Zusammenfassung
Die dopplersonographische Messung der uterinen Perfusion ist eine etablierte und nicht-invasive
Methode zur Einschätzung des uteroplazentaren Blutflusses und der Impedanz im nachgeschalteten
Gefäßbett. Diese Methode ist heute als einzige in der Lage, im 2. Trimenon mit hoher
Sensitivität ein Risikokollektiv für spätere Schwangerschaftserkrankungen wie Präeklampsie
oder intrauterine Wachstumsretardierung zu erkennen. Die Spezifität ist dagegen gering,
da ein großer Teil der Schwangeren mit uteriner Perfusionsstörung trotz dieses Befundes
einen normalen Schwangerschaftsverlauf hat. Gegenwärtig fehlt ein zur Dopplersonographie
zusätzlicher und unabhängiger Marker, der in Kombination mit der uterinen Perfusionsmessung
eine mögliche Schwangerschaftskomplikation besser vorhersagt. Therapeutische Optionen
sind bislang gegenwärtig nur in der Lage, den klinischen Verlauf dieser Schwangerschaften
etwas zu verbessern. Eine kausale Behandlung dieser Schwangerschaftserkrankungen auf
Grundlage einer gestörten Plazentaentwicklung gibt es derzeit noch nicht.
Abstract
Doppler sonographic measurement of uterine perfusion in second trimester pregnancies
is nowadays an established, non-invasive method to assess uteroplacental blood supply
and down-stream vascular resistance. This method is able to identify women at risk
for subsequent pregnancy complications like preeclampsia and intrauterine growth retardation.
However, its specificity is limited since not all pregnancies with pathological perfusion
develop later complications. At present, there is no additional and independent marker
available that could increase the predictive value of uterine Doppler sonography.
Therapeutic approaches may improve clinical course and outcome of those high-risk
pregnancies but do not target the cause of the disturbed placental development.
Schlüsselwörter
uterine Perfusion - Dopplersonographie - Präeklampsie - intrauterine Wachstumsretardierung
Key words
Uterine perfusion - Doppler sonography - preeclampsia - intrauterine growth retardation
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Privatdozent Dr. med. Holger Stepan
Universitätsfrauenklinik
Philipp-Rosenthalstr. 55
04103 Leipzig
Telefon: 0341-9723595
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eMail: steh@medizin.uni-leipzig.de
