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Der SGA-Fetus — die intrauterine Wachstumsrestriktion

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Dopplersonographie in Geburtshilfe und Gynäkologie

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Zusammenfassung

Das Geburtsgewicht ist die wichtigste Determinante für die perinatale Morbidität und Mortalität. Bei gleichem Gestationsalter sind niedrige Fetalgewichte mit einer 4- bis 8fach höheren perinatalen Mortalität korreliert (Schneider 1993). Die IUGR (intrauterine growth retardation/restriction) macht mehr als 20% der intrauterinen Fruchttode aus (Pollack u. Divon 1992). Die Tatsache, daß unter Frühgeburten ein höherer Anteil an IUGR-Feten zu finden ist als unter Reifgeborenen weist darauf hin, daß durch die plazentare Insuffizienz Frühgeburtlichkeit induziert wird. Darüber hinaus ist das relative Risiko dieser Feten bezüglich Asphyxie, Mekoniumaspiration, Hypoglykämie und Hyperviskosität als Zeichen chronischer Hypoxämie um ein Vielfaches erhöht. Wachstumsretardierte Kinder zeigen zudem vermehrt Störungen in ihrer neurologischen Langzeitentwicklung (Bar 1982; Clark 1992; Pollack u. Divon 1992). Das Risiko einer Chromosomenstörung bei Verdacht auf IUGR wird mit 2–8% angegeben.

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Literatur

  • Anyaegbunam A, Brustman L, Langer O (1991) A longitudinal evaluation of the efficacy of umbilical Doppler velocimetry in the diagnosis of intrauterine growth retardation. Int J Gynecol Obstet 34:121–125

    Article  CAS  Google Scholar 

  • Arabin B, Mohnhaupt A, Vollert W, Weitzel HK (1994) Prediction of fetal distress and poor outcome in prolonged pregnancy using Doppler ultrasound and fetal heart rate monitoring combined with stress tests (II). Fetal Diagn Ther 9:1–6

    Article  PubMed  CAS  Google Scholar 

  • Arbeille P (1991) Cerebral Doppler in the assessment of IUGR and the fetal hypoxia. J Matern Fetal Invest 1:51–56

    Google Scholar 

  • Arduini D, Romanini C, Mancuso S (1987) Fetal blood flow velocity wave forms as predictors of growth retardation. Obstet Gynecol 70:7–10

    PubMed  CAS  Google Scholar 

  • Arduini D (1991) Fetal renal artery velocity waveforms and amniotic fluid volume in growth-retarded and post-term fetuses. Obstet Gynecol 77:370–373

    PubMed  CAS  Google Scholar 

  • Bates JA, Evans JA, Mason G (1996) Differentiation of growth retarded from normally grown fetuses and prediction of intrauterine growth retardation using Doppler ultrasound. Br J Obstet Gynecol 103:670–675

    Article  CAS  Google Scholar 

  • Beattie RB, Dornan JC (1989) Antenatal screening for intrauterine growth retardation with umbilical artery Doppler ultrasonography. Br Med J 298:631–635

    Article  CAS  Google Scholar 

  • Beley S, Chard, Grudzinskas G, Cooper D, Campbell S (1992) Early prediction of uteroplacental complications of pregnancy using Doppler ultrasound, placental function tests and combinating testing. Ultrasound Obstet Gynecol 2:333–337

    Article  Google Scholar 

  • Bilardo CM, Nicolaides KH, Campbell S (1990) Doppler measurements of fetal and uteroplacental circulations: relationship with umbilical venous blood gases measured at cordocentesis. Am J Obstet Gynecol 162:115–120

    Article  PubMed  CAS  Google Scholar 

  • Brar HS (1982) Classification of intrauterine growth retardation. Semin Perinatol 12:2–10

    Google Scholar 

  • Burke G, Stuart B, Crowley P, Scanaill S, Drumm J (1990) Is intrauterine growth retardation with normal umbilical artery blood flow a benign condition? Br Med J 300:1044–1045

