Kongressnachlese. Präeklampsie – Screening/Prädiktion/Prävention

Präeklampsie ist eine der Hauptursachen für mütterliche und kindliche Morbidität und Mortalität. Insbesondere in westlichen Ländern, in denen andere geburtshilfliche Krankheitsbilder gut beherrschbar sind, stellen präeklampsiebedingte Komplikationen eine große Herausforderung für den Geburtshelfer dar. In 20/22 mütterlichen Todesfällen in Großbritannien in den Jahren 2006 – 2012 war eine Präeklampsie ursächlich und 63% dieser Fälle wurden als vermeidbar eingestuft [1]. Das verdeutlicht die Notwendigkeit eines effizienten Screenings sowie einer präziseren Diagnosestellung.

• Literatur

• 1 Shennan AH, Redman C, Cooper C. et al. Are most maternal deaths from pre-eclampsia avoidable?. Lancet 2012; 379: 1686-1687
• 2 Brown M, Lindheimer M, de Swiet M. et al. The classification and diagnosis of the hypertensive disorders of pregnancy: statement from the International Society for the Study of Hypertension in Pregnancy (ISSHP). Hypertens Pregnancy 2001; 20: IX-XIV
• 3 Zhang J, Klebanoff M, Roberts J. Prediction of adverse outcomes by common definitions of hypertension in pregnancy. Obstet Gynecol 2001; 97: 261-267
• 4 American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy. Hypertension in Pregnancy: Report of the American College of Obstetricians and Gynecologistsʼ Task Force on Hypertension in Pregnancy. Obstet Gynecol 2013; 122: 1122-1131
• 5 Rolnik DL, Wright D, Poon LC. et al. Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia. N Engl J Med 2017; 377: 613-622
• 6 Wright D, Rolnik DL, Syngelaki A. et al. Aspirin for Evidence-Based Preeclampsia Prevention trial: effect of aspirin on length of stay in the neonatal intensive care unit. Am J Obstet Gynecol 2018; 218: 612.e1-612.e6
• 7 Poon LC, Wright D, Rolnik DL. et al. Aspirin for Evidence-Based Preeclampsia Prevention trial: effect of aspirin in prevention of preterm preeclampsia in subgroups of women according to their characteristics and medical and obstetrical history. Am J Obstet Gynecol 2017; 217: 585.e1-585.e5
• 8 OʼGorman N, Wright D, Syngelaki A. et al. Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 11–13 weeks gestation. Am J Obstet Gynecol 2016; 214: 103.e1-103.e12
• 9 Zeisler H, Llurba E, Chantraine F. et al. Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia. N Engl J Med 2016; 374: 13-22
• 10 Zeisler H, Llurba E, Chantraine F. et al. Soluble fms-Like Tyrosine Kinase-1-to-Placental Growth Factor Ratio and Time to Delivery in Women With Suspected Preeclampsia. Obstet Gynecol 2016; 128: 261-269
• 11 Zeisler H, Llurba E, Chantraine FJ. et al. The sFlt-1/PlGF Ratio: ruling out pre-eclampsia for up to 4 weeks and the value of retesting. Ultrasound Obstet Gynecol 2018;
• 12 Schlembach D, Hund M, Schroer A. et al. Economic assessment of the use of the sFlt-1/PlGF ratio test to predict preeclampsia in Germany. BMC Health Serv Res 2018; 18: 1-11