Skip to main content

Der Fetus als Patient

  • Chapter
Pränatale Medizin
  • 34 Accesses

Zusammenfassung

Während der letzten 15 Jahre sind bemerkenswerte Fortschritte in der vorgeburtlichen Diagnostik erzielt worden. Das Endziel dieser Bemühungen ist jedoch die Entwicklung von Therapiemöglichkeiten der diagnostizierten fetalen Störungen. Aufgrund der jüngsten Entwicklungen auf dem Gebiet der aktiven fetalen Interventionen [5, 7, 14, 23] kann der Fetus immer mehr auch als Patient angesehen werden. Erste erfolgreiche Versuche wurden bereits unternommen, erfolgreiche Maßnahmen zur Therapie des Fetus mit einem kongenitalen Defekt zu entwickeln [9, 15, 20]. Die Aufmerksamkeit der Öffentlichkeit wurde zwar durch die ersten operativen Behandlungen anatomischer Fehlbildungen erregt, die ersten Versuche der pränatalen Therapie beschäftigten sich jedoch auch mit der medikamentösen Behandlung fetaler Störungen. Das erste und bekannteste Beispiel einer fetalen Therapie war allerdings die intrauterine Transfusion von roten Blutkörperchen bei Rhesusinkompatibilität, die in einem anderen Kapitel dieses Buches dargestellt wird. In diesem Kapitel soll insbesondere auch auf die nichtoperativen Möglichkeiten einer pränatalen Therapie eingegangen werden.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 44.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 59.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Adzick NS, Harrison MR, Glick PL et al. (to be published) Diaphragmatic hernia in the fetus: Prenatal diagnosis and outcome in 94 cases. J Pediatr Surg

    Google Scholar 

  2. Ampola MG, Mahoney MJ, Nakamura E, Tanaka K (1975) Prenatal therapy of a patient with vitamin B12-responsive methylmalonic acidemia. N Engl J Med 293: 313–317

    Article  PubMed  CAS  Google Scholar 

  3. Anderson WF (1984) Prospects for human gene therapy. Science 226: 401–409

    Article  PubMed  CAS  Google Scholar 

  4. Bang J, Bock JE, Trolle D (1982) Ultrasound-guided fetal intravenous transfusion for severe rhesus hemolytic disease. Br Med J 284: 373–374

    Article  CAS  Google Scholar 

  5. Birnholz JC, Frigoletto FD (1981) Antenatal treatment of hydrocephalus. N Engl J Med 304: 1021–1023

    Article  PubMed  CAS  Google Scholar 

  6. Chervenak FA, Ment LR, McClure M et al. (1984) Outcome of fetal ventriculomegaly. Lancet II: 179–181

    Google Scholar 

  7. Clewell WH, Johnson ML, Meier PR et al. (1982) A surgical approach to the treatment of hydrocephalus. N Engl J Med 306: 1320–1325

    Article  PubMed  CAS  Google Scholar 

  8. David MJ, Forest MG (1984) Prenatal treatment of congenital adrenal hyperplasia resulting from 21-hydroxylase deficiency. J Pediatr 105: 799–803

    Article  PubMed  CAS  Google Scholar 

  9. Diament MJ, Fine RN, Ehrlich R, Kangarloo H (1983) Fetal hydronephrosis: Problems in diagnosis and management. J Pediatr 103: 435–440

    Article  PubMed  CAS  Google Scholar 

  10. Dumesic DA, Silverman NH, Tobias S, Golbus MS (1982) Transplacental cardioversion of fetal supraventricular tachycardia with procainamide. N Engl J Med 307: 1128–1131

    Article  PubMed  CAS  Google Scholar 

  11. Fiske CE, Filly RA (1982) Ultrasound of the normal and abnormal fetal neural axis. Radiol Clin North Am 20: 285–296

    PubMed  CAS  Google Scholar 

  12. Frydman M, Magenis RE, Mohandas TK, Kaback MM (1983) Chromosome abnormalities in infants with prune belly anomaly: Association with trisomy 18. Am J Med Genet 15: 145–148

    Article  Google Scholar 

  13. Glick PL, Nakayama DK, Harrison MR et al. (1984) Management of the fetus with ventriculomegaly. J Pediatr 105: 97–105

    Article  PubMed  CAS  Google Scholar 

  14. Golbus MS, Harrison MR, Filly RA et al. (1982) In utero treatment of urinary tract obstruction. Am J Obstet Gynecol 142: 383–388

    PubMed  CAS  Google Scholar 

  15. Golbus MS, Harrison MR, Filly RA (1983) Prenatal diagnosis and treatment of fetal hydronephrosis. Semin Perinatol 7: 102–108

    PubMed  CAS  Google Scholar 

  16. Gustavii B, Lofberg L, Olofsson T (1982) Transfer of tissue cells to the fetus. Acta Obstet Gynecol Scand 61: 361–365

    PubMed  CAS  Google Scholar 

  17. Harrison MR, deLorimier AA (1981) Congenital diaphragmatic hernia. Surg Clin North Am 61: 1023–1035

    PubMed  CAS  Google Scholar 

  18. Harrison MR, Bressack MC, Chung AM, deLorimier AA (1980) Correction of congenital diaphragmatic hernia in utero. II. Simulated correction permits fetal lung growth with survival at birth. Surgery 88: 260–268

    PubMed  CAS  Google Scholar 

  19. Harrison MR, Jester JA, Ross NA (1980) Correction of congenital diaphragmatic hernia in utero. I. The model: Intrathoracic balloon produces fatal pulmonary hypoplasia. Surgery 88: 174–182

    PubMed  CAS  Google Scholar 

  20. Harrison MR, Golbus MS, Filly RA (1981a) Management of the fetus with a correctable congenital defect. JAMA 246: 774–777

    Article  PubMed  CAS  Google Scholar 

  21. Harrison MR, Ross NA, deLorimier AA (1981b) Correction of congenital diaphragmatic hernia in utero. III. Development of a successful surgical technique using abdominoplasty to avoid compromise of umbilical blood flow. J Pediatr Surg 16: 934–942

    Article  PubMed  CAS  Google Scholar 

  22. Harrison MR, Filly RA, Golbus MS et al. (1982a) Fetal treatment 1982. N Engl J Med 307: 1651–1652

    Article  PubMed  CAS  Google Scholar 

  23. Harrison MR, Golbus MS, Filly RA et al. (1982b) Fetal surgery for congenital hydronephrosis. N Engl J Med 306: 591–593

    Article  PubMed  CAS  Google Scholar 

  24. Harrison MR, Golbus MS, Filly RA et al. (1982c) Management of the fetus with congenital hydronephrosis. J Pediatr Surg 17: 728–742

    Article  PubMed  CAS  Google Scholar 

  25. Heaton FC, Vaughan R (1982) Intrauterine supraventricular tachycardia: Cardioversion with maternal digoxin. Obstet Gynecol 60: 749–752

    PubMed  CAS  Google Scholar 

  26. Krivit W, Pierpont ME, Ayaz K et al. (1984) Bone marrow transplantation in the Maroteaux-Lamy Syndrome (mucopolysaccharidosis Type VI): Biochemical and clinical status 24 months after transplantation. N Engl J Med 311: 1606–1611

    Article  PubMed  CAS  Google Scholar 

  27. Liley AW (1963) Intrauterine transfusion of fetus in haemolytic disease. Br Med J 5365: 1107–1109

    Article  Google Scholar 

  28. Mahoney BS, Filly RA, Callen PW et al. (1984) Fetal renal dysplasia: Sonographic evaluation. Radiology 152: 143–146

    Google Scholar 

  29. Miller AD, Eckner RJ, Jolly DJ et al. (1984) Expression of a retrovirus encoding human HPRT in mice. Science 225: 630–632

    Article  PubMed  CAS  Google Scholar 

  30. Moser HW, Tutschka PJ, Brown FR III et al. (1984) Bone marrow transplant in adrenoleukodystrophy. Neurology 34: 1410–1417

    PubMed  CAS  Google Scholar 

  31. Nevin NC, Nevin J, Dunlop JM, Gray M (1983) Antenatal detection of grossly distended bladder owing to absence of the urethra in a fetus with trisomy 18. J Med Genet 20: 132–133

    Article  PubMed  CAS  Google Scholar 

  32. Packman S, Cowan MJ, Golbus MS et al. (1982) Prenatal treatment of biotin-responsive multiple carboxylase deficiency. Lancet 1: 1435–1439

    Article  PubMed  CAS  Google Scholar 

  33. Palmiter RD, Brinster RL, Hammer RE et al. (1982) Dramatic growth of mice that develop from eggs microinjected with metallothionine-growth hormone fusion genes. Nature 300: 611–615

    Article  PubMed  CAS  Google Scholar 

  34. Prout TE (1975) Thyroid disease in pregnancy. Am J Obstet Gynecol 122: 669–676

    PubMed  CAS  Google Scholar 

  35. Rappeport JM, Ginns EI (1984) Bone marrow transplantation in severe Gaucher’s disease. N Engl J Med 311: 84–88

    Article  PubMed  CAS  Google Scholar 

  36. Rodeck CH, Holman CA, Karnicki J et al. (1981) Direct intravascular fetal blood transfusion by fetoscopy in severe Rhesus isoimmunization. Lancet 1: 625

    Article  PubMed  CAS  Google Scholar 

  37. Rodeck CH, Nicolaides KH, Warsof SL et al. (1984) The management of severe rhesus isoimmunization by fetoscopic intravascular transfusions. Am J Obstet Gynecol 150: 769–774

    Google Scholar 

  38. Silverstein AM (1964) Ontogeny of the immune response. Science 144: 1423–1428

    Article  PubMed  CAS  Google Scholar 

  39. Spinnato JA, Shaver DC, Flinn GS et al. (1984) Fetal supraventricular tachycardia: In utero therapy with digoxin and quinidine. Obstet Gynecol 64: 730–735

    PubMed  CAS  Google Scholar 

  40. Stewart TA, Wagner EF, Mintz B (1982) Human beta-globin gene sequence injected into mouse eggs, retained in adults, and transmitted to progeny. Science 217: 1046–1048

    Article  CAS  Google Scholar 

  41. Teuscher A, Bossi E, Imhof E et al. (1978) Effect of propranolol on fetal tachycardia in diabetic pregnancy. Am J Cardiol 42: 304–307

    Article  PubMed  CAS  Google Scholar 

  42. Weiner S, Scharf J, Bolognese R, Librizzi R (1980) Antenatal diagnosis and treatment of a fetal goiter. J Reprod Med 24: 39–42

    PubMed  CAS  Google Scholar 

  43. Wenger DA, Gasper PW, Thrall MA (1984) Feline arylsulfatase ß deficiency (mucopolysaccharidosis VI): Correction by bone marrow transplantation. Am J Hum Genet 36: Suppl 1: 80

    Google Scholar 

  44. Williamson RA, Schauberger CW, Varner MW, Aschenbrener CA (1984) Heterogeneity of prenatal onset hydrocephalus: Management and counseling implications. Am J Med Genet 17: 497–508

    Article  PubMed  CAS  Google Scholar 

  45. Yatziv S, Weiss L, Fuks Z et al. (1982) Long term enzyme replacement therapy in beta glucuronidase deficient mice by allogenic bone marrow transplantation. J Lab Clin Med 99: 792–797

    PubMed  CAS  Google Scholar 

  46. Yeager AM, Brennan S, Tiffany C et al. (1984) Prolonged survival and remyelination after hematopoietic cell transplantation in the twitcher mouse. Science 225: 1052–1054

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1987 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Hogge, W.A., Golbus, M.S. (1987). Der Fetus als Patient. In: Holzgreve, W. (eds) Pränatale Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-71048-3_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-71048-3_12

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-71049-0

  • Online ISBN: 978-3-642-71048-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics