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2016 | OriginalPaper | Buchkapitel

40. Schulterdystokie

verfasst von : Joachim Gnirs, Karl-Theo M. Schneider

Verlag: Springer Berlin Heidelberg

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Zusammenfassung

Die Schulterdystokie zählt zu den seltenen, aber besonders gefährlichen Geburtskomplikationen. Neben der Geburtsasphyxie stehen Frakturen und Armplexusparesen im Vordergrund. Die fetale Makrosomie ist der wichtigste Risikofaktor; gerade Kindsgewichte >4000 g werden häufig stark unterschätzt. Eine sinnvolle Prävention, z. B. durch frühzeitigere Geburtseinleitung, steht allenfalls bei fetaler Makrosomie in Kombination mit maternalem Diabetes mellitus oder Gestationsdiabetes zur Diskussion. Die klinische wie sonographische Makrosomiediagnostik ist für die Indikationstellung zur Sectio caesarea zu unpräzise. Die Eltern sollten über individuelle Risikofaktoren (z. B. Makrosomieverdacht, Z. n. Schulterdystokie) und Behandlungsalternativen (Einleitung/Sectio caesarea) aufgeklärt werden.

Bei einer manifesten Schulterdystokie sollte zunächst das McRoberts-Manöver genutzt werden, da es wenig traumatisierend ist und häufig schon ohne additive Maßnahmen die Geburt der Schultern ermöglicht.

Vorheriges Kapitel Regelwidrigkeiten des Geburtsmechanismus: Poleinstellungsanomalien

Nächstes Kapitel Pathologie der Plazentarperiode

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Titel: Schulterdystokie
verfasst von: Joachim Gnirs
Karl-Theo M. Schneider
Verlag: Springer Berlin Heidelberg
Buch: Die Geburtshilfe
Print ISBN: 978-3-662-45063-5

Electronic ISBN: 978-3-662-45064-2

Copyright-Jahr: 2016
DOI: https://doi.org/10.1007/978-3-662-45064-2_39

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Zusammenfassung

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