Kernaussagen
Ungefähr 0,02–0,1 % aller Schwangerschaften werden durch die Diagnose einer Tumorerkrankung erschwert und bedürfen besonderer Betreuung. Hierzu gehört nicht nur die immer an den Einzelfall anzupassende Therapie, sondern auch ein soziales und psychoonkologisches Betreuungsangebot für die Betroffenen sowie eine ethische Begleitung des interdisziplinären Betreuerteams. Denn neben der mütterlichen Erkrankung ist auch das Kindswohl zu berücksichtigen. Die gynäkologischen Tumoren umfassen etwa 2 Drittel der in der Schwangerschaft auftretenden Tumorerkrankungen. Verglichen mit einem altersgleichen Kollektiv ohne Schwangerschaft, treten Zervix-, Mamma- und Ovarialkarzinome während einer Schwangerschaft nicht häufiger auf. Sie werden jedoch aufgrund der Schwangerschaft in vielen Fällen verzögert und damit in einem fortgeschritteneren Stadium diagnostiziert – mit entsprechenden Auswirkungen auf die Prognose. Es sollte auf keine diagnostische Maßnahme verzichtet werden, sofern diese medizinisch indiziert ist. Staging-Untersuchungen sollten analog der nicht schwangeren Patientin durchgeführt werden. Therapeutisch gibt es für jede Tumorentität operative sowie meist auch systemische Optionen, die jedoch immer an den Einzelfall anzupassen sind.
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Dr. med. C. M. Bayer
Frauenklinik Universitätsklinikum Erlangen
Universitätsstraße 21–23
91054 Erlangen
Email: christian.bayer@uk-erlangen.de
