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Blutungen im 3. Trimenon (ante- und subpartual), Placenta und Vasa praevia, vorzeitige Plazentalösung

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Die Geburtshilfe

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Zusammenfassung

Grundsätzlich muss zwischen schwangerschaftsbedingten und nicht schwangerschaftsbedingten Ursachen für Blutungen in der Spätschwangerschaft unterschieden werden. Erstere gehen meist mit einem geringeren Risiko für Mutter und Kind einher. Schwere schwangerschaftsbedingte Blutungen führen meist zu einem Blutverlust von >1000 ml und sind zu 40–70 % durch eine Placenta praevia oder eine vorzeitige Plazentalösung hervorgerufen. Ausschließlich fetale Blutungen – z. B. durch Ruptur der Vasa praevia– sind selten.

Da die Prognose für den weiteren Schwangerschaftsverlauf schwer eingeschätzt werden kann, ist auch bei leichten Blutungen primär eine stationäre Überwachung angezeigt. Die klinische Untersuchung und die Sonografie ermöglichen in den meisten Fällen sehr rasch eine Beurteilung, ob die Beendigung der Schwangerschaft erforderlich ist. Bei schweren Blutungen steht – neben den allgemeinen Richtlinien der Notfallmedizin – die unverzügliche Beendigung der Schwangerschaft im Vordergrund.

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Authors and Affiliations

  1. Klinik für Geburtsmedizin, Vivantes Netzwerk für Gesundheit GmbH, Klinikum Neukölln, Berlin, Deutschland

    Dietmar Schlembach

  2. Geburtshilfe und Pränatalmedizin, DIAKONEO, Klinik Hallerwiese, Nürnberg, Deutschland

    Franz Kainer

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  1. Dietmar Schlembach
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  2. Franz Kainer
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Correspondence to Dietmar Schlembach .

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Editors and Affiliations

  1. Frauenklinik, Medizinische Hochschule Hannover, Hannover, Niedersachsen, Deutschland

    Constantin von Kaisenberg

  2. Klinische Abteilung für Geburtshilfe, Medizinische Universität Graz, Graz, Steiermark, Österreich

    Philipp Klaritsch

  3. Geburtshilfe, Universitätsspital Basel, Basel Universitätsspital, Basel Stadt, Schweiz

    Irene Hösli-Krais

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Schlembach, D., Kainer, F. (2023). Blutungen im 3. Trimenon (ante- und subpartual), Placenta und Vasa praevia, vorzeitige Plazentalösung. In: von Kaisenberg, C., Klaritsch, P., Hösli-Krais, I. (eds) Die Geburtshilfe. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44369-9_20-2

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  • DOI: https://doi.org/10.1007/978-3-662-44369-9_20-2

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  1. Latest

    Blutungen im 3. Trimenon (ante- und subpartual), Placenta und Vasa praevia, vorzeitige Plazentalösung
    Published:
    05 December 2023

    DOI: https://doi.org/10.1007/978-3-662-44369-9_20-2

  2. Original

    Blutungen im 3. Trimenon
    Published:
    13 March 2015

    DOI: https://doi.org/10.1007/978-3-662-44369-9_20-1

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