[Maternal Emergencies: Methodically qualified - Conclusive Treatment].

Abstract:

:Maternal emergencies can significantly affect the outcome of pregnancy and childbirth. Since obstetrical emergencies may happen at any time during pregnancy an emergency transport to a hospital nearby may not always be possible. So, obstetrical emergency-management may already become mandatory in a prehospital setting. Emergency teams attentiveness should not only focus pathological findings directly caused by pregnancy (premature/rash birth, preterm premature rupture of membranes, cord prolapse) but also look at health threats evolving coincidental to partuation (trauma, acute abdomen, uterine rupture, anaphylaxis). The obstetrically inexperienced emergency team coping with prehospital-inherent management limitations is to be sustained by concrete algorithms. Perinatal knowledge combined with clinical pragmatism determine the basis for emergency management: systematically skilled - acting consistently. :Mütterliche Notfälle können den Ausgang von Schwangerschaft und Geburt in erheblichem Maße beeinflussen. Da bedrohliche Situationen in nahezu jeder Lebenssituation und zu jedem beliebigen Zeitpunkt während der Schwangerschaft auftreten können, ist ein Notfalltransport in eine Klinik nicht immer rasch genug möglich. In diesen Fällen hat die Patientinnenversorgung außerhalb einer stationären perinatologischen Einrichtung zumindest zu beginnen. Dabei darf sich der Fokus des Rettungsteams nicht nur auf sich direkt aus der Schwangerschaft ergebende Befunde (z. B. überraschend beginnende oder besonders rasch verlaufende Geburtsbestrebungen, vorzeitiger Blasensprung, Nabelschnurvorfall) konzentrieren, sondern muss ebenso auf Schwangerschaft-koinzidenten Ereignissen (u. a. Akutes Abdomen, Trauma, Uterusverletzung, Anaphylaxie) liegen. Der unvermeidlichen geburtshilflichen Unerfahrenheit des Notarztes gepaart mit den situationsimmanenten Beschränktheiten der Mittel am Einsatzort sind konkrete situationsadaptierte Handlungsschemata entgegenzustellen. Ballastfreies perinatologisches Basiswissen verbunden mit klinischem Pragmatismus markieren hierbei die Eckpunkte ihrer Zweckdienlichkeit: methodisch zu qualifizieren um schlüssig zu handeln.

authors

Strauss A,Gräsner JT

doi

10.1055/a-0762-1024

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

73-84

issue

2

eissn

0948-2393

issn

1439-1651

journal_volume

223

pub_type

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