nach oben

Erschienen in:

2025 | OriginalPaper | Buchkapitel

3. Gestörte Entwicklung im I. Trimester

verfasst von : Dr. med. Gottfried Hasenöhrl, Univ.-Prof. Dr. med. Horst Steiner, Prof. Dr. med. Harm-Gerd Karl Blaas

Erschienen in: Ultraschalldiagnostik in Geburtshilfe und Gynäkologie

Verlag: Springer Berlin Heidelberg

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die klinischen Zeichen des drohenden Aborts stellen für jede betroffene Frau eine psychische Belastung dar. Klare Kriterien für die Diagnose einer intakten oder gestörten Schwangerschaft sind für die Beratung der Frauen und die Planung des weiteren Vorgehens von Bedeutung.

Besonders wird auf die Klärung und Diagnose einer ektopen und einer Schwangerschaft unklarer Lokalisation eingegangen. Auch wird die sonografische Darstellung seltener Entitäten, wie Schwangerschaften bei Uterusanomalien, IUD oder mit Adnextumoren, abgehandelt.

Vorheriges Kapitel Sonographie der Frühschwangerschaft und Sonoembryologie

Nächstes Kapitel Ersttrimesterultraschall

Abbasi S, Jamal A, Eslamian L, Marsousi V (2008) Role of clinical and ultrasound findings in the diagnosis of retained products of conception. Ultrasound Gynecol Obstet 32:704–707CrossRef

Abdallah Y, Daemen A, Kirk E, Pexsters A, Naji O, Stalder C, Gould D, Ahmed S, Guha S, Syed S, Bottomley C, Timmerman D, Bourne T (2011a) Limitations of current definitions of miscarriage using mean gestational sac diameter and crown-rump length measurements: a multicenter observational study. Ultrasound Obstet Gynecol 38:497–502PubMedCrossRef

Abdallah Y, Daemen A, Guha S, Syed S, Naji O, Pexsters A, Kirk E, Stalder C, Gould D, Ahmed S, Bottomley C, Timmerman D, Bourne T (2011b) Gestational sac and embryonic growth are not useful as criteria to define miscarriage: a multicenter observational study. Ultrasound Gynecol Obstet 38:503–509CrossRef

Abramov Y, Nadjari M, Shushan A, Prus D, Anteby SO (1997) Doppler findings in chronic ectopic pregnancy: case report. Ultrasound Obstet Gynecol 9:344–346PubMedCrossRef

ACOG (American College of Obstetricians and Gynecologists) (2016) Committee Opinion No 672: Clinical challenges of long-acting reversible contraceptive methods. Obstet Gynecol 128:e69–77CrossRef

ACOG (American College of Obstetricians and Gynecologists) (2018a) Early pregnancy loss. Practice Bulletin No. 200. Obstet Gynecol 132:1311–1313CrossRef

ACOG (American College of Obstetricians and Gynecologists) (2018b) Tubal ectopic pregnancy. Practice bulletin No. 193. Obstet Gynecol 131:e91–e103CrossRef

Alves JA, Alves NG, Alencar Júnior CA, Feitosa FE, da Silva Costa F (2011) Term angular pregnancy: successful expectant management. J Obstet Gynaecol Res 37:641–644PubMedCrossRef

Atri M (2003) Ectopic pregnancy versus corpus luteum cyst; revisited best Doppler predictors. J Ultrasound Med 22:1181–1184PubMedCrossRef

Barnhart K, van Mello N, Bourne T, Kirk E, Van Calster B, Bottomley C, Hung K, Condous G, Goldstein S, Hajenius P, Willem Mol B, Molinaro T, O’Flynn O’Brien K, Husicka R, Sammel M, Timmerman D (2011) Pregnancy of unknown location: a consensus statement of nomenclature, definitions and outcome. Fertil Steril 95:857–866PubMedCrossRef

Barnhart KT, Guo W, Cary MS, Morse CB, Chung K, Takacs P, Senapati S, Sammel MD (2016) Differences in serum human chorionic gonadotropin rise in early pregnancy by race and value at presentation. Obstet Gynecol 128:504–511PubMedPubMedCentralCrossRef

