassungsjahr 2015 – Geburtshilfe – Qualitätsindikatoren. 2015 Online: https://iqtig.org/ Stand: 05/2017
  • 9 DGGG. Leitlinie zum Management von Dammrissen III. und IV. Grades nach vaginaler Geburt. 2014 Online: http://www.dggg.de/ Stand: 09/2017
  • 10 Carroli G, Cuesta C, Abalos E. et al. Epidemiology of postpartum haemorrhage: a systematic review. Best Pract Res Clin Obstet Gynaecol 2008; 22: 999-1012
  • 11 DGGG. Plazentationsstörungen bei Status nach Sectio. 2006 Online: http://www.dggg.de/ Stand: 10/2010
  • 12 Robert Koch-Institut. Hrsg. Gesundheit in Deutschland. Gesundheitsberichterstattung des Bundes. Gemeinsam getragen von RKI und Destatis. Berlin: Robert Koch-Institut; 2015
  • 13 Steer PJ, Modi N. Elective caesarean sections–risks to the infant. Lancet 2009; 374: 675-676
  • 14 Gillessen A, Lanfer A, Suling M. et al. Geburtenreport der Techniker Krankenkasse Analysen zu Einflussfaktoren auf die Kaiserschitt- und Frühgeburtenrate. Z Geburtshilfe Neonatol 2017; 221: E1-E113 doi:10.1055/s-0037-1607791
  • 15 Betran A, Torloni M, Zhang J. et al. WHO statement on caesarean section rates. BJOG 2016; 123: 667-670 doi:10.1111/1471-0528.13526
  • 16 Allen VM, OʼConnell CM, Baskett TF. Maternal morbidity associated with cesarean delivery without labor compared with induction of labor at term. Obstet Gynecol 2006; 108: 286-294
  • 17 Dahlgren LS, von Dadelszen P, Christilaw J. et al. Caesarean section on maternal request: risks and benefits in healthy nulliparous women and their infants. J Obstet Gynaecol Can 2009; 31: 808-817
  • 18 Geller EJ, Wu JM, Jannelli ML. et al. Maternal outcomes associated with planned vaginal versus planned primary cesarean delivery. Am J Perinatol 2010; 27: 675-683
  • 19 Haas DM, Morgan S, Contreras K. Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections. Cochrane Database Syst Rev 2014; (12) CD007892
  • 20 Jaiyeoba O. Postoperative infections in obstetrics and gynecology. Clin Obstet Gynecol 2012; 55: 904-913
  • 21 Lapinsky SE. Obstetric infections. Crit Care Clin 2013; 29: 509-520
  • 22 Liu S, Liston RM, Joseph KS. et al. Maternal Health Study Group of the Canadian Perinatal Surveillance System. Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term. CMAJ 2007; 176: 455-460
  • 23 Mpogoro FJ, Mshana SE, Mirambo MM. et al. Incidence and predictors of surgical site infections following caesarean sections at Bugando Medical Centre, Mwanza, Tanzania. Antimicrob Resist Infect Control 2014; 3: 25
  • 24 Shi Z, Ma L, Yang Y. et al. Adhesion formation after previous caesarean section-a meta-analysis and systematic review. BJOG 2011; 118: 410-422
  • 25 Smaill FM, Grivell RM. Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section. Cochrane Database Syst Rev 2014; (10) CD007482
  • 26 Gizzo S, Noventa M, Fagherazzi S. et al. Update on best available options in obstetrics anaesthesia: perinatal outcomes, side effects and maternal satisfaction. Fifteen years systematic literature review. Arch Gynecol Obstet 2014; 290: 21-34
  • 27 Knight M, Kurinczuk JJ, Spark P. et al. United Kingdom Obstetric Surveillance System Steering Committee. Cesarean delivery and peripartum hysterectomy. Obstet Gynecol 2008; 111: 97-105
  • 28 Mozurkewich EL, Hutton EK. Elective repeat cesarean delivery versus trial of labor: a meta-analysis of the literature from 1989 to 1999. Am J Obstet Gynecol 2000; 183: 1187-1197
  • 29 van den Berg A, van Elburg RM, van Geijn HP. et al. Neonatal respiratory morbidity following elective caesarean section in term infants. A 5-year retrospective study and a review of the literature. Eur J Obstet Gynecol Reprod Biol 2001; 98: 9-13
  • 30 Lyell DJ. Adhesions and perioperative complications of repeat cesarean delivery. Am J Obstet Gynecol 2011; 205: S11-S18
  • 31 Sbarra M, Boyd M, Dardarian TS. Complications due to adhesion formation following cesarean sections: a review of deliveries in three cases. Fertil Steril 2009; 9: 394.e13-6
  • 32 Walfisch A, Beloosesky R, Shrim A. et al. Adhesion prevention after cesarean delivery: evidence, and lack of it. Am J Obstet Gynecol 2014; 211: 446-452
