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Ultraschall Med
DOI: 10.1055/a-2620-4879
DOI: 10.1055/a-2620-4879
Continuing Medical Education
Ektope Schwangerschaften: Ultraschall-Diagnostik und therapeutische Optionen
Article in several languages: English | deutschAuthors

Zusammenfassung
Extra-Uterin-Gravidität – jegliche Schwangerschaft außerhalb des Cavum uteri – betrifft 1–2 % aller Schwangerschaften. Während die Diagnostik und Therapie der häufigsten ektopen Schwangerschaften (Tubar-Gravidität mit > 90 %) etabliert ist, stellt beispielsweise die Sectionarben-Schwangerschaft eine zunehmende Herausforderung dar. Dieser Beitrag beschreibt die verschiedenen Formen der ektopen Schwangerschaften und die jeweiligen therapeutischen Optionen.
Publication History
Received: 30 October 2024
Accepted after revision: 21 May 2025
Article published online:
16 October 2025
© 2025. Thieme. All rights reserved.
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