    Article  CAS  Google Scholar 

  • Campbell S, Pearce JM, Hackett G, Cohen-Overbeck T, Hernandez C (1986) Qualitative assessment of uteroplacental blood flow: early screening test for high-risk pregnancies. Obstet Gynecol 68:649–653

    PubMed  CAS  Google Scholar 

  • Carlson DE (1988) Maternal diseases associated with intrauterine growth retardation. Semin Perinatol 12:17–22

    PubMed  CAS  Google Scholar 

  • Chang TC, Boys RJ, Spencer JA (1992) Prediction of the small for gestational age infant: which ultrasonic measurement is best? Obstet Gynecol 80:103 0–1038

    Google Scholar 

  • Clark SL (1992) Patterns of intrauterine growth retardation: case examples. Clin Obstet Gynecol 35:194–201

    Article  PubMed  CAS  Google Scholar 

  • Divon MY (1992) Maternal and fetal blood flow velocity waveforms in intrauterine growth retardation. Am J Obstet Gynecol 35:156–171

    CAS  Google Scholar 

  • Divon MY, Hsu HW, Katz NT. Henderson CE (1992) A Meta-Analysis of umbilical artery Doppler velocimetry for the diagnosis of IUGR in high risk pregnancies. Soc Gynecol Invest 131

    Google Scholar 

  • Divon MY, Guidetti DA, Braverman JJ (1988) Intrauterine growth retardation: a prospective study of the diagnostic value of real-time sonography combined with umbilical artery flow velocimetry. Obstet Gynecol 72:611–614

    PubMed  CAS  Google Scholar 

  • Flynn AM, Kelly J, Matthews K, O’Conor M, Viegas O (1982) Predictive value of, and observer variablity in, several ways of reporting antepartum cardiotocographs. Br J Obstet Gynaecol 89:434–440

    Article  PubMed  CAS  Google Scholar 

  • Gardosi J, Chang A, Kalyan B, Sahota D, Symonds EM (1992) Customised antenatal growth charts. Lancet 339: 283–287

    Article  PubMed  CAS  Google Scholar 

  • Gaudoin MR (1992) Cardiotocography and Doppler velocimetry for surveillance of small-for-gestational-age fetuses. Lancet 340:1348–1349

    Article  PubMed  CAS  Google Scholar 

  • Gnirs J (1995) Kineto-Kardiotokographie — automatische Detektion der fetalen Bewegungsaktivität als integraler Bestandteil antepartualer CTG — Registrierungen und ihre Bedeutung für die fetale Zustandsdiagnostik. Habilitationsschrift, TU München

    Google Scholar 

  • Gudmundsson S, Marsal K (1991) Blood velocity waveforms in the fetal aorta and umbilical artery as predictors of fetal outcome: a comparison. Am J Perinatol 8:1–6

    Article  PubMed  CAS  Google Scholar 

  • Jacobson SL, Imhof R, Manning N, Mannion V, Little D, Rey E, Redman C (1990) The value of Doppler assessment of the uteroplacental circulation in predicting preeclampsia or intrauterine growth retardation. Am J Obstet Gynecol 162:110–114

    Article  PubMed  CAS  Google Scholar 

  • Karsdorp VHM, van Geijn HP, Kostense PJ, Arduini D, Montenegro N, Todros T (1994) Clinical significance of absent or reversed end diastolic velocity waveforms (ARED flow) in the umbilical artery: results of a multi-center European study. Lancet 344:1664–1667

    Article  PubMed  CAS  Google Scholar 

  • Kay HH, Dahmus M, Killam AP (1991). Sonographic measurements with umbilical and uterine artery Doppler analysis in suspected intrauterine growth retardation. J Reprod Med 36:65–68

    PubMed  CAS  Google Scholar 

  • Khoury MJ, Errickson JD, Cordero JF, McCarthy BJ (1988) Congenital malformations and intrauterine growth retardation: a population study. Pediatrics 82:83–90

    PubMed  CAS  Google Scholar 

  • Kurjak A (1992) Antepartum and intrapartum management of the growth-retarded fetus. Clin Obstet Gynecol 35:185–193