  • 33 Schindl M, Birner P, Reingrabner M. et al. Elective cesarean section vs. spontaneous delivery: a comparative study of birth experience. Acta Obstet Gynecol Scand 2003; 82: 834-840
  • 34 Clark SL, Scott JR, Porter TF. et al. Is vaginal birth after cesarean less expensive than repeat cesarean delivery?. Am J Obstet Gynecol 2000; 182: 599-602
  • 35 Hemminki E. Effects of cesarean section on fertility and abortions. J Reprod Med 1986; 31: 620-624
  • 36 Hemminki E. Long term maternal health effects of caesarean section. J Epidemiol Community Health 1991; 45: 24-28
  • 37 Gilliam M. Cesarean delivery on request: reproductive consequences. Semin Perinatol 2006; 30: 257-260
  • 38 Hemminki E. Impact of caesarean section on future pregnancy–a review of cohort studies. Paediatr Perinat Epidemiol 1996; 10: 366-379
  • 39 Sadeghi H, Rutherford T, Rackow BW. et al. Cesarean scar ectopic pregnancy: case series and review of the literature. Am J Perinatol 2010; 27: 111-120
  • 40 Paul P. The trouble with repeat Cesareans. Time 2009; 173: 36-37
  • 41 Smith GC, Pell JP, Dobbie R. Caesarean section and risk of unexplained stillbirth in subsequent pregnancy. Lancet 2003; 362: 1779-1784
  • 42 Tulandi T, Agdi M, Zarei A. et al. Adhesion development and morbidity after repeat cesarean delivery. Am J Obstet Gynecol 2009; 201: 56.e1-56.e6
  • 43 Barger MK, Weiss J, Nannini A. et al. Risk factors for uterine rupture among women who attempt a vaginal birth after a previous cesarean: a case-control study. J Reprod Med 2011; 56: 313-320
  • 44 Grivell RM, Barreto MP, Dodd JM. The influence of intrapartum factors on risk of uterine rupture and successful vaginal birth after cesarean delivery. Clin Perinatol 2011; 38: 265-275
  • 45 Holmgren CM. Uterine rupture associated with VBAC. Clin Obstet Gynecol 2012; 55: 978-987
  • 46 Hall MH, Campbell DM, Fraser C. et al. Mode of delivery and future fertility. Br J Obstet Gynaecol 1989; 96: 1297-1303
  • 47 Hemminki E, Graubard BI, Hoffman HJ. et al. Cesarean section and subsequent fertility: results from the 1982 National Survey of Family Growth. Fertil Steril 1985; 43: 520-528
  • 48 Mollison J, Porter M, Campbell D. et al. Primary mode of delivery and subsequent pregnancy. BJOG 2005; 112: 1061-1065
  • 49 Onwere C, Gurol-Urganci I, Cromwell DA. et al. Maternal morbidity associated with placenta praevia among women who had elective caesarean section. Eur J Obstet Gynecol Reprod Biol 2011; 159: 62-66
  • 50 Wortman AC, Alexander JM. Placenta accreta, increta, and percreta. Obstet Gynecol Clin North Am 2013; 40: 137-154
  • 51 Mylonas I, Friese K. Indications for and risks of elective cesarean section. Dtsch Arztebl Int 2015; 112: 489-495
  • 52 Chen FCK, Bolten K, Dudenhausen JW. Schlechteres Outcome von Schwangeren mit extremer Adipositas bei der Geburt. Z Geburtshilfe Neonatol 2009; 213: PO_G_12_02
  • 53 Franz A, Härtel C, Herting E. et al. Prophylaxe der Neugeborenensepsis – frühe Form – durch Streptokokken der Gruppe B. Leitlinie des BVF, BVDfK, der DGGG, DGHM, DGPI, DGPM und GNPI. (S2k-Level, AWMF-Registernummer 024/020, März 2016). Z Geburtshilfe Neonatol 2017; 221: 122-129 doi:10.1055/s-0043-105207
  • 54 Milazzo GN, Catalano A, Badia V. et al. Myoma and myomectomy: Poor evidence concern in pregnancy. J Obstet Gynaecol Res 2017; 43: 1789-1804
  • 55 Deveer M, Deveer R, Engin-Ustun Y. et al. Comparison of pregnancy outcomes in different localizations of uterine fibroids. Clin Exp Obstet Gynecol 2012; 39: 516-518
  • 56 Lefebvre G, Vilos G, Allaire C. et al. The management of uterine leiomyomas. J Obstet Gynaecol Can 2003; 25: 396-418 quiz 419–422
  • 57 Obara M, Hatakeyama Y, Shimizu Y. Vaginal myomectomy for semipedunculated cervical myoma during pregnancy. AJP Rep 2014; 4: 37-40
  • 58 Degani S, Tamir A, Leibovitz Z. et al. Three-dimensional power Doppler in the evaluation of painful leiomyomas and focal uterine thickening in pregnancy. Int J Gynaecol Obstet 2007; 99: 122-126
  • 59 Parazzini F, Tozzi L, Bianchi S. Pregnancy outcome and uterine fibroids. Best Pract Res Clin Obstet Gynaecol 2016; 34: 74-84
  • 60 Silver RM, Landon MB, Rouse DJ. et al. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol 2006; 107: 1226-1232
  • 61 Rath W, Strauss A. Hrsg. Komplikationen in der Geburtshilfe. Berlin, Heidelberg: Springer; 2018
  • 62 Barrett JF, Hannah ME, Hutton EK. et al. Twin Birth Study Collaborative Group. A randomized trial of planned cesarean or vaginal delivery for twin pregnancy. N Engl J Med 2013; 369: 1295-1305
  • 63 Oçer F, Kaleli S, Budak E. et al. Fetal weight estimation and prediction of fetal macrosomia in non-diabetic pregnant women. Eur J Obstet Gynecol Reprod Biol 1999; 83: 47-52
  • 64 Vergani P, Ornaghi S, Pozzi I. et al. Placenta previa: distance to internal os and mode of delivery. Am J Obstet Gynecol 2009; 201: 266.e1-266.e5
  • 65 Stepan H, Kuse S, Klockenbusch W. et al. Diagnosis and treatment of hypertensive pregnancy disorders. Guideline of DGGG (S1-Level, AWMF Registry No. 015/018, December 2013). Geburtsh Frauenheilk 2015; 75: 900-914 doi:10.1055/s-0035-1557924
  • 66 Nassar AH, Adra AM, Chakhtoura N. et al. Severe preeclampsia remote from term: labor induction or elective cesarean delivery?. Am J Obstet Gynecol 1998; 179: 1210-1213
  • 67 Kleinwechter H. Gestationsdiabetes mellitus (GDM) -Diagnostik, Therapie und Nachsorge. Praxisleitlinie der Deutschen Diabetes Gesellschaft (DDG) und der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG). Diabetologie 2016; 11: S182-S194
  • 68 Iannaccone A, Enekwe A, Winter A. et al. Geburtseinleitung: „anything new?“. Gynäkologe 2015; 48: 753-757
  • 69 Heslehurst N, Simpson H, Ells LJ. et al. The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis. Obes Rev 2008; 9: 635-683
  • 70 Vernini JM, Moreli JB, Magalhães CG. et al. Maternal and fetal outcomes in pregnancies complicated by overweight and obesity. Reprod Health 2016; 13: 100
  • 71 Ritzinger P. Späte Mutterschaft und deren Risiken. J Reproduktionsmed Endokrinol 2011; 8: 112-122
  • 72 Marchi J, Berg M, Dencker A. et al. Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes Rev 2015; 16: 621-638
  • 73 Grubinger E, Scheier M. Mehrlingsschwangerschaften – Epidemiologie, Entwicklung und Morbidität. J Gynäkol Endokrinol 2011; 21: 14-19
  • 74 Mercer BM, Crocker LG, Pierce WF. et al. Clinical characteristics and outcome of twin gestation complicated by preterm premature rupture of the membranes. Am J Obstet Gynecol 1993; 168: 1467-1473
  • 75 Nabet C, Lelong N, Ancel PY. et al. Smoking during pregnancy according to obstetric complications and parity: results of the EUROPOP study. Eur J Epidemiol 2007; 22: 715-721
  • 76 De Santis M, Cavaliere AF, Straface G. et al. Inherited and acquired thrombophilia: pregnancy outcome and treatment. Reprod Toxicol 2006; 22: 227-233
  • 77 Kim HS, Oh SY, Choi SJ. et al. Uterine rupture in pregnancies following myomectomy: A multicenter case series. Obstet Gynecol Sci 2016; 59: 454-462
  • 78 Robinson H, Tkatch S, Mayes DC. et al. Is maternal obesity a predictor of shoulder dystocia?. Obstet Gynecol 2003; 101: 24-27
  • 79 Lee VR, Darney BG, Snowden JM. et al. Term elective induction of labour and perinatal outcomes in obese women: retrospective cohort study. BJOG 2016; 123: 271-278
  • 80 Weltrich H, Beck L. Risikofaktor Makrosomie des Kindes. Rheinisches Ärzteblatt 2005; 7: 20-22
  • 81 Gundelach T. Adipositas vor Schwangerschaftsbeginn beeinträchtigt das geburtshilfliche und neonatale Outcome signifikant – retrospektive Analyse [Dissertation]. Universität Ulm; 2016 Open Access Repositorium der Universität Ulm
  • 82 Seracchioli R, Rossi S, Govoni F. et al. Fertility and obstetric outcome after laparoscopic myomectomy of large myomata: a randomized comparison with abdominal myomectomy. Hum Reprod 2000; 15: 2663-2668
  • 83 Bangal VB, Giri PA, Shinde KK. et al. Vaginal birth after cesarean section. N Am J Med Sci 2013; 5: 140-144
  • 84 Garite TJ, Clark R, Thorp JA. Intrauterine growth restriction increases morbidity and mortality among premature neonates. Am J Obstet Gynecol 2004; 191: 481-487
  • 85 Bajoria R, Wee LY, Anwar S. et al. Outcome of twin pregnancies complicated by single intrauterine death in relation to vascular anatomy of the monochorionic placenta. Hum Reprod 1999; 14: 2124-2130
  • 86 Norwitz ER, Snegovskikh VV, Caughey AB. Prolonged pregnancy: when should we intervene?. Clin Obstet Gynecol 2007; 50: 547-557