Frauenheilkunde up2date 2018; 12(04): 317-324
DOI: 10.1055/a-0664-4551
Schritt für Schritt
Georg Thieme Verlag KG Stuttgart · New York

Doppler-Sonografie in der Schwangerschaft – Schritt für Schritt

Anne Doster
,
Nathalie Rippinger
,
Herbert Fluhr
Further Information

Publication History

Publication Date:
12 September 2018 (online)

Die Doppler-Sonografie gibt Auskunft über Blutströmungsmuster und -kurven einzelner Gefäßgebiete. In der Geburtshilfe dient sie bei definierten mütterlichen und fetalen Indikationen der Untersuchung des uteroplazentaren und des fetoplazentaren Kreislaufs sowie der Blutströmungsanalyse intrafetaler Gefäße.

 
  • Literatur

  • 1 Acharya G, Sonesson SE, Flo K. et al. Hemodynamic aspects of normal human feto-placental (umbilical) circulation. Acta Obstet Gynecol Scand 2016; 95: 672-682
  • 2 Acharya G, Wilsgaard T, Berntsen GK. et al. Reference ranges for serial measurements of blood velocity and pulsatility index at the intra-abdominal portion, and fetal and placental ends of the umbilical artery. Ultrasound Obstet Gynecol 2005; 26: 162-169
  • 3 Arabin B, Bergmann PL, Saling E. [Pathophysiologic and clinical aspects of measuring blood flow in utero-placental vessels, the umbilical artery, the fetal aorta and the fetal common carotid artery]. Geburtshilfe Frauenheilkd 1987; 47: 587-593
  • 4 Arabin B, Jimenez E, Vogel M. et al. Relationship of utero- and fetoplacental blood flow velocity wave forms with pathomorphological placental findings. Fetal Diagn Ther 1992; 7: 173-179
  • 5 Arduini D, Rizzo G. Umbilical artery velocity waveforms in early pregnancy: a transvaginal color Doppler study. J Clin Ultrasound 1991; 19: 335-339
  • 6 Assali NS, Rauramo L, Peltonen T. Measurement of uterine blood flow and uterine metabolism. VIII. Uterine and fetal blood flow and oxygen consumption in early human pregnancy. Am J Obstet Gynecol 1960; 79: 86-98
  • 7 Baschat AA, Harman CR. Venous Doppler in the assessment of fetal cardiovascular status. Curr Opin Obstet Gynecol 2006; 18: 156-163
  • 8 Berkley E, Chauhan SP, Abuhamad A. Doppler assessment of the fetus with intrauterine growth restriction. Am J Obstet Gynecol 2012; 206: 300-308
  • 9 Bieniarz J, Yoshida T, Romero-Salinas G. et al. Aortocaval compression by the uterus in late human pregnancy. IV. Circulatory homeostasis by preferential perfusion of the placenta. Am J Obstet Gynecol 1969; 103: 19-31
  • 10 Bilardo CM, Timmerman E, De Medina PG. et al. Low-resistance hepatic artery flow in first-trimester fetuses: an ominous sign. Ultrasound Obstet Gynecol 2011; 37: 438-443
  • 11 Boito SM, Ursem NT, Struijk PC. et al. Umbilical venous volume flow and fetal behavioral states in the normally developing fetus. Ultrasound Obstet Gynecol 2004; 23: 138-142
  • 12 Brace RA. Fetal blood volume responses to acute fetal hemorrhage. Circ Res 1983; 52: 730-734
  • 13 Campbell S, Bewley S, Cohen-Overbeek T. Investigation of the uteroplacental circulation by Doppler ultrasound. Semin Perinatol 1987; 11: 362-368
  • 14 Cruz-Martinez R, Figueras F, Hernandez-Andrade E. et al. Fetal brain Doppler to predict cesarean delivery for nonreassuring fetal status in term small-for-gestational-age fetuses. Obstet Gynecol 2011; 117: 618-626
  • 15 Duggan PM, McCowan LM. Reference ranges and ultrasonographic exposure conditions for pulsed Doppler sonographic studies of the fetal internal carotid artery. J Ultrasound Med 1993; 12: 719-722
  • 16 Ebbing C, Rasmussen S, Godfrey KM. et al. Hepatic artery hemodynamics suggest operation of a buffer response in the human fetus. Reprod Sci 2008; 15: 166-178
  • 17 Fuller EO, Galletti PM, Takeuchi T. Major and collateral components of blood flow to pregnant sheep uterus. Am J Physiol 1975; 229: 279-285
  • 18 Haugen G, Godfrey K, Crozier S. et al. Doppler blood flow velocity waveforms in the fetal renal arteries: variability at proximal and distal sites in the right and left arteries. Ultrasound Obstet Gynecol 2004; 23: 590-593
  • 19 Haugen G, Kiserud T, Godfrey K. et al. Portal and umbilical venous blood supply to the liver in the human fetus near term. Ultrasound Obstet Gynecol 2004; 24: 599-605
  • 20 Iura T, Makinoda S, Fujita S. et al. Analysis of renal artery hemodynamics in normal fetuses using the color Doppler method. Fetal Diagn Ther 2005; 20: 86-90
  • 21 Jauniaux E, Jurkovic D, Campbell S. et al. Doppler ultrasonographic features of the developing placental circulation: Correlation with anatomic findings. Am J Obstet Gynecol 1992; 166: 585-587
  • 22 Johnson P, Maxwell DJ, Tynan MJ. et al. Intracardiac pressures in the human fetus. Heart 2000; 84: 59-63
  • 23 Kessler J, Rasmussen S, Godfrey K. et al. Fetal growth restriction is associated with prioritization of umbilical blood flow to the left hepatic lobe at the expense of the right lobe. Pediatr Res 2009; 66: 113-117
  • 24 Kessler J, Rasmussen S, Kiserud T. The left portal vein as an indicator of watershed in the fetal circulation: development during the second half of pregnancy and a suggested method of evaluation. Ultrasound Obstet Gynecol 2007; 30: 757-764
  • 25 Khong TY, De Wolf F, Robertson WB. et al. Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small-for-gestational age infants. Br J Obstet Gynaecol 1986; 93: 1049-1059
  • 26 Kirkinen P, Muller R, Huch R. et al. Blood flow velocity waveforms in human fetal intracranial arteries. Obstet Gynecol 1987; 70: 617-621
  • 27 Kiserud T, Eik-Nes SH, Blaas HG. et al. Ultrasonographic velocimetry of the fetal ductus venosus. Lancet 1991; 338: 1412-1414
  • 28 Kiserud T, Kessler J, Ebbing C. et al. Ductus venosus shunting in growth-restricted fetuses and the effect of umbilical circulatory compromise. Ultrasound Obstet Gynecol 2006; 28: 143-149
  • 29 Koppelaar I, Wladimiroff JW. Quantitation of breathing-related modulation of umbilical arterial and venous flow velocity waveforms in the normal term fetus. Eur J Obstet Gynecol Reprod Biol 1992; 45: 177-180
  • 30 Makikallio K, Tekay A, Jouppila P. Yolk sac and umbilicoplacental hemodynamics during early human embryonic development. Ultrasound Obstet Gynecol 1999; 14: 175-179
  • 31 Mari G, Kirshon B, Abuhamad A. Fetal renal artery flow velocity waveforms in normal pregnancies and pregnancies complicated by polyhydramnios and oligohydramnios. Obstet Gynecol 1993; 81: 560-564
