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Intrauterine Wachstumsrestriktion

Teil I. Klassifikation, Pathogenese und Diagnose

Intrauterine growth restriction

I. Classification, pathogenetic mechanisms, and diagnosis

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Der Gynäkologe Aims and scope

Zusammenfassung

Der Begriff „intrauterine Wachstumsrestriktion“ (IUGR) bedeutet, dass Feten ihr genetisches Wachstumspotenzial in utero nicht erreicht haben. Differenzialdiagnostisch abzugrenzen sind SGA („small for gestational age“)-Feten (Abdomenumfang oder Schätzgewicht <10. Perzentile) von IUGR (SGA-Fet mit pathologischem Doppler der A. umbilicalis)-Feten. Nur etwa 50% der SGA-Feten haben eine IUGR, etwa 25% der IUGR-Kinder weisen ein Geburtsgewicht >10. Perzentile auf. Das intrauterine Wachstum wird durch genetische Einflüsse und elterliche, fetale sowie plazentare Umgebungsfaktoren reguliert. In mehr als 50% der Fälle von IUGR besteht eine Assoziation mit anamnestischen und/oder klinischen Risikofaktoren. Die Diagnose beruht auf der Biometrie. Allerdings beträgt deren Sensitivität in Low-risk-Kollektiven nur 30–40%. Zur erweiterten Diagnostik gehören obligat die Doppler-Sonographie und die ausführliche Sonographie zwecks Fehlbildungsausschluss, optional eine Infektionsserologie und die Karyotypisierung.

Abstract

The term “intrauterine growth restriction” (IUGR) defines fetuses who fail to realize their genetically endowed growth potential. Small for gestational age (SGA) fetuses (abdominal circumference or estimated fetal weight below the 10th percentile) have to be distinguished from IUGR fetuses (SGA fetuses having abnormal umbilical artery Doppler). About 50% of SGA fetuses also have IUGR. The birth weight of 25% of IUGR fetuses is above the 10th percentile. Fetal growth is regulated by genetic and environmental factors of parental, fetal, and placental origin. In more than 50% of cases, IUGR is associated with risk factors (medical history, clinical findings). The diagnosis relies on fetal biometry; however, the sensitivity in low-risk groups is only 30–40%. Diagnostic procedures should always include Doppler sonography of the fetomaternal circulation, detailed assessment of the fetal organs by ultrasound, and, optionally, serological examinations to exclude infections and determine the karyotype.

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  1. Abteilung Gynäkologie und Geburtshilfe, St. Marien-Hospital, Hospitalstraße 44, 52353, Düren, Deutschland

    G. Crombach

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Crombach, G. Intrauterine Wachstumsrestriktion. Gynäkologe 40, 891–902 (2007). https://doi.org/10.1007/s00129-007-2057-9

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  • DOI: https://doi.org/10.1007/s00129-007-2057-9

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