Beck P, Silverman M, Oehninger S, Muasher SJ, Acosta AA, Rosenwaks Z (1990) Survival of the cornual pregnancy in a heterotopic gestation after in vitro fertilization and embryo transfer. Fertil Steril 53:732–734PubMedCrossRef

Benagiano G, Farris M, Grudzinskas G (2010) Fate of fertilized human oocytes. Reprod Biomed Online 21:732–741PubMedCrossRef

Blaas H-GK (1999) Editorial: The examination of the embryo and early fetus: how and by whom? Ultrasound Obstet Gynecol 14:153–158PubMedCrossRef

Bobdiwala S, Kyriacou C, Christodoulou E, Farren J, Mitchell-Jones N, Al-Memar M, Ayim F, Chohan B, Kirk E, Abughazza O, Guruwadahyarhalli B, Guha S, Vathanan V, Gould D, Stalder C, Timmerman D, Van Calster B, Bourne T (2022) Evaluating cut-off levels for progesterone, β human chorionic gonadotropin and β human chorionic gonadotropin ratio to exclude pregnancy viability in women with a pregnancy of unknown location: A prospective multicenter cohort study. Acta Obstet Gynecol Scand 101:46–55

Bollig KJ, Schust DJ (2020) Refining angular pregnancy diagnosis in the first trimester: a case series of expectant management. Obstet Gynecol 135(1):175PubMedCrossRef

Brahmi D, Steenland MW, Renner RM, Gaffield ME, Curtis KM (2012) Pregnancy outcomes with an IUD in situ: a systematic review. Contraception 85:131–139PubMedCrossRef

Breen JL (1970) A 21 year survey of 654 ectopic pregnancies. Am J Obstet Gynecol 106:1004–1019PubMedCrossRef

Cacciatore B, Stenman UH, Ylöstalo P (1989) Comparison of abdominal and vaginal sonography in suspected ectopic pregnancy. Obstet Gynecol 73:770–774PubMed

Calí G, Timor-Tritsch IE, Forlani F, Palacios-Jaraquemada J, Monteagudo A, Kaelin Agten A, Flacco ME, Khalil A, Buca D, Manzoli L, Liberati M, D’Antonio F (2020) Value of first-trimester ultrasound in prediction of third-trimester sonographic stage of placenta accreta spectrum disorder and surgical outcome. Ultrasound Obstet Gynecol 55:450–459

Casikar I, Reid S, Condous G (2012) Ectopic pregnancy: ultrasound diagnosis in modern management. Clin Obstet Gynecol 55:402–409PubMedCrossRef

Christodoulou E et al (2021) External validation of models to predict the outcome of pregnancies of unknown location: a multicentre cohort study. BJOG 128:552–562PubMedCrossRef

Connolly A, Ryan DH, Stuebe AM, Wolfe HM (2013) Reevaluation of discriminatory and threshold levels for serum beta-hCG in early pregnancy. Obstet Gynecol 121:65–70PubMedCrossRef

Deaton JL, Honoré GM, Huffman CS, Bauguess P (1997) Early transvaginal ultrasound following an accurately dated pregnancy: the importance of finding a yolk sac or fetal heart motion. Hum Reprod 12:2820–2823PubMedCrossRef

Doubilet PM, Benson CB (2011) Further evidence against the reliability of the human chorionic gonadotropin discriminatory level. J Ultras Med 30(12):1637–1642CrossRef

Doubilet PM, Benson CB, Bourne T, Blaivas M, Barnhart KT, Benacerraf BR, Brown DL, Filly RA, Fox JC, Goldstein SR, Kendall JL, Lyons EA, Porter MB, Pretorius DH, Timor-Tritsch IE (2013) Diagnostic criteria for nonviablepregnancy early in the first trimester. Society of Radiologists in Ultrasound Multispecialty Panel on Early First Trimester Diagnosis of Miscarriage and Exclusion of a Viable Intrauterine Pregnancy. N Engl J Med 369:1443–1451PubMedCrossRef

Dubinsky TJ, Parvey HR, Maklad N (1997) Endometrial color flow/image-directed Doppler imaging: negative predictive value for excluding ectopic pregnancy. J Clin Ultrasound 25:103–109PubMedCrossRef

Hertz RH, Timor-Tritsch I, Sokol RJ, Zador I (1977) Diagnostic studies and fetal assessment in advanced extrauterine pregnancy. Obstet Gynecol 50(1 Suppl):62–65