  • 32 Mari G, Moise jr. KJ, Deter RL. et al. Doppler assessment of the pulsatility index in the cerebral circulation of the human fetus. Am J Obstet Gynecol 1989; 160: 698-703
  • 33 Marx GF, Patel S, Berman JA. et al. Umbilical blood flow velocity waveforms in different maternal positions and with epidural analgesia. Obstet Gynecol 1986; 68: 61-64
  • 34 Noordam MJ, Hoekstra FM, Hop WC. et al. Doppler colour flow imaging of fetal intracerebral arteries relative to fetal behavioural states in normal pregnancy. Early Hum Dev 1994; 39: 49-56
  • 35 Palmer SK, Zamudio S, Coffin C. et al. Quantitative estimation of human uterine artery blood flow and pelvic blood flow redistribution in pregnancy. Obstet Gynecol 1992; 80: 1000-1006
  • 36 Rasanen J, Wood DC, Weiner S. et al. Role of the pulmonary circulation in the distribution of human fetal cardiac output during the second half of pregnancy. Circulation 1996; 94: 1068-1073
  • 37 Robertson WB, Brosens I, Dixon HG. The pathological response of the vessels of the placental bed to hypertensive pregnancy. J Pathol Bacteriol 1967; 93: 581-592
  • 38 Rudolph AM. Distribution and regulation of blood flow in the fetal and neonatal lamb. Circ Res 1985; 57: 811-821
  • 39 Sarno L, Maruotti GM, Saccone G. et al. Maternal body mass index influences umbilical artery Doppler velocimetry in physiologic pregnancies. Prenat Diagn 2015; 35: 125-128
  • 40 Sonesson SE, Fouron JC, Drblik SP. et al. Reference values for Doppler velocimetric indices from the fetal and placental ends of the umbilical artery during normal pregnancy. J Clin Ultrasound 1993; 21: 317-324
  • 41 Thompson RS, Trudinger BJ, Cook CM. Doppler ultrasound waveforms in the fetal umbilical artery: quantitative analysis technique. Ultrasound Med Biol 1985; 11: 707-718
  • 42 Trudinger BJ, Cook CM. The fetal breath cycle. Early Hum Dev 1990; 21: 181-191
  • 43 Trudinger BJ. The umbilical circulation. Semin Perinatol 1987; 11: 311-321
  • 44 Ville Y, Sideris I, Hecher K. et al. Umbilical venous pressure in normal, growth-retarded, and anemic fetuses. Am J Obstet Gynecol 1994; 170: 487-494
  • 45 Vyas S, Nicolaides KH, Campbell S. Renal artery flow-velocity waveforms in normal and hypoxemic fetuses. Am J Obstet Gynecol 1989; 161: 168-172
  • 46 Wladimiroff JW, van Bel F. Fetal and neonatal cerebral blood flow. Semin Perinatol 1987; 11: 335-346
  • 47 Yao AC, Lind J. Effect of gravity on placental transfusion. Lancet 1969; 2: 505-508
  • 48 Zvanca M, Gielchinsky Y, Abdeljawad F. et al. Hepatic artery Doppler in trisomy 21 and euploid fetuses at 11–13 weeks. Prenat Diagn 2011; 31: 22-27
  • 49 Gemeinsamer Bundesausschuss. Richtlinien des Bundesausschusses der Ärzte und Krankenkassen über die ärztliche Betreuung während der Schwangerschaft und nach der Entbindung („Mutterschafts-Richtlinien“). Fassung vom: 10.12.1985 BAnz. Nr. 60 a (Beilage) vom 27.03.1986. Letzte Änderung: 21.04.2016 BAnz AT 19.07.2016 B5. In Kraft getreten am: 20.07.2016. Im Internet: http://www.g-ba.de/informationen/richtlinien/19/ Stand: 17.08.2018
  • 50 AWMF-Leitlinie 015/019 „Dopplersonographie in der Schwangerschaft“ Klasse: S1; Online-Publikation der Überarbeitung: 27.6.2012;. Im Internet: http://www.awmf.org/leitlinien/detail/ll/015-019.html Stand: 17.08.2018