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Pränataldiagnostik

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  • Pränataldiagnostik

ULTRASCHALL FEINDIAGNOSTIK

Im 2. Schwangerschaftsdrittel

Zwischen der ca. 18.-22. Schwangerschaftswoche liegt der geeignete Zeitpunkt für eine Ultraschalluntersuchung mit Feindiagnostik des Kindes. Die Feindiagnostik im 2. Schwangerschaftsdrittel ermöglicht die Diagnose von Entwicklungsstörungen sowie die Durchführung einer sorgfältigen Organdiagnostik. Der Einsatz der farbcodierten Doppleruntersuchung erlaubt die Diagnose zahlreicher Fehlbildungen des Herzens. Screening nach Fehlbildungen bedeutet vorrangig Screening nach großen Fehlbildungen. Große Fehlbildungen sind definiert als Fehlbildungen, die die Lebensfähigkeit oder Lebensqualität beeinflussen und interventionswürdig sind. Große Fehlbildungen sind nicht gleichzusetzen mit nicht lebensfähigen Fehlbildungen. Häufig handelt es sich um Fehlbildungen, bei denen nicht ein Schwangerschaftsabbruch im Vordergrund steht, sondern ein gezieltes prä- und postpartales Management optimale Voraussetzungen für das Neugeborene schafft.

An Zentren für pränatale Diagnostik beträgt die Entdeckungsrate angeborener Fehlbildungen im 2. Schwangerschaftsdrittel 34–74 %. Die Entdeckungsrate ist zu Beginn des 2. Drittels niedriger als im späten 2. Drittel, da sich einige Anomalien z.B. am Herzen oder zentralen Nervensystem erst später manifestieren. Auch bei ausreichender Erfahrung des Untersuchers und entsprechender apperativer Ausstattung gelingt keine absolut sichere Darstellung aller möglichen kindlichen Fehlbildungen. Sowohl Fruchtwassermenge, Dicke der Bauchdecke und Lage des Kindes können zu suboptimalen Untersuchungsbedingungen führen. Mittels der 3-dimensionalen – oder im Echtzeitverfahren auch 4-D-genannten Ultraschalluntersuchung ist eine plastische Oberflächendarstellung des Feten möglich. Gute Resultate sind hierbei erst ab der 20. SSW, besser noch zwischen der 26. und 28. SSW, und auch nur bei einem Teil der Untersuchungen möglich. Das diagnostische Spektrum wird durch die 3D / 4D-Technik nur gering bereichert.

 


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ERSTTRIMESTERSCREENING

ERSTTRIMESTERSCREENING

Ultraschall-Untersuchung im 1. Schwangerschaftsdrittel

FETALE ECHOKARDIOGRAPHIE

FETALE ECHOKARDIOGRAPHIE

Das Herz ist der Schlüssel zum Feten

FETOMATERNALE DOPPLERSONOGRAPHIE

FETOMATERNALE DOPPLERSONOGRAPHIE

Sonographische Blutflussmessung

NICHT INVASIVE PRÄNATALE DIAGNOSTIK

NICHT INVASIVE PRÄNATALE DIAGNOSTIK

Risikofreie kindliche NIPT-Untersuchung (non-invasive prenatal testing) anhand mütterlichen Blutes

CHORIONZOTTENBIOPSIE

CHORIONZOTTENBIOPSIE

Chormosomale Untersuchung ab der 11. Schwangerschaftswoche

AMNIOCENTESE

AMNIOCENTESE

Fruchtwasseruntersuchung ab der 15. Schwangerschaftswoche

ULTRASCHALL FEINDIAGNOSTIK

ULTRASCHALL FEINDIAGNOSTIK

Im 2. Schwangerschaftsdrittel

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