Die Schwangerenvorsorge im Normalkollektiv - was ist evidenzbasiert?

 

 Buy Article Permissions and Reprints

Zusammenfassung

Vorsorgeuntersuchungen sind essenzieller Bestandteil der Schwangerenbetreuung und Geburtsplanung. Nicht alle Aspekte der Routine-Schwangerenvorsorge erfüllen allerdings die Kriterien evidenzbasierter Medizin. In der folgenden Übersicht wird näher auf den Evidenzgrad diagnostischer Maßnahmen eingegangen.

Abstract

Prenatal care is an essential prerequisite for low maternal and fetal morbidity and mortality. Not all aspects of routine prenatal care, however, are based on solid evidence. It was our aim to review the evidence-level of currently available and widely performed routine diagnostic procedures in pregnancy.

Literatur

• 1 Vetter K. Kontroversen in der Schwangerenbetreuung und Geburtshilfe. In Beweisnot?.  Gynäkologie + Geburtshilfe. 2004;  2 1-3
  PubMedGoogle Scholar
• 2 Carr D B, Epplein M, Johnson C O, Easterling T R, Critchlow C W. A sister's risk: family history as a predictor of preeclampsia.  Am J Obstet Gynecol. 2005;  193(3 Pt 2) 965-972
  CrossrefPubMedGoogle Scholar
• 3 Hjartardottir S, Leifsson B G, Geirsson R T, Steinthorsdottir V. Recurrence of hypertensive disorder in second pregnancy.  Am J Obstet Gynecol. 2006;  194 916-920
  CrossrefPubMedGoogle Scholar
• 4 Richter O N, Rath W. Thromboembolic diseases in pregnancy.  Z Geburtshilfe Neonatol. 2007;  211 1-7
  Article in Thieme ConnectPubMedGoogle Scholar
• 5 Kim C, Berger D K, Chamany S. Recurrence of gestational diabetes: a systematic review.  Diabetes Care. 2007; 
  PubMedGoogle Scholar
• 6 Dawes M G, Grudzinskas J G. Repeated measurement of maternal weight during pregnancy. Is this a useful practice?.  Br J Obstet Gynaecol. 1991;  98 189-194
  PubMedGoogle Scholar
• 7 Buekens P, Alexander S, Boutsen M, Blondel B, Kaminski M, Reid M. Randomised controlled trial of routine cervical examinations in pregnancy. European Community Collaborative Study Group on Prenatal Screening.  Lancet. 1994;  344 841-844
  CrossrefPubMedGoogle Scholar
• 8 Carroli G, Villar J, Piaggio G, Khan-Neelofur D, Gulmezoglu M, Mugford M. et al . WHO systematic review of randomised controlled trials of routine antenatal care.  Lancet. 2001;  357 1565-1570
  CrossrefPubMedGoogle Scholar
• 9 Villar J, Carroli G, Khan-Neelofur D, Piaggio G, Gulmezoglu M. Patterns of routine antenatal care for low-risk pregnancy.  Cochrane Database Syst Rev. 2001 (4);  CD000934
  PubMedGoogle Scholar
• 10 Crowther C A, Kornman L, O'Callaghan S, George K, Furness M, Willson K. Is an ultrasound assessment of gestational age at the first antenatal visit of value? A randomised clinical trial.  Br J Obstet Gynaecol. 1999;  106 1273-1279
  PubMedGoogle Scholar
• 11 Neilson J P. Ultrasound for fetal assessment in early pregnancy.  Cochrane Database Syst Rev. 2000 (2);  CD000182
  PubMedGoogle Scholar
• 12 National, Health CCfWsaCs .Antenatal care: routine care for the healthy pregnant woman. Accessed online January 04, 2006, at: http://wwwrcogorguk: > Guidelines > National Evidence-Based Clinical Guidelines > Antenatal Care Routine for the Healthy Pregnant Womanpdf. 2003
  Google Scholar
• 13 Langer B, Caneva M P, Schlaeder G. Routine prenatal care in Europe: the comparative experience of nine departments of gynaecology and obstetrics in eight different countries.  Eur J Obstet Gynecol Reprod Biol. 1999;  85 191-198
  CrossrefPubMedGoogle Scholar
• 14 Bricker L, Neilson J P. Routine ultrasound in late pregnancy (after 24 weeks gestation).  Cochrane Database Syst Rev. 2000 (2);  CD001451
  PubMedGoogle Scholar
• 15 Heath V C, Daskalakis G, Zagaliki A, Carvalho M, Nicolaides K H. Cervicovaginal fibronectin and cervical length at 23 weeks of gestation: relative risk of early preterm delivery.  Bjog. 2000;  107 1276-1281
  PubMedGoogle Scholar
• 16 Iams J D, Goldenberg R L, Meis P J, Mercer B M, Moawad A, Das A. et al . The length of the cervix and the risk of spontaneous premature delivery. National Institute of Child Health and Human Development Maternal Fetal Medicine Unit Network.  N Engl J Med. 1996;  334 567-572
  CrossrefPubMedGoogle Scholar
• 17 de Carvalho M H, Bittar R E, Brizot Mde L, Bicudo C, Zugaib M. Prediction of preterm delivery in the second trimester.  Obstet Gynecol. 2005;  105 532-536
  CrossrefPubMedGoogle Scholar
• 18 Darcy M A, Watson L F, Rayner J, Rowlands S. Risk scoring systems for predicting preterm birth with the aim of reducing associated adverse outcomes.  Cochrane Database Syst Rev. 2004 (3);  CD004902
  PubMedGoogle Scholar
• 19 Conde-Agudelo A, Villar J, Lindheimer M. World Health Organization systematic review of screening tests for preeclampsia.  Obstet Gynecol. 2004;  104 1367-1391
  CrossrefPubMedGoogle Scholar
• 20 Malone F D, Canick J A, Ball R H, Nyberg D A, Comstock C H, Bukowski R. et al . First-trimester or second-trimester screening, or both, for Down's syndrome.  N Engl J Med. 2005;  353 2001-2011
  CrossrefPubMedGoogle Scholar
• 21 Pattison N, McCowan L. Cardiotocography for antepartum fetal assessment.  Cochrane Database Syst Rev. 2000 (2);  CD001068
  PubMedGoogle Scholar
• 22 Schneider K TM, Butterwegge M, Daumer M, Dudenhausen J AF. et al .Anwendung des CTG während Schwangerschaft und Geburt. AWMF 2004; 015/036: 27. 9. 2005. 
  Google Scholar
• 23 Figueras F, Martinez J M, Puerto B, Coll O, Cararach V, Vanrell J A. Contraction stress test versus ductus venosus Doppler evaluation for the prediction of adverse perinatal outcome in growth-restricted fetuses with non-reassuring non-stress test.  Ultrasound Obstet Gynecol. 2003;  21 250-255
  PubMedGoogle Scholar
• 24 Lagrew Jr D C. The contraction stress test.  Clin Obstet Gynecol. 1995;  38 11-25
  PubMedGoogle Scholar
• 25 Staisch K J, Westlake J R, Bashore R A. Blind oxytocin challenge test and perinatal outcome.  Am J Obstet Gynecol. 1980;  138 399-403
  PubMedGoogle Scholar
• 26 Crowley P. Interventions for preventing or improving the outcome of delivery at or beyond term.  Cochrane Database Syst Rev. 2000 (2);  CD000170
  PubMedGoogle Scholar
• 27 Levran D, Shoham Z, Geranek M, Greenwald M, Mashiach S. The value of amnioscopy in surveillance of postdate pregnancy.  Aust N Z J Obstet Gynaecol. 1988;  28 271-274
  CrossrefPubMedGoogle Scholar
• 28 Weber S, Schneider K T, Bung P, Fallenstein F, Huch A, Huch R. Effects of compression stockings on blood circulation in late pregnancy.  Geburtsh Frauenheilk. 1987;  47 395-400
  Article in Thieme ConnectPubMedGoogle Scholar
• 29 Crowther C A, Hiller J E, Moss J R, McPhee A J, Jeffries W S, Robinson J S. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes.  N Engl J Med. 2005;  352 2477-2486
  CrossrefPubMedGoogle Scholar
• 30 Langer O, Yogev Y, Most O, Xenakis E M. Gestational diabetes: the consequences of not treating.  Am J Obstet Gynecol. 2005;  192 989-997
  Google Scholar
• 31 Whalley P. Bacteriuria of pregnancy.  Am J Obstet Gynecol. 1967;  97 723-738
  PubMedGoogle Scholar
• 32 Millar L K, Cox S M. Urinary tract infections complicating pregnancy.  Infect Dis Clin North Am. 1997;  11 13-26
  CrossrefPubMedGoogle Scholar
• 33 Smaill F. Antibiotics for asymptomatic bacteriuria in pregnancy.  Cochrane Database Syst Rev. 2001 (2);  CD000490
  PubMedGoogle Scholar
• 34 McDonald H, Brocklehurst P, Gordon A. Antibiotics for treating bacterial vaginosis in pregnancy.  Cochrane Database Syst Rev. 2007 (1);  CD000262
  PubMedGoogle Scholar
• 35 Kiss H, Petricevic L, Husslein P. Prospective randomised controlled trial of an infection screening programme to reduce the rate of preterm delivery.  BMJ. 2004;  329 371
  CrossrefPubMedGoogle Scholar
• 36 Brocklehurst P, Rooney G. Interventions for treating genital chlamydia trachomatis infection in pregnancy.  Cochrane Database Syst Rev. 2000 (2);  CD000054
  PubMedGoogle Scholar
• 37 Postma M J, Bakker A, Welte R, van Bergen J E, van den Hoek J A, de Jong-van den Berg L T. et al . [Screening for asymptomatic Chlamydia trachomatis infection in pregnancy; cost-effectiveness favorable at a minimum prevalence rate of 3 % or more].  Ned Tijdschr Geneeskd. 2000;  144 2350-2354
  PubMedGoogle Scholar
• 38 Mardh P A. Influence of infection with Chlamydia trachomatis on pregnancy outcome, infant health and life-long sequelae in infected offspring.  Best Pract Res Clin Obstet Gynaecol. 2002;  16 847-864
  CrossrefPubMedGoogle Scholar
• 39 Nigro G, Anceschi M M, Cosmi E V. Clinical manifestations and abnormal laboratory findings in pregnant women with primary cytomegalovirus infection.  BJOG. 2003;  110 572-577
  PubMedGoogle Scholar
• 40 Ville Y. The megalovirus.  Ultrasound Obstet Gynecol. 1998;  12 151-153
  PubMedGoogle Scholar
• 41 Yow M D, Demmler G J. Congenital cytomegalovirus disease - 20 years is long enough.  N Engl J Med. 1992;  326 702-703
  PubMedGoogle Scholar
• 42 Enders G, Bader U, Lindemann L, Schalasta G, Daiminger A. Prenatal diagnosis of congenital cytomegalovirus infection in 189 pregnancies with known outcome.  Prenat Diagn. 2001;  21 362-377
  CrossrefPubMedGoogle Scholar
• 43 Adler S P, Finney J W, Manganello A M, Best A M. Prevention of child-to-mother transmission of cytomegalovirus by changing behaviors: a randomized controlled trial.  Pediatr Infect Dis J. 1996;  15 240-246
  CrossrefPubMedGoogle Scholar
• 44 Wong V C, Ip H M, Reesink H W, Lelie P N, Reerink-Brongers E E, Yeung C Y. et al . Prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carriers of HBsAg and HBeAg by administration of hepatitis-B vaccine and hepatitis-B immunoglobulin. Double-blind randomised placebo-controlled study.  Lancet. 1984;  1 921-926
  PubMedGoogle Scholar
• 45 ACOG . Viral hepatitis in pregnancy.  ACOG Education Bulletin. 1992;  248
  PubMedGoogle Scholar
• 46 Connor E M, Sperling R S, Gelber R, Kiselev P, Scott G, O'Sullivan M J. et al . Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group.  N Engl J Med. 1994;  331 1173-1180
  CrossrefPubMedGoogle Scholar
• 47 Mandelbrot L, Le Chenadec J, Berrebi A, Bongain A, Benifla J L, Delfraissy J F. et al . Perinatal HIV‐1 transmission: interaction between zidovudine prophylaxis and mode of delivery in the French Perinatal Cohort.  Jama. 1998;  280 55-60
  CrossrefPubMedGoogle Scholar
• 48 Smaill F. Intrapartum antibiotics for group B streptococcal colonisation.  Cochrane Database Syst Rev. 2000 (2);  CD000115
  PubMedGoogle Scholar
• 49 CDC . Prevention of Group B streptococcal disease: a public health perspective.  Morbidity Mortality Weekly Report. 1996;  45 1-24
  PubMedGoogle Scholar
• 50 Benitz W E, Gould J B, Druzin M L. Preventing early-onset group B streptococcal sepsis: strategy development using decision analysis.  Pediatrics. 1999;  103 e76
  CrossrefPubMedGoogle Scholar
• 51 Ingraham Jr N R. The value of penicillin alone in the prevention and treatment of congenital syphilis.  Acta Derm Venereol Suppl (Stockh). 1950;  31 60-87
  PubMedGoogle Scholar
• 52 Goh B T, van Voorst Vader P C. European guideline for the management of syphilis.  Int J STD AIDS. 2001;  12 14-26