    Article  PubMed  CAS  Google Scholar 

  • Larsen T, Petersen S, Greisen G (1992) Detection of small-for-gestational-age fetuses by ultrasound screening in a high risk population: a randomized controlled study. Br J Obstet Gynaecol 99:469–474

    Article  PubMed  CAS  Google Scholar 

  • Laurin J, Marsal K, Persson PH, Lingman G (1987) Ultrasound measurement of fetal blood flow in predicting fetal outcome. Br J Obstet Gynecol 94:940–948

    Article  CAS  Google Scholar 

  • Lindhard A, Nielsen PV, Mouritsen LA, Zachariassen A, Sörensen HU, Rosenö H (1990) The implications of introducing the symphyseal-fundal height-measurement. A prospective randomized controlled trial. Br J Obstet Gynaecol 97:675–680

    Article  PubMed  CAS  Google Scholar 

  • Meizner I, Glezerman M (1992) Cordocentesis in the evaluation of the growth-retarded fetus. Clin Obstet Gynecol 35:126–137

    Article  PubMed  CAS  Google Scholar 

  • Mutterschafts-Richtlinien (1995) Ultraschall-Doppler. Deutsches Ärzteblatt 92:233–235

    Google Scholar 

  • Nicolaides KH, Vyas S, Rabinowitz R, Rosen DJD, Campbell S (1990) Relation of rate of urine production to oxygen tension in small-for-gestational-age fetuses. Am J Obstet Gynecol 162:387–391

    Article  PubMed  CAS  Google Scholar 

  • Nicolaides KH, Economides DL, Soothill PW (1989) Blood gases, pH, and lactate in appropriate- and small-for-gestational-age fetuses. Am J Obstet Gynecol 161:996–1001

    Article  PubMed  CAS  Google Scholar 

  • Nienhuis SJ, Vies JS, Gerver WJ, Hoogland HJ (1997) Doppler ultrasonography in suspected intrauterine growth retardation: a randomized clinical trial. Ultrasound Obstet Gynecol 9:6–13

    Article  PubMed  CAS  Google Scholar 

  • Pfeiffer KH (1990) Die Erfassung der fetalen Wachstumsretardierung durch apparative und biochemische Überwachungsmethoden. Z Geburtshilfe Perinatol 194:99–103

    PubMed  CAS  Google Scholar 

  • Platt LD (1988) Genetic factors in intrauterine growth retardation. Semin Perinatol 2:11–16

    Google Scholar 

  • Pollack RN, Divon MY (1992) Intrauterine growth retardation: definition, classification, and etiology. Clin Obstet Gynecol 35:99–107

    Article  PubMed  CAS  Google Scholar 

  • Sarmandal P (1990) Effectiveness of ultrasound determination of fetal abdominal circumference and fetal ponderal index in the diagnosis of asymmetrical growth retardation. Br J Obstet Gynaecol 97:118–123

    Article  PubMed  CAS  Google Scholar 

  • Schneider KTM, Amberg-Wendland D, Renz S, Fürstenau U (1991) Prospektiv randomisierte Untersuchung zum klinischen Wert der Dopplersonographie als Screeningverfahren. Gynakol Geburtshilfliche Rundsch 31:139–140

    Article  Google Scholar 

  • Schneider KTM (1993) IUGR-Probleme der Diagnostik. In: Schmidt W (Hrsg) Jahrbuch der Gynäkologie und Geburtshilfe 1992/93. Biermann, Zülpich, S 113–123

    Google Scholar 

  • Secher NJ, Lundbye-Christensen S, Qvist I, Bagger P (1991) An evaluation of clinical estimation of fetal weight and symphysis fundai distance for detection of SGA infants. Eur J Obstet Gynecol Reprod Biol 38:91–96

    Article  PubMed  CAS  Google Scholar 

  • Soothill PW, Campbell S (1993) Predicition of morbidity in small and normally grown fetuses by fetal heart rate variability, biophysical profile score and umbilical artery Doppler studies. Br J Obstet Gynaecol 100:742–745

