Die Ductus venosus Dopplerflusskurve vor intrauterinem Fruchttod bei schwerer Plazentainsuffizienz mit dopplersono­grafisch enddiastolischem Null- und Rückfluss in der Art. Umbilicalis

 

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Zusammenfassung

Die ausgeprägte Plazentainsuffizienz mit dopplersonografisch nachweisbarem enddiastolischem Null- oder Rückfluss (absent or reversed enddiastolic velocity, AREDV) in der Art. umbilicalis ist assoziiert mit einer hohen Morbidität und Mortalität. Die Detektion einer Veränderung der Flusskurve des Ductus venosus als Zeichen einer fortgeschrittenen Gefährdung bzw. Dekompensation hilft intrauterin bedrohte Feten zu selektieren. Allerdings wurde die Annahme einer sequentiellen Veränderung von Dopplerparametern bei zunehmender Beeinträchtigung des Feten jüngst in Frage gestellt. 4 Hochrisikoschwangerschaften mit umbilikalem AREDV wurden dopplersonografisch vor intrauterinem Fruchttod seriell untersucht. Unsere Ergebnisse bestätigen, dass die dopplersonografische Untersuchung der Ductus venosus Blutflusskurve selbst bei bevorstehendem IUFT unauffällig sein kann.

Abstract

Significant placental insufficiency with Doppler ultrasound findings of absent or reverse end-diastolic flow velocities (AREDV) is associated with increased morbidity and mortality. An analysis of blood flow in the ductus venosus assists in the early recognition of threatened foetuses. However, the prognostic value of multivessel Doppler assessment for the timing of delivery is being questioned. Four high-risk pregnancies with umbilical AREDV were repeatedly examined prior to intrauterine foetal demise. Our results demonstrate that ductus venosus Doppler flow velocimetry can be normal prior to intrauterine foetal death.

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