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Adipositas - Ursachen, Folgeerkrankungen, Therapie 2024; 18(04): 183-187
DOI: 10.1055/a-2408-3631
Review

Übergewicht und Adipositas in der Geburtshilfe

Overweight and Obesity in Obstetrics
Massimiliano Lia
1   Universitätsklinikum Leipzig, Klinik und Poliklinik für Frauenheilkunde, Leipzig, Deutschland
,
Holger Stepan
1   Universitätsklinikum Leipzig, Klinik und Poliklinik für Frauenheilkunde, Leipzig, Deutschland
,
Bahriye Aktas
1   Universitätsklinikum Leipzig, Klinik und Poliklinik für Frauenheilkunde, Leipzig, Deutschland
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Zusammenfassung

Übergewicht oder Adipositas können die Schwangerschaft in zahlreichen Aspekten beeinflussen. Über die Risikoerhöhung für Präeklampsie, Gestationsdiabetes oder Makrosomie führt Adipositas nicht nur zu einem erhöhten Aufwand bei der Schwangerschaftsbetreuung, sondern beeinflusst auch direkt deren Ausgang. Zusätzlich erhöht eine zurückliegende bariatrische Operation die Risiken für die Schwangerschaft, indem ein solcher Eingriff einen Nährstoffmangel durch Malabsorption verursachen oder bei einer internen Herniation sogar lebensgefährlich werden kann. Übergewicht und insbesondre Adipositas führen durch deren Risiken und Auswirkungen auf die Schwangerschaft zu einer häufigeren Indikation einer Geburtseinleitung und einer höheren Rate an Schnittentbindungen. Somit muss die Betreuung bei einer adipösen Schwangeren in vielen Aspekten angepasst werden und eventuell auch ein Perinatalzentrum in diese involviert werden. Zuletzt ist auch unter der Geburt eine entsprechende Expertise von großer Bedeutung, da sowohl eine Anästhesie als auch operative Maßnahmen bei ausgeprägter Adipositas herausfordernd sein können.

Abstract

Overweight and obesity can influence a pregnancy in several aspects. Obesity increases the risk for preeclampsia, gestational diabetes and fetal macrosomy, thus intensifying the needed obstetric care and influencing the outcome of the pregnancy. Additionally, a previous bariatric surgery could lead to more complications, such as nutritional deficiencies due to malabsorption, and may even be fatal in the case of internal herniation. Overweight and especially obesity increase the odds for an induction of labor and cesarean section due to their risks for the pregnancy and the birth. Thus, obstetric care in obese women must be adjusted in several ways and a tertiary obstetric care center may be involved. Lastly, obstetric care during birth should have adequate expertise, as both anesthesia and surgery may be challenging in cases of marked obesity.

Schlüsselwörter

Adipositas - Übergewicht - Schwangerschaft - Geburt

Keywords

obesity - overweight - pregnancy - obstetrics


Publication History

Article published online:
13 December 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
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