Risikoprävention bei Geminigraviditäten und Schwangerschaften nach assistierter Reproduktion

Zusammenfassung

Hintergrund und Fragestellung: Zwillingsschwangerschaften und Graviditäten nach assistierter Reproduktion stellen aufgrund der erhöhten Rate an Komplikationen spezifische geburtshilfliche Risikokonstellationen dar. Die Auswirkungen medizinischer Maßnahmen zur Verhinderungen von Komplikationen bei diesen Konstellationen ist bis dato wenig erforscht.

Methodik: Die vorliegende Arbeit beinhaltet eine selektive Literaturübersicht über präventive Optionen für Schwangerschaftskomplikationen wie hypertensive Erkrankungen, Anämie, Gestationsdiabetes, Frühgeburtlichkeit und andere, die bei Zwillingsgraviditäten und Schwangerschaften nach assistierter Reproduktion signifikant häufiger auftreten.

Ergebnisse: In der Mehrzahl der Fälle sind Präventionsmaßnahmen für komplikationsträchtige Mehrlingsschwangerschaften und Graviditäten nach IVF/ICSI nicht speziell untersucht. Für einige Maßnahmen können sogar überwiegend negative Effekte nicht ausgeschlossen werden.

Schlussfolgerung: Die Datenlage zur speziellen Primärprävention von Komplikationen bei Zwillingsschwangerschaften und Gravidität nach IVF/ICSI ist als spärlich zu bezeichnen. Prospektive Studien sind daher dringend notwendig, um die Bedeutung präventiver Maßnahmen in diesen Risikokonstellationen zu ermitteln.

Abstract

Background: Twin pregnancies and gestations after assisted reproductive therapy (ART) are of special obstetric significance with regard to their associated risks. However, little is known about preventive approaches specifically evaluated for these constellations.

Methods: A selective literature search was conducted to examine possible preventive approaches for complications such as hypertensive disorders, anaemia, gestational diabetes, prematurity, and others, seen significantly more often in twin gestations and pregnancies after ART.

Results: For both constellations, preventive approaches are not specifically evaluated for the majority of complications. For some preventive methods a possible detrimental effect cannot even be ruled out.

Conclusions: The knowledge about specific preventive approaches against complications in twin pregnancies and gestations after ART is scarce. More prospective trials are urgently needed to assess the risks and benefits of prophylactic approaches for these risk constellations.

Schlüsselwörter

Schwangerschaft - Zwillinge - assistierte Reproduktion - spezifische Risiken - Prävention

Key words

pregnancy - twins - assisted reproduction - specific risks - prevention

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