Die Urologie pp 1809-1825 | Cite as

Pränatale Diagnostik in der Urologie

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Zusammenfassung

Die pränatale Untersuchung des fetalen Urogenitaltraktes umfasst die Beurteilung der Fruchtwassermenge, der beiden Nieren, der Harnblase und des Geschlechts. Im Verlauf der Schwangerschaft sind drei sonographische Screening-Untersuchungen vorgesehen. Durch die Mutterschaftsrichtlinien und DEGUM-Leitlinien sind detaillierte Vorgaben zur sonographischen Beurteilung des Feten festgelegt worden, um fetale Auffälligkeiten frühzeitig erkennen und ggf. weiterführende diagnostische und therapeutische Maßnahmen einleiten zu können. Vor Durchführung des Ultraschallscreenings ist es wichtig, die Schwangere ärztlicherseits gemäß den Vorgaben der Mutterschaftsrichtlinien und des Gendiagnostikgesetzes über Ziele, Inhalt und Grenzen sowie über mögliche Folgen der Untersuchung aufzuklären. Im zweiten Ultraschallscreening hat die Schwangere die Möglichkeit, zwischen einer Sonographie mit Biometrie ohne systematische Untersuchung der fetalen Morphologie und einer Sonographie mit Biometrie und systematischer Untersuchung der fetalen Morphologie durch einen besonders qualifizierten Untersucher zu wählen. Für die Beurteilung des fetalen Urogenitalsystems ist nur die Darstellung der fetalen Harnblase explizit gefordert. Ergeben sich bei den sonographischen Vorsorgeuntersuchungen auffällige Befunde, so erfolgt gemäß den Empfehlungen des Mehrstufenkonzeptes der DEGUM eine weitere detaillierte Abklärung durch einen spezialisierten Pränatalmediziner. Die Kenntnis über den Nachweis einer Auffälligkeit im fetalen Urogenitaltrakt ermöglicht zum einen die weitere pränatale Abklärung von chromosomalen Risiken, die Einschätzung der kindlichen Prognose und die perinatalogische Planung der Geburt in einem dafür vorgesehenen spezialisierten Perinatalzentrum möglichst der Stufe I, zum anderen die frühzeitige postnatale Einleitung von präventiven und therapeutischen Maßnahmen und Untersuchungen bis hin zu einer rechtzeitigen chirurgischen Intervention mit dem Ziel, die Nieren- und Harnblasenfunktion aufrechtzuerhalten.

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© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Bürgerhospital Frankfurt, FrauenklinikFrankfurt am MainDeutschland

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