{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T09:30:39Z","timestamp":1783071039176,"version":"3.54.6"},"reference-count":39,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Geburtshilfe Neonatol"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Die Pr\u00e4valenz hypertensiver Schwangerschaftserkrankungen (HES) betr\u00e4gt 6\u20138%. HES geh\u00f6ren zu den f\u00fchrenden Ursachen m\u00fctterlicher Sterbef\u00e4lle in den Industriel\u00e4ndern. Die Messung des Blutdrucks (RR) ist nach wie vor Eckpfeiler der Diagnose. Die Blutdruckmessung sollte nach standardisierter Vorgehensweise mit automatischen, f\u00fcr die Schwangerschaft validierten Messger\u00e4ten erfolgen. Die Blutdruckmessung in der Praxis erlaubt nur eine \u201epunktuelle\u201c Messung in \u201eartifizieller\u201c Umgebung und kann eine Wei\u00dfkittelhypertonie (WCH) nicht erfassen. Nach aktuellen Leitlinien sollte die ambulante 24-Stunden-Blutdruckmessung (ABPM) bei allen Schwangeren mit erh\u00f6hten Blutdruckwerten zur Diagnosesicherung und Differenzierung der Hypertonie durchgef\u00fchrt werden. Die ABPM ist eine geeignete Methode zur fr\u00fchzeitigen Identifizierung der WCH und der maskierten Hypertonie sowie zur Differenzierung zwischen WCH und chronischer Hypertonie vor der 20. SSW. Fehlender n\u00e4chtlicher Blutdruckabfall und v. a. Blutdruckspitzen w\u00e4hrend der Nachtstunden sind mit einem signifikant erh\u00f6hten Risiko f\u00fcr Pr\u00e4eklampsie und kardiovaskul\u00e4rer Morbidit\u00e4t assoziiert. ABPM und h\u00e4usliche Blutdruckmessung (HBPM) wurden zur Blutdruckkontrolle bei Schwangeren mit Gestationshypertonie, chronischer Hypertonie, milder Pr\u00e4eklampsie und Schwangeren mit Risikofaktoren f\u00fcr eine HES nach der 18. SSW empfohlen. Sie erm\u00f6glichen eine exakte Blutdruckeinstellung mit Antihypertensiva. Wichtige Voraussetzungen f\u00fcr die Anwendung beider Methoden ist die Compliance der Patientin. Wie in Studien gezeigt, reduziert die HBPM die Zahl antenataler Arztbesuche und Krankenhausaufnahmen im Vergleich zur Blutdruckmessung in der Praxis ohne erh\u00f6htes Risiko f\u00fcr Mutter und Kind, sie vermindert dar\u00fcber hinaus die Rate an Geburtseinleitungen und die Diagnose \u201ePr\u00e4eklampsie\u201c und tr\u00e4gt zur Vermeidung einer unn\u00f6tigen antihypertensiven Therapie bei. Die Methode weist eine hohe Akzeptanz bei den Schwangeren auf und ist kosteneffektiv. Die Probleme der ABPM liegen v. a. in ihrer limitierten Verf\u00fcgbarkeit und der Bel\u00e4stigung der Schwangeren durch Schlafst\u00f6rungen. Die wesentlichen Nachteile der HBPM sind die Notwendigkeit zur Schulung\/Training der Patientin, m\u00f6gliche Messfehler und dem Fehlen evidenzbasierter Blutdruckgrenzwerte. Derzeit werden Telemonitoring-Plattformen zur ambulanten \u00dcberwachung von Schwangeren mit erh\u00f6htem Risiko f\u00fcr HES evaluiert. Die breite Anwendung v. a. der HBPM kann dazu beitragen, die Arbeitsbelastung des geburtshilflichen Personals im Krankenhaus zu reduzieren und Krankenhauskosten einzusparen.<\/jats:p>","DOI":"10.1055\/a-1266-7401","type":"journal-article","created":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T20:51:34Z","timestamp":1608151894000},"page":"333-338","source":"Crossref","is-referenced-by-count":5,"title":["Ambulante und h\u00e4usliche Blutdruckmessung bei hypertensiven Schwangeren"],"prefix":"10.1055","volume":"224","author":[{"given":"Werner","family":"Rath","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gyn\u00e4kologie und Geburtshilfe, Universit\u00e4tsklinikum Schleswig-Holstein Campus Kiel, Kiel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Tsikouras","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Democritus University of Thrace, Komotini, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietmar","family":"Schlembach","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Geburtsmedizin, Vivantes Klinikum Neuk\u00f6lln, Berlin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,12,4]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"e323","DOI":"10.1016\/S2214-109X(14)70227-X","article-title":"Global causes of maternal deaths: A WHO systematic analysis","volume":"2","author":"L Say","year":"2014","journal-title":"Lancet Glob Health"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1055\/a-0607-2816","article-title":"M\u00fcttersterbef\u00e4lle weltweit r\u00fcckl\u00e4ufig, aber h\u00e4ufig vermeidbar","volume":"222","author":"W Rath","year":"2018","journal-title":"Z Geburtsh Neonatol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1016\/j.amjmed.2009.03.036","article-title":"Hypertension in pregnancy and women of childbearing age","volume":"122","author":"S R Yoder","year":"2009","journal-title":"Am J Med"},{"key":"ref4","first-page":"24","article-title":"Pregnancy outcomes in healthy nulliparous who developed hypertension","volume":"95","author":"J C Hauth","year":"2000","journal-title":"Calcium for preeclampsia prevention study group. 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