Skip to main content

2025 | OriginalPaper | Buchkapitel

39. Point-of-Care-Ultraschall in Geburtshilfe und Gynäkologie

verfasst von : Priv.-Doz. Dr. med., MME Florian Recker

Erschienen in: Ultraschalldiagnostik in Geburtshilfe und Gynäkologie

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Point-of-Care Ultraschall (POCUS) hat in der Gynäkologie und Geburtshilfe in den letzten Jahren an Bedeutung gewonnen. Es bietet einen schnellen und einfachen Zugang zu diagnostischen Informationen, die in Echtzeit und ohne Strahlung erfasst werden können. Die mittlerweile zur Verfügung stehenden tragbaren Handheld-Ultraschallsysteme mit guter Bildqualität und geringen Kosten ermöglichen einen breiten Point-of-care-Einsatz der sonographischen Bildgebung in der ambulanten und stationären Versorgung. POCUS kann in der Präkonzeptions-, Schwangerschafts- und Postpartalperiode eingesetzt werden. Die Anwendung von POCUS in der Geburtshilfe umfasst die Beurteilung der Fruchtbarkeit, die Diagnose von Schwangerschaftskomplikationen wie, Eileiterschwangerschaften, Plazentaablösungen oder Fehlbildungen des Feten, sowie die Überwachung von Risikoschwangerschaften und postpartalen Zuständen. Darüber hinaus kann POCUS auch bei gynäkologischen Erkrankungen wie Ovarialzysten, Endometriose oder Tumoren eingesetzt werden. Die Integration von POCUS in die klinische Praxis erfordert jedoch eine entsprechende Ausbildung und Zertifizierung, um die korrekte Durchführung der Untersuchungen und Interpretation der Ergebnisse sicherzustellen. Die Vorteile und Möglichkeiten des POCUS sind vielversprechend und werden sich auch in den nächsten Jahren weiterentwickeln, sodass der POCUS zunehmend in das klinische Setting integriert wird.
Literatur
Zurück zum Zitat Allan A, Bedforth N, Nicholls B, Denny N (2011) Comparing ultrasound and nerve stimulation: time to ask the question?: Correspondence. Anaesthesia 66:222–223CrossRefPubMed Allan A, Bedforth N, Nicholls B, Denny N (2011) Comparing ultrasound and nerve stimulation: time to ask the question?: Correspondence. Anaesthesia 66:222–223CrossRefPubMed
Zurück zum Zitat Avula R, Niemann M, Dorinzi N, Robinson K, Sharon M, Minardi J (2017) Occult iliac deep vein thrombosis in second trimester pregnancy: clues on bedside ultrasound. Clin Pract Cases Emerg Med 1:183–186CrossRefPubMedPubMedCentral Avula R, Niemann M, Dorinzi N, Robinson K, Sharon M, Minardi J (2017) Occult iliac deep vein thrombosis in second trimester pregnancy: clues on bedside ultrasound. Clin Pract Cases Emerg Med 1:183–186CrossRefPubMedPubMedCentral
Zurück zum Zitat Bidner A, Bezak E, Parange N (2022) Evaluation of antenatal Point-of-Care Ultrasound (PoCUS) training: a systematic review. Med Educ Online 27:204136CrossRef Bidner A, Bezak E, Parange N (2022) Evaluation of antenatal Point-of-Care Ultrasound (PoCUS) training: a systematic review. Med Educ Online 27:204136CrossRef
Zurück zum Zitat Dietrich CF, Goudie A, Chiorean L, Cui XW, Gilja OH, Dong Y, Abramowicz JS, Vinayak S, Westerway SC, Nolsøe CP, Chou Y-H, Blaivas M (2017) Point of care ultrasound: a WFUMB position paper. Ultrasound Med Biol 43:49–58CrossRefPubMed Dietrich CF, Goudie A, Chiorean L, Cui XW, Gilja OH, Dong Y, Abramowicz JS, Vinayak S, Westerway SC, Nolsøe CP, Chou Y-H, Blaivas M (2017) Point of care ultrasound: a WFUMB position paper. Ultrasound Med Biol 43:49–58CrossRefPubMed
Zurück zum Zitat Fischer LM, Woo MY, Lee AC, Wiss R, Socransky S, Frank JR (2015) Emergency medicine point-of-care ultrasonography: a national needs assessment of competencies for general and expert practice. CJEM 17:74–88CrossRefPubMed Fischer LM, Woo MY, Lee AC, Wiss R, Socransky S, Frank JR (2015) Emergency medicine point-of-care ultrasonography: a national needs assessment of competencies for general and expert practice. CJEM 17:74–88CrossRefPubMed
Zurück zum Zitat Froehlich E, Pauluschke-Froehlich J, Debove I, Vey W, Klinger C, Dietrich C (2017) Geriatrischer Ultraschall. Z Gastroenterol 55:277–290CrossRefPubMed Froehlich E, Pauluschke-Froehlich J, Debove I, Vey W, Klinger C, Dietrich C (2017) Geriatrischer Ultraschall. Z Gastroenterol 55:277–290CrossRefPubMed
