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Sonographische Diagnostik bei abnorm invasiver Plazenta

Ultrasound diagnostics for abnormally invasive placenta

  • Leitthema
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Das Krankheitsbild der abnorm invasiven Plazenta (AIP) trägt heute maßgeblich zur peripartalen Morbidität bei, weil es lebensbedrohliche Blutungen bei der Geburt verursachen kann. Vorangehende uterine chirurgische Eingriffe gelten als der wichtigste Risikofaktor. Es erscheint nahe liegend, dass besonders die gestiegene Rate an Schnittentbindungen mit dem Anstieg der AIP in Zusammenhang steht. Die präpartale – nicht erst intrapartale – Erkennung der AIP ist wichtig für die mögliche Reduktion des peripartalen Blutungsrisikos. Der präpartale Ultraschall sollte zum Screening auf eine AIP verwendet werden. Es gibt B-Bild-, Farbdoppler- und dynamische Ultraschallzeichen, die auf ein erhöhtes Risiko für AIP hinweisen. Dieser Beitrag beschreibt die Zeichen einer AIP anhand klinischer Beispiele.

Abstract

Abnormally invasive placenta (AIP or “morbidly adherent placenta”) significantly contributes to maternal morbidity and mortality, potentially causing severe hemorrhage at delivery. Previous uterine surgery is the main risk factor. It may be speculated that with the rise in Caesarean delivery rates the incidence of AIP will also increase. Prenatal detection of AIP is mandatory to reduce the perinatal morbidity. Obstetrical ultrasound should be used as a screening tool for AIP. There are well known sonographic signs in B-mode, color Doppler and dynamic ultrasound that form the basis for prenatal detection. This review highlights these ultrasound markers and shows clinical examples.

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Abbreviations

AIP:

abnorm invasive Plazenta

AFP:

α-Fetoprotein

MRI:

Magnetresonanztomographie

TAS:

Transabdomineller Ultraschall

TVS:

Transvaginaler Ultraschall

US:

Ultraschall

AIP:

abnormally invasive placenta

AFP:

α-Fetoprotein

MRI:

magnetic resonance imaging

TAS:

transabdominal scan

TVS:

transvaginal scan

US:

ultrasound

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Einhaltung ethischer Richtlinien

Interessenkonflikt. B. Tutschek, F. Chantraine, T. Braun und W. Henrich geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Ultraschallpraxis Zürich, Zürich, Schweiz

    B. Tutschek

  2. Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf, Deutschland

    B. Tutschek

  3. Klinik für Geburtshilfe und Gynäkologie, Universität Lüttich, Lüttich, Belgien

    F. Chantraine

  4. Labor für Tumor- und Entwicklungsbiologie, CHU, GIGA-Cancer, Universität Lüttich, Lüttich, Belgien

    F. Chantraine

  5. Kliniken für Geburtsmedizin, Charité Campus Virchow-Klinikum und Campus Mitte, Universitätsmedizin Berlin, Berlin, Deutschland

    T. Braun M.D. & W. Henrich M.D., Ph.D.

Authors
  1. B. Tutschek
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  2. F. Chantraine
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  3. T. Braun M.D.
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  4. W. Henrich M.D., Ph.D.
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Corresponding author

Correspondence to B. Tutschek.

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Tutschek, B., Chantraine, F., Braun, T. et al. Sonographische Diagnostik bei abnorm invasiver Plazenta. Gynäkologe 47, 408–417 (2014). https://doi.org/10.1007/s00129-013-3308-6

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  • DOI: https://doi.org/10.1007/s00129-013-3308-6

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