Advertisement

Ersttrimesterultraschall

  • Markus Hoopmann
  • Karl-Oliver Kagan
Chapter

Zusammenfassung

Das Ersttrimesterscreening sollte nicht als reines Aneuploidie- Screening missverstanden werden. Es bietet ein großes Potenzial für die Verbesserung der Detektion von Fehlbildungen. In fast der Hälfte der Fälle können schwere Fehlbildungen bereits im I. Trimenon diagnostiziert werden. Die Erweiterung der Nackentransparenz ist in vielen Fällen das leitende Symptom. Späte Schwangerschaftsabbrüche können durch qualifizierte Frühdiagnostik reduziert werden.

Literatur

  1. Abele H, Wagner N, Hoopmann M et al (2010) Effect of deviation from the mid-sagittal plane on the measurement of fetal nuchal translucency. Ultrasound Obstet Gynecol 35:525–529CrossRefGoogle Scholar
  2. Axt-Fliedner R, Chiriac A, Gembruch U (2009) First and early second trimester fetal heart scanning. Ultraschall Med 30:364–375CrossRefGoogle Scholar
  3. Axt-Fliedner R, Gembruch U (2010) Nuchal translucency and fetal cardiac malformations. Ultraschall Med 31:144–150CrossRefGoogle Scholar
  4. Becker R, Wegner RD (2006) Detailed screening for fetal anomalies and cardiac defects at the 11–13-week scan. Ultrasound Obstet Gynecol 27:613–618CrossRefGoogle Scholar
  5. Bilardo CM, Muller MA, Pajkrt E et al (2007) Increased nuchal translucency thickness and normal karyotype: time for parental reassurance. Ultrasound Obstet Gynecol 30:11–18CrossRefGoogle Scholar
  6. Bronshtein M, Amit A, Achiron R et al (1994) The early prenatal sonographic diagnosis of renal agenesis: techniques and possible pitfalls. Prenat Diagn 14:291–297CrossRefGoogle Scholar
  7. Carvalho MH, Brizot ML, Lopes LM et al (2002) Detection of fetal structural abnormalities at the 11–14 week ultrasound scan. Prenat Diagn 22:1–4CrossRefGoogle Scholar
  8. Cedergren M, Selbing A (2006) Detection of fetal structural abnormalities by an 11–14-week ultrasound dating scan in an unselected Swedish population. Acta Obstet Gynecol Scand 85:912–915CrossRefGoogle Scholar
  9. Chaoui R, Benoit B, Mitkowska-Wozniak H et al (2009) Assessment of intracranial translucency (IT) in the detection of spina bifida at the 11–13-week scan. Ultrasound Obstet Gynecol 34:249–252CrossRefGoogle Scholar
  10. Chen M, Lee CP, Lam YH et al (2008) Comparison of nuchal and detailed morphology ultrasound examinations in early pregnancy for fetal structural abnormality screening: a randomized controlled trial. Ultrasound Obstet Gynecol 31:136–146 (discussion 146)CrossRefGoogle Scholar
  11. Dane B, Dane C, Sivri D et al (2007) Ultrasound screening for fetal major abnormalities at 11–14 weeks. Acta Obstet Gynecol Scand 86:666–670CrossRefGoogle Scholar
  12. Daskalakis G, Sebire NJ, Jurkovic D et al (1997) Body stalk anomaly at 10–14 weeks of gestation. Ultrasound Obstet Gynecol 10:416–418CrossRefGoogle Scholar
  13. Dolk H, Loane M, Garne E (2010) The prevalence of congenital anomalies in Europe. Adv Exp Med Biol 686:349–364CrossRefGoogle Scholar
  14. D’Ottavio G, Mandruzzato G, Meir YJ et al (1998) Comparisons of first and second trimester screening for fetal anomalies. Ann N Y Acad Sci 847:200–209CrossRefGoogle Scholar
  15. Drysdale K, Ridley D, Walker K et al (2002) First-trimester pregnancy scanning as a screening tool for high-risk and abnormal pregnancies in a district general hospital setting. J Obstet Gynaecol 22:159–165CrossRefGoogle Scholar
  16. Ebrashy A, El Kateb A, Momtaz M et al (2010) 13–14-week fetal anatomy scan: a 5-year prospective study. Ultrasound Obstet Gynecol 35:292–296CrossRefGoogle Scholar
  17. Economides DL, Braithwaite JM (1998) First trimester ultrasonographic diagnosis of fetal structural abnormalities in a low risk population. Br J Obstet Gynaecol 105:53–57CrossRefGoogle Scholar
  18. Economides DL, Whitlow BJ, Braithwaite JM (1999) Ultrasonography in the detection of fetal anomalies in early pregnancy. Br J Obstet Gynaecol 106:516–523CrossRefGoogle Scholar
  19. Economides DL, Whitlow BJ, Kadir R et al (1998) First trimester sonographic detection of chromosomal abnormalities in an unselected population. Br J Obstet Gynaecol 105:58–62CrossRefGoogle Scholar
  20. Fong KW, Toi A, Salem S et al (2004) Detection of fetal structural abnormalities with US during early pregnancy. Radiographics 24:157–174CrossRefGoogle Scholar
  21. Gembruch U, Knopfle G, Bald R et al (1993) Early diagnosis of fetal congenital heart disease by transvaginal echocardiography. Ultrasound Obstet Gynecol 3:310–317CrossRefGoogle Scholar
  22. Hafner E, Schuchter K, Liebhart E et al (1998) Results of routine fetal nuchal translucency measurement at weeks 10–13 in 4233 unselected pregnant women. Prenat Diagn 18:29–34CrossRefGoogle Scholar