Jaffe R (2001) Development of early uteroplacental circulation. Early Pregnancy 5:34–35PubMed

Jordans IPM, Verberkt C, De Leeuw RA, Bilardo CM, Van Den Bosch T, Bourne T, Brölmann HAM, Dueholm M, Hehenkamp WJK, Jastrow N, Jurkovic D, Kaelin Agten A, Mashiach R, Naji O, Pajkrt E, Timmerman D, Vikhareva O, Van Der Voet LF, Huirne JAF (2022) Definition and sonographic reporting system for Cesarean scar pregnancy in early gestation: modified Delphi method. Ultrasound Obstet Gynecol 59:437–449

Knez J, Day A, Jurkovic D (2014) Ultrasound imaging in the management of bleeding and pain in early pregnancy. Best Pract Res Clin Obstet Gynaecol 28:621–636PubMedCrossRef

Lim JE, Kim T, Lee NW, Oh MJ, Seol HJ, Jung NH, Park SH, Jung SE, Park IH, Kim HJ (2007) Ultrasonographic endometrial features in tubal pregnancy: are they predictive factors of successful medical treatment? Ultrasound Med Biol 33:714–719PubMedCrossRef

Matorras R, Zallo A, Hernandez-Pailos R, Ferrando M, Quintana F, Remohi J, Malaina I, Laínz L, Exposito A (2020) Cervical pregnancy in assisted reproduction: an analysis of risk factors in 91,067 ongoing pregnancies. Reprod Biomed Online 40:355–361PubMedCrossRef

Mavrelos D, Sawyer E, Helmy S, Holland TK, Ben-Nagi J, Jurkovic D (2007) Ultrasound diagnosis of ectopic pregnancy in the non-communicating horn of a unicornuate uterus (cornual pregnancy). Ultrasound Obstet Gynecol 30:765–770PubMedCrossRef

McCarthy EA (2015) Diagnosing a miscarriage. When is it safe to make the call? BMJ 351:h4769PubMedCrossRef

Mehta T, Sharp T, Levine D, Barbieri R (2023) Ultrasonography of pregnancy of unknown location. Uptodate.com. Zugegriffen: 28. Febr. 2023

Muram D, Gillieson M, Walters JH (1980) Myomas of the uterus in pregnancy: Ultrasonographic follow-up. Am J Obstet Gynecol 138:16–19PubMedCrossRef

NICE (2019) NICE guideline [NG126] Published: 2019 Last updated: 2021. Ectopic pregnancy and miscarriage: diagnosis and initial management. nice.org.uk/guidance/ng126

Nybo Andersen AM, Wohlfahrt J, Christens P, Olsen J, Melbye M (2000) Maternal age and fetal loss: population based register linkage study. BMJ 320:1708–1712PubMedCrossRef

Paalman RJ, McElin TW (1959) Cervical pregnancy, review of the literature and presentation of cases. Am J Obstet Gynecol 77:1261–1270PubMedCrossRef

Pexsters A, Luts J, Van Schoubroeck D, Bottomley C, Van Calster B, Van Huffel S, Abdallah Y, D’Hooghe T, Lees C, Timmerman D, Bourne T (2011) Clinical implications of intra- and interobserver reproducibility of transvaginal sonographic measurement of gestational sac and crown-rump length at 6–9 weeks’ gestation. Ultras Obstet Gynecol 38:510–515

Prager S, Micks E, Dalton VK (2022) Pregnancy loss (miscarriage): Clinical presentations, diagnosis, and initial evaluation. uptodate.com

Preisler J, Kopeika J, Ismail L, Vathanan V, Farren J, Abdallah Y, Battacharjee P, Van Holsbeke C, Bottomley C, Gould D, Johnson S, Stalder C, Van Calster B, Hamilton J, Timmerman D, Bourne T (2015) Defining safe criteria to diagnose miscarriage: prospective observational multicentre study. BMJ 351:h4579PubMedPubMedCentralCrossRef

Rempen A, Chaoui R, Häusler M, Kagan K-O, Kozlowski P, von Kaisenberg C, Wisser J (2016) Quality requirements for ultrasound examination in early pregnancy (DEGUM Level I) between 4+0 and 13+6 weeks of gestation. Ultraschall in Med 37:579–583CrossRef

