Auszug
Die Abklärung einer möglichen fetalen Anämie hat bei Blutgruppensensibilisierungen, bei anämisierenden Infektionen (Parvovirus), bei fetomaternaler Transfusion sowie bei Hinweiszeichen bei der Ultraschalluntersuchung (Hydrops fetalis) oder auffälligen, anämieverdächtigen fetalen Herzfrequenzmustern zu erfolgen. Die Diagnosestellung der Anämie erfolgt mittels Chordozentese. Sie ist zuverlässig und bietet den Vorteil der gleichzeitigen Abnahmemöglichkeit von fetalem Blut für verschiedene Labortests, um die Ursache der Anämie festzustellen bzw. eine Differenzialdiagnostik bei Hydrops durchführen zu können. Ihr Nachteil ist die Invasivität und damit das Restrisiko. Während beim sonographischen Bild des Hydrops fetalis die Chordozentese zur Diagnostik und ggf. Therapie unverzichtbar erscheint, hat sich bei nichthydropischen Feten die fetale Doppleruntersuchung ggf. in Kombination mit mütterlichen Antikörpertitern etabliert. Damit ist der Großteil der Schwangeren mit entsprechendem fetalem Anämierisiko observant nichtinvasiv zu führen. Erst bei auffälligen Dopplerergebnissen oder zwingenden mütterlichen Serumtitern ist ein invasiver Zugang notwendig.
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Schaffer, H., Steiner, H. (2008). Anämie - Blutgruppensensibilisierung. In: Steiner, H., Schneider, KT.M. (eds) Dopplersonographie in Geburtshilfe und Gynäkologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-72371-4_14
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