  23. Hernadi L, Torocsik M (1997) Screening for fetal anomalies in the 12th week of pregnancy by transvaginal sonography in an unselected population. Prenat Diagn 17:753–759CrossRefGoogle Scholar
  24. Johnson SP, Sebire NJ, Snijders RJ et al (1997) Ultrasound screening for anencephaly at 10–14 weeks of gestation. Ultrasound Obstet Gynecol 9:14–16CrossRefGoogle Scholar
  25. Jouannic JM, Hyett JA, Pandya PP et al (2003) Perinatal outcome in fetuses with megacystis in the first half of pregnancy. Prenat Diagn 23:340–344CrossRefGoogle Scholar
  26. Kagan KO, Staboulidou I, Syngelaki A et al (2010) The 11–13-week scan: diagnosis and outcome of holoprosencephaly, exomphalos and megacystis. Ultrasound Obstet Gynecol 36:10–14CrossRefGoogle Scholar
  27. Lachmann R, Chaoui R, Moratalla J et al (2011) Posterior brain in fetuses with open spina bifida at 11 to 13 weeks. Prenat Diagn 31:103–106CrossRefGoogle Scholar
  28. McFadyen A, Gledhill J, Whitlow B et al (1998) First trimester ultrasound screening, Carries ethical and psychological implications. BMJ 317:694–695CrossRefGoogle Scholar
  29. Ngo C, Viot G, Aubry MC et al (2007) First-trimester ultrasound diagnosis of skeletal dysplasia associated with increased nuchal translucency thickness. Ultrasound Obstet Gynecol 30:221–226CrossRefGoogle Scholar
  30. Odeh M, Granin V, Kais M et al (2009) Sonographic fetal sex determination. Obstet Gynecol Surv 64:50–57CrossRefGoogle Scholar
  31. Oztekin O, Oztekin D, Tinar S et al (2009) Ultrasonographic diagnosis of fetal structural abnormalities in prenatal screening at 11–14 weeks. Diagn Interv Radiol 15:221–225PubMedGoogle Scholar
  32. Pilu G, Visentin A, Valeri B (2000) The Dandy-Walker complex and fetal sonography. Ultrasound Obstet Gynecol 16:115–117CrossRefGoogle Scholar
  33. Rosati P, Guariglia L, Bertuzzi A (2000) Transvaginal assessment of fetal anatomy at 11 to 16 weeks of gestation in relation to fetal position. Fetal Diagn Ther 15:63–70CrossRefGoogle Scholar
  34. Saltvedt S, Almstrom H, Kublickas M et al (2006) Detection of malformations in chromosomally normal fetuses by routine ultrasound at 12 or 18 weeks of gestation – a randomised controlled trial in 39,572 pregnancies. BJOG 113:664–674CrossRefGoogle Scholar
  35. Schramm T, Gloning KP, Minderer S et al (2009) Prenatal sonographic diagnosis of skeletal dysplasias. Ultrasound Obstet Gynecol 34:160–170CrossRefGoogle Scholar
  36. Sebire NJ, Snijders RJ, Davenport M et al (1997) Fetal nuchal translucency thickness at 10–14 weeks’ gestation and congenital diaphragmatic hernia. Obstet Gynecol 90:943–946CrossRefGoogle Scholar
  37. Sebire NJ, Von Kaisenberg C, Rubio C et al (1996) Fetal megacystis at 10–14 weeks of gestation. Ultrasound Obstet Gynecol 8:387–390CrossRefGoogle Scholar
  38. Sepulveda W, Sebire NJ, Souka A et al (1997) Diagnosis of the Meckel–Gruber syndrome at eleven to fourteen weeks’ gestation. Am J Obstet Gynecol 176:316–319CrossRefGoogle Scholar
  39. Sepulveda W, Wong AE, Martinez-Ten P et al (2010) Retronasal triangle: a sonographic landmark for the screening of cleft palate in the first trimester. Ultrasound Obstet Gynecol 35:7–13CrossRefGoogle Scholar
  40. Souka AP, Von Kaisenberg CS, Hyett JA et al (2005) Increased nuchal translucency with normal karyotype. Am J Obstet Gynecol 192:1005–1021CrossRefGoogle Scholar
  41. Syngelaki A, Chelemen T, Dagklis T et al (2011) Challenges in the diagnosis of fetal non-chromosomal abnormalities at 11–13 weeks. Prenat Diagn 31:90–102CrossRefGoogle Scholar
  42. Taipale P, Ammala M, Salonen R et al (2004) Two-stage ultrasonography in screening for fetal anomalies at 13–14 and 18–22 weeks of gestation. Acta Obstet Gynecol Scand 83:1141–1146CrossRefGoogle Scholar
  43. Weiner Z, Goldstein I, Bombard A et al (2007) Screening for structural fetal anomalies during the nuchal translucency ultrasound examination. Am J Obstet Gynecol 197(181):e181–e185Google Scholar
  44. Whitlow BJ, Chatzipapas IK, Lazanakis ML et al (1999) The value of sonography in early pregnancy for the detection of fetal abnormalities in an unselected population. Br J Obstet Gynaecol 106:929–936CrossRefGoogle Scholar
  45. Whitlow BJ, Economides DL (1998) The optimal gestational age to examine fetal anatomy and measure nuchal translucency in the first trimester. Ultrasound Obstet Gynecol 11:258–261CrossRefGoogle Scholar
  46. Yagel S, Cohen SM, Messing B (2007) First and early second trimester fetal heart screening. Curr Opin Obstet Gynecol 19:183–190CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Markus Hoopmann
    • 1
  • Karl-Oliver Kagan
    • 1
  1. 1.FrauenklinikUniversitätsklinikum TübingenTübingenDeutschland

Personalised recommendations