Langzeitüberwachung nach dopplersonografischem Nachweis eines umbilikalen Null- und Rückflusses vor extrauteriner Lebensfähigkeit – 2 Kasuistiken

Zusammenfassung

Der Nachweis eines enddiastolischen Null- oder Rückflusses (absent or reversed enddiastolic velocity, AREDV) in der Art. umbilicalis mittels Dopplersonografie bereits vor extrauteriner Lebensfähigkeit dokumentiert die stärkste Ausprägung einer Plazentainsuffizienz. Zur Prognose der Feten existieren kaum Erfahrungen oder Literatur. Wir berichten 2 Kasuistiken mit strukturell und chromosomal unauffälligen Feten und schwerer früher Wachstumsrestriktion, aber positivem Wachstum. Die Schwangerschaften konnten für 62 bzw. 64 Tage prolongiert werden, das kindliche Langzeitergebnis ist erfreulich.

Abstract

The finding of absent or reverse end-diastolic flow velocities (AREDV) in the umbilical artery already prior to viability corresponds to the most severe end of the clinical spectrum of placental insufficiency. However, there is little or no experience or published literature with regard to perinatal outcome. We report 2 cases in which structurally and chromosomally normal foetuses showed severe early onset retardation but were continuing to grow. These gestations could be prolonged by 62 and 64 days, respectively. Perinatal outcome was good in both following Caesarean section at 32+3 and 31+5 gestational weeks respectively.

Schlüsselwörter

Doppler-Ultraschall - Fetale Überwachung - frühe intrauterine Wachstumsrestriktion - Umbilikalarterie - Ductus venosus

Key words

doppler ultrasound - foetal surveillance - early foetal growth restriction - umbilical artery - ductus venosus

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