Hyperemesis gravidarum

Zusammenfassung

Circa 80 % aller Frauen leiden während der Schwangerschaft an Übelkeit und Erbrechen. In bis zu 20 % der Fälle können die Symptome über die gesamte Gravidität beobachtet werden. Die Ursache ist nach heutigem Kenntnisstand multifaktoriell und nicht endgültig geklärt. Die Betroffenen zeigen ein über den Tag hinweg übermäßig häufiges Erbrechen. Die weiteren Beschwerden sind häufig unspezifisch. Für die Diagnose richtungsweisend sind v. a. die Klinik der Patientin und die Ergebnisse der Laboruntersuchung (Elektrolytentgleisung, Hämatokriterhöhung, Ketonurie etc.). Die Behandlung ist symptomatisch. Neben der medikamentösen Therapie (Vitamin B₆, Antihistaminika, Anticholinergika und andere niedrig dosierte Antiemetika sowie gastrointestinal wirksame Medikamente) haben auch naturheilkundliche Verfahren (Akupunktur, Akupressur, Ingwer etc.) ihren Stellenwert. Darüber hinaus sollte die Indikation zur psychosomatischen und ‐therapeutischen Begleitbehandlung großzügig gestellt werden, da davon auszugehen ist, dass psychologische Faktoren in der Pathogenese eine gewichtige Rolle spielen. Bei ausgeprägtem Verlauf (Hyperemesis Grad II) ist eine stationäre Behandlung indiziert.

Abstract

About 80 % of pregnant women suffer from nausea and vomiting and about 20 % will remain symptomatic throughout the whole course of pregnancy. The origin is not fully clarified and is believed to be multifactorial. The key symptoms that point towards the diagnosis of hyperemesis gravidarum consist of the clinical presentation and changes in the blood and urine analysis (increasing hematocrit, ketonuria, dysbalance of electrolytes, etc.). The treatment is symptomatic and consists of vitamin B₆, antihistaminics, anticholinergics and other low dosed anti-emetics. Alternative approaches such as acupuncture, acupressure, ginger, etc. also play an important role. As psychological factors may often be of importance, psychosomatic treatment should always be considered. If the clinical symptoms are more pronounced (hyperemesis gravidarum level 2), an inpatient treatment should be considered.

Schlüsselwörter

Übelkeit - Erbrechen - Schwangerschaft - Hyperemesis gravidarum

Key words

nausea - vomiting - pregnancy - hyperemesis gravidarum

Literatur

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