Dopplersonografie in der Schwangerschaft – Qualitätsanforderungen der DEGUM und klinischer Einsatz (Teil 2)

Zusammenfassung

Im 2. Teil zum Einsatz der Methode der Dopplersonografie in der Pränatal- und Geburtsmedizin geht es um den klinischen Einsatz. Die Erwartungen einer breiten Anwendung der Methode als Screeningverfahren haben sich nicht bestätigt. Allerdings spielen die Widerstandsindizes der Aa. uterinae im Rahmen eines multimodalen Ansatzes für die Vorhersage der Präeklampsie im 1. Trimester eine wichtige Rolle, verbessern die Genauigkeit und schaffen die Grundlage für eine effektive Prophylaxe mit Aspirin. Für die Zustandsdiagnostik und Überwachung wachstumsretardierter Föten im 2. und 3. Trimester hat die Dopplersonografie der A. umbilicalis, A. cerebri media und des Ductus venosus eine herausragende Bedeutung. Insbesondere die Hämodynamik des Ductus venosus ist ein entscheidendes Kriterium für das Geburtsmanagement der frühen, schweren IUGR vor 34 SSW. Die maximale Geschwindigkeit in der A. cerebri media ist der zentrale Parameter in der fetalen Anämiediagnostik und hat deren Qualität grundlegend verändert und verbessert. Allerdings sind diese Verbesserungen an eine hohe methodische Qualität der Messung gekoppelt. Dies alles trifft natürlich auch für Zwillinge und höhergradige Mehrlinge zu. Die differenzierte Diagnostik spezifischer Komplikationen von monochorialen Mehrlingen wie FFTS, TAPS und TRAP ist ohne den Einsatz der Dopplersonografie nicht mehr zu denken. Der Erfolg des vielfältigen Einsatzes der Dopplersonografie ist verknüpft mit exakter methodischer Anwendung und präziser pathophysiologischer Interpretation.

Key words

dopplersonography - fetal surveillance - guideline - clinical application

Publication History

Received: 27 February 2021

Accepted: 16 March 2021

Article published online:
27 April 2021

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