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Der SGA-Fetus — die intrauterine Wachstumsrestriktion

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Dopplersonographie in Geburtshilfe und Gynäkologie

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Das Geburtsgewicht ist die wichtigste Determinante für die perinatale Morbidität und Mortalität. Bei gleichem Gestationsalter sind niedrige Fetalgewichte mit einer 4- bis 8fach höheren perinatalen Mortalität korreliert (Schneider 1993). Die»Intrauterine-Growth-Restriction«(IUGR) macht mehr als 20% der intrauterinen Fruchttode aus (Haram et al. 2006). Die Tatsache, dass unter Frühgeburten ein höherer Anteil an IUGR-Feten zu finden ist (20% bei Einlingen, 30% bei Gemini) als unter Reifgeborenen weist darauf hin, dass durch die plazentare Insuffizienz Frühgeburtlichkeit induziert wird. Darüber hinaus ist das relative Risiko dieser Feten bezüglich Asphyxie, Mekoniumaspiration, Hypoglykämie und Hyperviskosität als Zeichen chronischer Hypoxämie um ein Vielfaches erhöht. Wachstumsretardierte Kinder zeigen zudem vermehrt Störungen in ihrer neurologischen Langzeitentwicklung (Clark 1992; Wienerrhoiter 2001; Haram et al. 2006). Das Risiko einer Chromosomenstörung bei Verdacht auf IUGR wird mit 2–8% angegeben. Da Fehlbildungen nahezu jedes fetalen Organs mit einer intrauterinen Wachstumsretardierung assoziiert sein können, sollte neben einer genetischen Abklärung intensiv nach derartigen Fehlbildungen gefahndet werden (Khoury et al. 1988; Harkness u. Mari 2004). All diese Faktoren machen deutlich, dass der Diagnostik und der Fürsorge für SGAbzw. IUGR-Feten eine zentrale Bedeutung in der Schwangerenbetreuung zukommt.

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  1. Frauenklinik und Poliklinik, Technische Universität München Klinikum rechts der Isar, Ismaninger Straße 22, 81675, München

    K. T. M. Schneider Prof.Dr.med.

  2. Universitätsklinik für Frauenheilkunde und Geburtshilfe, Paracelsus Medizinische Privat-universität, Müllner Hauptstraße 48, 5020, Salzburg, Österreich

    H. Steiner Univ.-Doz.Dr.med.

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  1. K. T. M. Schneider Prof.Dr.med.
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  1. Paracelsus Medizinische Privatuniversität, Universitätsklinik für Frauenheilkunde und Geburtshilfe, Müllner Hauptstraße 48, 5020, Salzburg, Österreich

    Horst Steiner

  2. Klinikum rechts der Isar, Frauenklinik und Poliklinik, Technische Universität München, Ismaninger Straße 22, 81675, München

    Karl-Theo M. Schneider

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Schneider, K.T.M., Steiner, H. (2008). Der SGA-Fetus — die intrauterine Wachstumsrestriktion. 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_8

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