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Update Pränataldiagnostik

Update: prenatal diagnostics

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Der Gynäkologe Aims and scope

Zusammenfassung

In einer Neuordnung „Sonographierichtlinien“ der MuVo soll das Screening auf Fehlbildungen aus fachlichen und ethischen Gründen durch Basisultraschalluntersuchungen mit dem Ziel der Erkennung von Entwicklungsstörungen und Erkrankungen des Kindes ersetzt werden. Alternativ kann die Schwangere zwischen 18+0 und 22+0 SSW eine Stufe-II/III-Sonographie wählen können – als Kassenleistung.

Für das Ersttrimesterscreening außerhalb der Mutterschaftsvorsorge werden neben der Nackentransparenz und dem Nasenbein neue Parameter wie Trikuspidalregurgitation und fehlender Ductus-venosus-Fluß für die Risikokalkulation validiert – auf Stufe-II/III-Niveau.

Die Dritttrimester- und Kreißsaalsonographie bekommt durch 3D/4D-Sonographie, Sectionarbendarstellung, Plazenta- und Vasa-praevia-Darstellung sowie durch die geburtsbegleitende Sonographie zur Beurteilung des Einleitungserfolgs, der Lage-und Einstellungsanomalien und Plazentalösungsproblemen eine zunehmende Bedeutung.

Abstract

For both medical and ethical reasons, new pregnancy care regulations indicate the replacement of screening for malformations by basic ultrasound examinations in order to check for developmental disturbances and illnesses.. Alternatively, the pregnant woman can choose a special level II/III scan at 18–22 weeks as part of the standard schedule of fees for medical services.

First trimester screening is extended from nuchal translucency and the nasal bone to include tricuspidal regurgitation and the absence of ductus venosus flow, providing a more exact risk calculation. This then becomes a proper level II/III examination.

The third trimester and labour suite examination becomes more important through 3D/4D, caesarean scar, placenta and vasa praevia examination. Sonography of the cervix before the induction of labour and head position ultrasound during labour are of increasing clinical importance as is post partum placental pathology.

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Notes

  1. DGGG Deutsche Gesellschaft für Gynäkologie und Geburtshilfe, DGPM Deutsche Gesellschaft für Perinatale Medizin, DGPGM Deutsche Gesellschaft für Pränatal- und Geburtsmedizin, FMF-D Fetal Medicine Foundation Deutschland, BVF Berufsverband der Frauenärzte, AGMFM Arbeitsgemeinschaft für Fetomaternale Medizin der DGGG, DEGUM Deutsche Gesellschaft für Ultraschall in der Medizin, AGLFMM Arbeitsgemeinschaft Leitender Fetomaternalmediziner.

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  1. Abt. für Geburtshilfe und Pränatalmedizin, Asklepios Klinik, Rübenkamp 220, 22 291 , Hamburg

    B.-J. Hackelöer

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Hackelöer, BJ. Update Pränataldiagnostik. Gynäkologe 39, 283–292 (2006). https://doi.org/10.1007/s00129-006-1819-0

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  • DOI: https://doi.org/10.1007/s00129-006-1819-0

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