  PubMedGoogle Scholar
• 53 Walker G J. Antibiotics for syphilis diagnosed during pregnancy.  Cochrane Database Syst Rev. 2001 (3);  CD001143
  PubMedGoogle Scholar
• 54 Martin D, Bertrand J, McKegney C, Thompson L, Belongia E, Mills W. Congenital syphilis surveillance and newborn evaluation in a low-incidence state.  Arch Pediatr Adolesc Med. 2001;  155 140-144
  PubMedGoogle Scholar
• 55 Chakraborty R, Luck S. Managing congenital syphilis again? The more things change.  Curr Opin Infect Dis. 2007;  20 247-252
  PubMedGoogle Scholar
• 56 Qolohle D C, Hoosen A A, Moodley J, Smith A N, Mlisana K P. Serological screening for sexually transmitted infections in pregnancy: is there any value in re-screening for HIV and syphilis at the time of delivery?.  Genitourin Med. 1995;  71 65-67
  PubMedGoogle Scholar
• 57 van Voorst Vader P C. Syphilis management and treatment.  Dermatol Clin. 1998;  16 699-711
  CrossrefPubMedGoogle Scholar
• 58 Gross U. Prevalence and public-health-aspects of toxoplasmosis.  Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2004;  47 692-697
  PubMedGoogle Scholar
• 59 Hohlfeld P, Daffos F, Thulliez P, Aufrant C, Couvreur J, MacAleese J. et al . Fetal toxoplasmosis: outcome of pregnancy and infant follow-up after in utero treatment.  J Pediatr. 1989;  115(5 Pt 1) 765-769
  PubMedGoogle Scholar
• 60 Peyron F, Wallon M, Liou C, Garner P. Treatments for toxoplasmosis in pregnancy.  Cochrane Database Syst Rev. 2000 (2);  CD001684
  PubMedGoogle Scholar
• 61 Lebech M, Andersen O, Christensen N C, Hertel J, Nielsen H E, Peitersen B. et al . Feasibility of neonatal screening for toxoplasma infection in the absence of prenatal treatment. Danish Congenital Toxoplasmosis Study Group.  Lancet. 1999;  353 1834-1837
  CrossrefPubMedGoogle Scholar
• 62 Wallon M, Liou C, Garner P, Peyron F. Congenital toxoplasmosis: systematic review of evidence of efficacy of treatment in pregnancy.  Bmj. 1999;  318 1511-1514
  PubMedGoogle Scholar
• 63 Khoshnood B, De Vigan C, Goffinet F, Leroy V. Prenatal screening and diagnosis of congenital toxoplasmosis: a review of safety issues and psychological consequences for women who undergo screening.  Prenat Diagn. 2007;  27 395-403
  CrossrefPubMedGoogle Scholar
• 64 Martinelli P, Agangi A, Maruotti G M. Screening for toxoplasmosis in pregnancy.  Lancet. 2007;  369 823-824
  PubMedGoogle Scholar
• 65 Lumley J, Watson L, Watson M, Bower C. Periconceptional supplementation with folate and/or multivitamins for preventing neural tube defects.  Cochrane Database Syst Rev. 2001 (3);  CD001056
  PubMedGoogle Scholar
• 66 Czeizel A E. The primary prevention of birth defects: Multivitamins or folic acid?.  Int J Med Sci. 2004;  1 50-61
  PubMedGoogle Scholar
• 67 Mahomed K. Folate supplementation in pregnancy.  Cochrane Database Syst Rev. 2000;  CD000183
  PubMedGoogle Scholar
• 68 Bhutta Z A, Khan I. Multiple micro-nutrient supplementation for women during pregnancy.  Cochrane Database Syst Rev. 2004 (3);  CD004905
  PubMedGoogle Scholar
• 69 Steer P, Alam M A, Wadsworth J, Welch A. Relation between maternal haemoglobin concentration and birth weight in different ethnic groups.  BMJ. 1995;  310 489-491
  CrossrefPubMedGoogle Scholar
• 70 Mello G, Parretti E, Cioni R, Lagozio C, Mealli F, Pratesi M. Individual longitudinal patterns in biochemical and hematological markers for the early prediction of pre-eclampsia.  J Matern Fetal Neonatal Med. 2002;  11 93-99
  CrossrefPubMedGoogle Scholar

Prof. Dr. MA MRCOG Ralf L. Schild

Leiter des Schwerpunktes Geburtshilfe und Perinatalmedizin
Frauenklinik, Universitätsklinikum Erlangen

Universitätsstraße 21 - 23

91054 Erlangen

Email: ralf.schild@uk-erlangen.de