    Article  PubMed  CAS  Google Scholar 

  • Steiner H, Schaffer H, Spitzer D, Staudach A (1994) Umbilical artery Doppler velocimetry classes and fetal outcome. J Matern Fetal Invest 4:163–166

    Google Scholar 

  • Steiner H, Staudach A, Spitzer D, Schaffer H, Gregg A, Weiner CP (1995) Growth deficient fetuses with absent or reversed umbilical artery end-diastolic flow are metabolically compromised. Early Hum Dev 41:1–9

    Article  PubMed  CAS  Google Scholar 

  • Thacker SB, Berkelman RL (1986) Assessing the diagnostic accuracy and efficacy of selected fetal surveillance techniques. Obstet Gynecol Surv 41:121–141

    Article  PubMed  CAS  Google Scholar 

  • Thorpe-Beeston JG (1992) Serum prolactin concentration in normal and small for gestational age fetuses. Br J Obstet Gynaecol 99:981–984

    Article  PubMed  CAS  Google Scholar 

  • Todros T, Ferrazzi E, Arduini D et al (1995) Performance of Doppler ultrasonography as a screening test in low risk pregnancies: Results of a multicenter study. J Ultrasound Med 14:343–348

    PubMed  CAS  Google Scholar 

  • Van Vugt JMG (1991) Validity of umbilical artery blood velocimetry in the prediction of intrauterine growth retardation and fetal compromise. J Perinat Med 19:15–20

    Article  PubMed  Google Scholar 

  • Villar J, Belizan JM (1986) The evaluation of the methods used in the diagnosis of intrauterine growth retardation: review. Obstet Gynecol Surv 41:187–199

    Article  PubMed  CAS  Google Scholar 

  • Vintzileos AM, Rodis JF, McLean DA, Fleming AD, Scorza WE (1991) The relationship between fetal biophysical assessment, umbilical artery velocimetry, and fetal acidosis. Obstet Gynecol 77:622–626

    PubMed  CAS  Google Scholar 

  • Voigt M, Schneider KTM, Jährig K (1996) Analyse des Geburtengutes des Jahrgangs 1992 der Bundesrepublik Deutschland. Teil 1: Neue Perzentilmaße für die Körpergewichte Neugeborener. Geburtshilfe Frauenheilkd 56: 550–258

    Article  PubMed  CAS  Google Scholar 

  • Voigt M, Schneider KTM, Jährig K (1997) Analyse des Geburtengutes des Jahrgangs 1992 der Bundesrepublik Deutschland. Teil 2: Mehrdimensionale Zusammenhänge zwischen Alter, Körpergewicht und Körperhöhe der Mutter und dem Geburtsgewicht. Geburtshilfe Frauenheilkd 57:246–255

    Article  Google Scholar 

  • Weiner CP, Williamson RA (1989) Evaluation of severe growth retardation using cordocentesis: hematologic and metabolic alterations by etiology. Obstet Gynecol 73:225–229

    PubMed  CAS  Google Scholar 

  • Wladimiroff JW (1991) A review of the etiology, diagnostic techniques and management of IUGR, and the clinical application of Doppler in the assessment of placental blood flow. J Perinat Med 19:11–13

    PubMed  CAS  Google Scholar 

  • Zimmer EZ, Divon MY (1992) Sonographic diagnosis of IUGR — Macrosomia. Clin Obstet Gynecol 35:172–184

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. K. T. M. Schneider
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  2. H. Steiner
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Editors and Affiliations

  1. St. Johanns Spital, Landesklinik, Frauenheilkunde und Geburtshilfe, Müllner Hauptstraße 48, A-5020, Salzburg, Deutschland

    H. Steiner

  2. Frauenklinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, D-81675, München, Deutschland

    K. T. M. Schneider

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Schneider, K.T.M., Steiner, H. (2000). Der SGA-Fetus — die intrauterine Wachstumsrestriktion. In: Steiner, H., Schneider, K.T.M. (eds) Dopplersonographie in Geburtshilfe und Gynäkologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-06767-3_8

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  • DOI: https://doi.org/10.1007/978-3-662-06767-3_8

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-06768-0

  • Online ISBN: 978-3-662-06767-3

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