Übelkeit und Erbrechen in der Schwangerschaft

In westlichen Industrieländern klagen rund drei Viertel aller Schwangeren im ersten Trimenon über Übelkeit und/oder Erbrechen. Die Symptome sind in der Regel selbstlimitierend, eine Persistenz wird in weniger als 20 % aller Schwangerschaften beobachtet. Bei unkompliziertem Verlauf ist die Prognose für die werdende Mutter und das ungeborene Kind gut. Als auslösende pathogenetische Trigger werden verschiedene hormonelle Faktoren diskutiert, genetische und psychosoziale Faktoren scheinen Intensität und Dauer der Symptomatik zu beeinflussen. Vom unkomplizierten Schwangerschaftserbrechen abzugrenzen ist die potentiell vital bedrohliche Hyperemesis gravidarum, die sich in < 2 % aller Schwangerschaften manifestiert. Während die unkomplizierte Emesis gravidarum meist keiner speziellen Therapie bedarf, erfordert die Hyperemesis neben Flüssigkeits- und Elektrolytsubstitution sowie adäquater Kalorien - und Vitaminzufuhr immer auch eine antiemetische Therapie.

In Western industrialised countries, some 75 % of all pregnant women complain of nausea and vomiting in the first trimester. As a rule, the symptoms are self-limiting and have been observed to persist in fewer than 20 % of all pregnancies. Provided the course is uncomplicated, the prognosis for both mother and unborn child is good. As the pathogenic triggers, various hormonal factors are under discussion, and genetic and psychosocial factors appear to impact on the intensity and duration of the symptoms. The potentially life-threatening emesis gravidarum, which manifests in fewer than 2 % of all pregnancies must be differentiated from uncomplicated vomiting of pregnancy. While uncomplicated emesis gravidarum usually does not call for any specific treatment, hyperemesis requires treatment with fluid and electrolyte substitution, antiemetic therapy, and also an appropriate intake of calories and vitamins.

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Anschrift des Verfassers