Runowicz D, Brewer M (2023) Adnexal mass: Evaluation and management in pregnancy. uptodate.com

Sawyer E, Jurkovic D (2007) Ultrasonography in the diagnosis and management of abnormal early pregnancy. Clin Obstet Gynecol 50:31–54PubMedCrossRef

Sawyer E, Ofuasia E, Ofili-Yebovi D, Helmy S, Gonzalez J, Jurkovic D (2007) The value of measuring endometrial thickness and volume on transvaginal ultrasound scan for the diagnosis of incomplete miscarriage. Ultras Obstet Gynecol 29:205–209CrossRef

Shinagawa S, Nagayama M (1969) Cervical pregnancy as a possible sequela of induced abortion. Report of 19 cases. Am J Obstet Gynecol 105:282–284PubMedCrossRef

Spitzer D, Steiner H, Graf A, Zajc M, Staudach A (1997) Conservative treatment of cervical pregnancy by curettage and local prostaglandin injection. Hum Reprod 12:860–866PubMedCrossRef

Spyropoulou K, Kosmas I, Tsakiridis I, Mamopoulos A, Kalogiannidis I, Athanasiadis A, Daponte A, Dagklis T (2020) Myomectomy during pregnancy: a systematic review. Eur J Obstet Gynecol Reprod Biol 254:15–24PubMedCrossRef

Stanley JH, Horger EO 3rd, Fagan CJ, Andriole JG, Fleischer AC (1986) Sonographic findings in abdominal pregnancy. AJR Am J Roentgenol 147:1043–1046PubMedCrossRef

Stiller RJ, Haynes de Regt R, Blair E (1989) Transvaginal ultrasonography in patients at risk for ectopic pregnancy. Am J Obstet Gynecol 161:930–913PubMedCrossRef

Stock RJ (1985) Histopathologic changes in tubal pregnancy. J Reprod Med 30:923–928PubMed

Testa AC, Mascilini F, Quagliozzi L, Moro F, Bolomini G, Mirandola MT, Moruzzi MC, Scambia G, Fagotti A (2021) Management of ovarian masses in pregnancy: patient selection for interventional treatment. Int J Gynecol Cancer 31:899–906PubMedCrossRef

Timor-Trisch IE, Monteagudo A, Cali G, El Refaey H, Kaelin Agten A, Arslan AA (2016) Easy sonographic differential diagnosis between intrauterine pregnancy and cesarean delivery scar pregnancy in the early first trimester. Am J Obstet Gynecol 215:225.e1–225.e7CrossRef

Tulandi T (2023) Ectopic pregnancy: Clinical manifestations and diagnosis. Uptodate.com

Turan C, Ugur M, Dogan M, Ekici E, Vicdan K, Gökmen O (1996) Transvaginal sonographic findings of chronic ectopic pregnancy. Eur J Obstet Gynecol Reprod Biol 67:115–119PubMedCrossRef

Ushakov FB, Elchalal U, Aceman PJ, Schenker JG (1997) Cervical pregnancy: past and future. Obstet Gynecol Surv 52:45–59PubMedCrossRef

Van Calster B, Bobdiwala S, Guha S, Van Hoorde K, Al-Memar M, Harvey R et al (2016) Managing pregnancy of unknown location based on initial serum progesterone and serial serum hCG levels: development and validation of a two-step triage protocol. Ultrasound Obstet Gynecol 48:642–649PubMedCrossRef

Ziel HK, Paulson RJ (2002) Contralateral corpus luteum in ectopic pregnancy: what does it tell us about ovum pickup? Fertil Steril 77:850–851PubMedCrossRef

Titel: Gestörte Entwicklung im I. Trimester
verfasst von: Dr. med. Gottfried Hasenöhrl
Univ.-Prof. Dr. med. Horst Steiner
Prof. Dr. med. Harm-Gerd Karl Blaas
Verlag: Springer Berlin Heidelberg
Buch: Ultraschalldiagnostik in Geburtshilfe und Gynäkologie
Print ISBN: 978-3-662-67372-0

Electronic ISBN: 978-3-662-67373-7

Copyright-Jahr: 2025
DOI: https://doi.org/10.1007/978-3-662-67373-7_3

Springerpflege

Zusammenfassung

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten