Zusammenfassung
In diesem Kapitel wird die Integration der Dopplersonographie in das klinische Management erläutert. Zuerst wird die Geschichte der Einführung der Dopplersonographie in die Klinik dargestellt. Danach werden Indikationen der Dopplersonographie aufgeführt, sowohl beim Screening im Niedrigrisikokollektiv als auch im Hochrisikokollektiv. Anschließend werden die für die Untersuchung geeigneten Gefäße und die Bedeutung pathologischer Blutströmungsmuster erläutert. Daran schließt sich die Darstellung der Überwachungsintervalle der Dopplersonographie an. Anschließend wird die Rolle der Dopplersonographie bei exspektativem Vorgehen und bei der Optimierung des Entbindungszeitpunktes erklärt.
Literatur
Agarwal, Neera, Suneja, Amita, Arora, Sunita, Tandon, Om Prakash & Sircar, Sabyasachi (2004) Role of uterine artery velocimetry using color-flow Doppler and electromyography of uterus in prediction of preterm labor. J Obstet Gynaecol Res 30 (6), 402–408
Agathokleous M, Chaveeva P, Poon LC, Kosinski P, Nicolaides KH. Meta-analysis of second-trimester markers for trisomy 21. Ultrasound Obstet Gynecol. (2013) 41(3):247–61 Review
Alfirevic Z1, Stampalija T, Gyte GM. Fetal and umbilical Doppler ultrasound in high-risk pregnancies.Cochrane Database Syst Rev. 2013 Nov 12;(11):CD007529. https://doi.org/10.1002/14651858.CD007529.pub3
Alfirevic Z, Stampalija T, Medley N: Fetal and umbilical Doppler ultrasound in normal pregnancy.Cochrane Database Syst Rev. (2015) Apr 15;(4):CD001450. https://doi.org/10.1002/14651858.CD001450.pub4
Alfirevic Z, Neilson JP (1995) Doppler ultrasonography in high-risk pregnancies: systematic review with meta-analysis. Am J Obstet Gynecol 172:1379‒1387
Almstrom H, Axelsson O, Cnattingius S (1992) Comparison of umbilical-artery velocimetry and cardiotocography for surveillance of small-for-gestational-age fetuses. Lancet 340:936‒940
Arduini D, Rizzo G, Romanini C (1993) The development of abnormal heart rate patterns after absent end-diastolic velocity in umbilical artery: analysis of risk factors. Am J Obstet Gynecol 168:43‒50
Babović I, Plešinac S, Radojičić Z, Antonović O, Sparić R, Plećaš D, Radunović Middle cerebral artery Doppler in prediction degree of fetal anemia and the best timing for the second intrauterine intravascular transfusion in red cell alloimmune disease. N.Clin Exp Obstet Gynecol. (2015);42(6):792–6
Baschat AA (2005) Arterial and venous Doppler in the diagnosis and management of early onset fetal growth restriction. Early Hum Dev. 81(11):877–87
Beattie RB, Dornan JC (1989) Antenatal screening for intrauterine growth retardation with umbilical artery Doppler ultrasonography. Br Med J 298:631‒635
Clerici G, Luzietti R, Di Renzo GC (2001) Monitoring of antepartum and intrapartum fetal hypoxemia: pathophysiological basis and available techniques Biol Neonate 79:246–253
Crispi F, Francesc F, Cruz-Lemini M, Bartrons J, Bijnens B, Gratacos E (2012) Cardiovascular programming in children born small for gestational age and relationship with prenatal signs of severitiy AJOG 207: 121.e1-9
Davies JA, Gallivan S, Spencer JA (1992) Randomised controlled trial of Doppler ultrasound screening of placental perfusion during pregnancy. Lancet 340:1299‒1303
DeVore GR. The importance of the cerebroplacental ratio in the evaluation of fetal well-being in SGA and AGA fetuses.Am J Obstet Gynecol. (2015)l;213(1):5–15.
DIAMOND Study Group. Doppler ultrasonography versus amniocentesis to predict fetal anemia. N Engl J Med. (2006) Jul 13;355(2):156–64
Divon MY (1995) Randomized controlled trials of umbilical artery Doppler velocimetry: how many are too many. Ultrasound Obstet Gynecol:377‒379
Ferrazzi E, Bozzo M, Rigano S, Bellotti M, Morabito A, Pardi G, Battaglia FC, Galan HL (2002) Temporal sequence of abnormal Doppler changes in the peripheral and central circulatory systems of the severely growth-restricted fetus. Ultrasound Obstet Gynecol. 19(2):140–6
Fitzgerald DE, Drumm JE (1977) Non-invasive measurement of human circulation using ultrasound: a new method. Br Med J 2:1450‒1451
Figueras F, Cruz-Martinez R, Sanz-Cortes M, Arranz A, Illa M, Botet F, Costas-Moragas C, Gratacos E (2011) Neurobehavioral outcomes in preterm, growth-restricted infants with and without prenatal advanced signs of brain-sparing. Ultrasound Obstet Gynecol 38(3):288–94
Gagnon R, Van den Hof M; Diagnostic Imaging Committee, Executive and Council of the Society of Obstetricians and Gynaecologists of Canada (2003) The use of fetal Doppler in obstetrics J Obstet Gynaecol Can. 25(7):601–14
Gudmundsson S, Flo K, Ghosh G, Wilsgaard T, Acharya G. Placental pulsatility index: a new more sensitive parameter for predicting adverse outcome in pregnancies suspected of fetal growth restriction.Acta Obstet Gynecol Scand. (2016) Nov 17. https://doi.org/10.1111/aogs.13060. [Epub ahead of print]
Haram K, Softeland E, Bukowski R (2006) Intrauterine growth restriction. Int J Gynaecol Obstet. 93(1):5–12
Harrington KF, Campbell S, Bewley S, Bower S (1991) Doppler velocimetry studies of the uterine artery in the early prediction of pre-eclampsia and intra-uterine growth retardation. Eur J Obstet Gynecol Reprod Biol 42:14‒20
Harrington K, Cooper D, Lees C, Hecher K, Campbell S (1996) Doppler ultrasound of the uterine arteries: the importance of bilateral notching in the prediction of pre-eclampsia, placental abruption or delivery of a small-for-gestational-age baby. Ultrasound Obstet Gynecol 7:182‒188
Harkness UF, Mari G (2004) Diagnosis and management of intrauterine growth restriction. Clin Perinatol. 31(4):743–64
Hayna M Dissertation Charité Berlin 2003
Hecher K, Campbell S, Doyle P, Harrington K, Nicolaides K (1995) Assessment of fetal compromise by Doppler ultrasound investigation of the fetal circulation. Arterial, intracardiac, and venous blood flow velocity studies. Circulation 91:129‒138
Johnstone FD, Prescott R, Hoskins P, Greer IA, McGlew T, Compton M (1993) The effect of introduction of umbilical Doppler recordings to obstetric practice. Br J Obstet Gynaecol 100:733‒741
Karsdorp VH, van Vugt JM, van Geijn HP, Kostense PJ, Arduini D, Montenegro N, Todros T (1994) Clinical significance of absent or reversed end diastolic velocity waveforms in umbilical artery. Lancet 344:1664‒1668
Kiserud T, Eik-Nes SH, Blaas HG, Hellevik LR (1991) Ultrasonographic velocimetry of the ductus venosus. Lancet 338:1412‒1414
Kurdi W, Fayyad A, Thakur V, Harrington K. (2004) Eur J Obstet Gynecol Reprod Biol. 10;117(1):20–3
Kutschera J, Tomaselli J, Urlesberger B, Maurer U, Hausler M, Gradnitzer E, Burmucic K, Muller W (2002) Absent or reversed end-diastolic blood flow in the umbilical artery and abnormal Doppler cerebroplacental ratio–cognitive, neurological and somatic development at 3 to 6 years. Early Hum Dev. 69(1-2):47–56
Kywon JY, Kwon HS, Kim YH, Park YW (2006) Abnormal Doppler velocimetry is related to adverse perinatal outcome for borderline amniotic fluid index during third trimester. J Obstet Gynaecol Res. 32(6):545–9
Lees CC, Marlow N, van Wassenaer-Leemhuis A3 Arabin B, Bilardo CM, Brezinka C, Calvert S, Derks JB, Diemert A9 Duvekot JJ1 Ferrazzi E, Frusca T, Ganzevoort W1 Hecher K9 Martinelli P Ostermayer E, Papageorghiou AT, Schlembach D, Schneider KT, Thilaganathan B, Todros T, Valcamonico A, Visser GH, Wolf H; TRUFFLE study group. 2 year neurodevelopmental and intermediate perinatal outcomes in infants with very preterm fetal growth restriction (TRUFFLE): a randomised trial. Lancet. 2015 May 30;385(9983):2162–72. https://doi.org/10.1016/S0140-6736(14)62049-3. Epub (2015)
Mason GC, Lilford RJ, Porter J, Nelson E, Tyrell S (1993) Randomised comparison of routine versus highly selective use of Doppler ultrasound in low risk pregnancies. Br J Obstet Gynaecol 100:130‒133
McCallum WD, Williams CS, Napel S, Daigle RE (1978) Fetal blood velocity waveforms. Am J Obstet Gynecol 132:425‒429
Mires GJ, Williams FL, Leslie J, Howie PW (1998) Assesment of uterine arterial notching as a screening test for adverse pregnancy outcome. Am J Obstet Gynecol 179: 317‒1323
Nicolini U, Nicolaidis P, Fisk NM, Vaughan JI, Fusi L, Gleeson R, Rodeck CH (1990) Limited role of fetal blood sampling in prediction of outcome in intrauterine growth retardation. Lancet 336:768‒772
Neilson JP (1999) Doppler ultrasound in high risk pregnancies. In: Enkin MW, JNC Keirse, MJ Renfrew, JP Neilson (eds) Pregnancy and childbirth module. Oxford: Update software. (Cochrane database of systematic reviews)
Oepkes D, Seaward PG, Vandenbussche FP, Windrim R, Kingdom J, Beyene J, Kanhai HH, Ohlsson A, Ryan G (2006) Doppler ultrasonography versus amniocentesis to predict fetal anemia. N Engl J Med 355(2):156–164
Ozcan T, Sbracia M, d’Ancona RL, Copel JA, Mari G (1998) Arterial and venous Doppler velocimetry in the severely growth-restricted fetus and associations with adverse perinatal outcome. Ultrasound Obstet Gynecol 12:39‒44
Park YW, Cho JS, Kim HS, Kim JS, Song CH (1996) The clinical implication of early diastolic notch in the third trimester Doppler waveform analysis of the uterine artery. J Ultrasound Med 15:47‒51
Park YW, Cho JS, Choi HM, Kim TY, Lee SH, Yu JK, Kim JW (2000) Clinical significance of early diastolic notch depth: uterine artery Doppler velocimetry in the third trimester. Am J Obstet Gynecol. 182(5):1204–9
Piazze J, Padula F, Cerekja A, Cosmi EV, Anceschi MM (2005) Prognostic value of umbilical-middle cerebral artery pulsatility index ratio in fetuses with growth restriction. Int J Gynaecol Obstet. 91(3):233–7
Polat I, Gedikbasi A, Kiyak H, Gulac B, Atis A, Goynumer G, Dundar O, Ark C. Double notches: association of uterine artery notch forms with pregnancy outcome and severity of preeclampsia.Hypertens Pregnancy. (2015) 34(1):90–101
Savchev S, Figueras F, Cruz-Martinez R, Illa M, Botet F, Gratacos E (2012) Estimated weight centile as a predictor of perinatal outcome in small-for-gestational-age pregnancies with normal fetal and maternal Doppler indices. Ultrasound Obstet Gynecol 39:299–303
Schneider KTM, Amberg-Wendland D, Renz S, Fürstenau U (1991) Prospektiv randomisierte Untersuchung zum klinischen Wert der Dopplersonographie als Screeningverfahren. Gynäkol Rundschau 31:139‒140
Schneider KTM (1997) Indikation zur Dopplersonographie während der Schwangerschaft. Arch Gynecol Obstet 260:153‒162
Schneider KTM (2003) Standards in der Perinatalmedizin - Dopplersonographie in der Schwangerschaft. Geburtshilfe Frauenheilkd 63:21‒25
Schneider H, Schneider KTM (2016) Intrauterine Wachstumsrestriktion (IUWR) in: Die Geburtshilfe, Springer Verlag Heidelberg – New York, 5. Auflage Kap. 27
Simeone S, Marchi L, Canarutto R, Pina Rambaldi M, Serena C1, Servienti C1, Mecacci F1. Doppler velocimetry and adverse outcome in labor induction for late IUGR. J Matern Fetal Neonatal Med. (2017) 30(3):323–328
Skodler WD, Philipp K, Pateisky N, Reinold E (1989) Practical use of blood flow with pulsed ultrasound in the 3d trimester of an at-risk pregnancy. Ultraschall Med 10:230‒234
Sovio U, White IR, Dacey A, Pasupathy D, Smith GC. (2015) Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study. Lancet. 21;386(10008):2089–97
The GRIT Study Group (1996) The GRIT Study Group. Europ J Obstet Gynecol Reprod Biol 67:121‒126
Thornton JG, Hornbuckle J, Vail A, Spiegelhalter DJ, Levene M; GRIT study group (2004) Infant wellbeing at 2 years of age in the Growth Restriction Intervention Trial (GRIT): multicentred randomised controlled trial. Lancet. 364(9433):513–20
Valcamonico A, Danti L, Frusca T, Soregaroli M, Zucca S, Abrami F, Tiberti A (1994) Absent end-diastolic velocity in umbilical artery: risk of neonatal morbidity and brain damage. Am J Obstet Gynecol 170:796‒801
Visser GH, Bilardo CM, Derks JB, Ferrazzi E, Fratelli N, Frusca T, Ganzevoort W, Lees C, Napolitano R, Todros T, Wolf H, Hecher K; TRUFFLE group investigators (2016).The TRUFFLE study; fetal monitoring indications for delivery in 310 IUGR infants with 2 year’s outcome delivered before 32 weeks of gestation. Ultrasound Obstet Gynecol. 201610.1002/uog.17361 Epub.1
Wienerroither H, Steiner H, Tomaselli J, Lobendanz M, Thun-Hohenstein L (2001) Intrauterine blood flow and long-term intellectual, neurologic, and social development. Obstet Gynecol. 97(3):449–53
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Schneider, K.T.M. (2018). Integration der Dopplersonographie in das klinische Management. In: Steiner, H., Schneider, KT. (eds) Dopplersonographie in Geburtshilfe und Gynäkologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54966-7_19
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