Zurück zum Zitat Fröhlich E, Beller K, Muller R, Herrmann M, Debove I, Klinger C, Pauluschke-Fröhlich J, Hoffmann T, Kreppenhofer S, Dietrich C (2020) Point of care ultrasound in geriatric patients: prospective evaluation of a portable handheld ultrasound device. Ultraschall Med 41:308–316CrossRefPubMed Fröhlich E, Beller K, Muller R, Herrmann M, Debove I, Klinger C, Pauluschke-Fröhlich J, Hoffmann T, Kreppenhofer S, Dietrich C (2020) Point of care ultrasound in geriatric patients: prospective evaluation of a portable handheld ultrasound device. Ultraschall Med 41:308–316CrossRefPubMed
Zurück zum Zitat Ghi T, Eggebø T, Lees C, Kalache K, Rozenberg P, Youssef A, Salomon LJ, Tutschek B (2018) ISUOG Practice Guidelines: Intrapartum ultrasound. Ultrasound Obstet Gynecol 52:128–139CrossRefPubMed Ghi T, Eggebø T, Lees C, Kalache K, Rozenberg P, Youssef A, Salomon LJ, Tutschek B (2018) ISUOG Practice Guidelines: Intrapartum ultrasound. Ultrasound Obstet Gynecol 52:128–139CrossRefPubMed
Zurück zum Zitat Granberg S, Gjelland K, Ekerhovd E (2009) The management of pelvic abscess. Best Pract Res Clin Obstet Gynaecol 23:667–678CrossRefPubMed Granberg S, Gjelland K, Ekerhovd E (2009) The management of pelvic abscess. Best Pract Res Clin Obstet Gynaecol 23:667–678CrossRefPubMed
Zurück zum Zitat Hansen W, Mitchell CE, Bhattarai B, Ayutyanont N, Stowell JR (2017) Perception of point-of-care ultrasound performed by emergency medicine physicians: Perception of point-of-care ultrasound. J Clin Ultrasound 45:408–415CrossRefPubMed Hansen W, Mitchell CE, Bhattarai B, Ayutyanont N, Stowell JR (2017) Perception of point-of-care ultrasound performed by emergency medicine physicians: Perception of point-of-care ultrasound. J Clin Ultrasound 45:408–415CrossRefPubMed
Zurück zum Zitat Knights S, Prasad S, Kalafat E, Dadali A, Sizer P, Harlow F, Khalil A (2023) Impact of point-of-care ultrasound and routine third trimester ultrasound on undiagnosed breech presentation and perinatal outcomes: An observational multicentre cohort study. PLoS Med 20:e1004192CrossRefPubMedPubMedCentral Knights S, Prasad S, Kalafat E, Dadali A, Sizer P, Harlow F, Khalil A (2023) Impact of point-of-care ultrasound and routine third trimester ultrasound on undiagnosed breech presentation and perinatal outcomes: An observational multicentre cohort study. PLoS Med 20:e1004192CrossRefPubMedPubMedCentral
Zurück zum Zitat Kodaira Y, Pisani L, Boyle S, Olumide S, Orsi M, Adeniji AO, Pisani E, Zanette M, Putoto G, Koroma MM (2021) Reliability of ultrasound findings acquired with handheld apparatuses to inform urgent obstetric diagnosis in a high-volume resource-limited setting. Int J Gynecol Obstet 153:280–286CrossRef Kodaira Y, Pisani L, Boyle S, Olumide S, Orsi M, Adeniji AO, Pisani E, Zanette M, Putoto G, Koroma MM (2021) Reliability of ultrasound findings acquired with handheld apparatuses to inform urgent obstetric diagnosis in a high-volume resource-limited setting. Int J Gynecol Obstet 153:280–286CrossRef
Zurück zum Zitat Lammers S, Hong C, Tepper J, Moore C, Baston C, Dolin CD (2021) Use of point-of-care ultrasound to diagnose spontaneous rupture of fibroid in pregnancy. Pocus J 6:16–21CrossRefPubMedPubMedCentral Lammers S, Hong C, Tepper J, Moore C, Baston C, Dolin CD (2021) Use of point-of-care ultrasound to diagnose spontaneous rupture of fibroid in pregnancy. Pocus J 6:16–21CrossRefPubMedPubMedCentral
Zurück zum Zitat Lammers S, Dolin CD, Baston C (2022) A call for development of point-of-care ultrasound training recommendations in obstetrics and gynecology residency. J Ultrasound Med 41:1845–1848CrossRefPubMed Lammers S, Dolin CD, Baston C (2022) A call for development of point-of-care ultrasound training recommendations in obstetrics and gynecology residency. J Ultrasound Med 41:1845–1848CrossRefPubMed
Zurück zum Zitat Leggett CB, Naqvi M, Esakoff TF, Diniz MA, Wong MS (2022) Incorporating personal-device-based point-of-care ultrasound into obstetric care: a validation study. Am J Obstet Gynecol 226:552.e1–552.e6CrossRefPubMed Leggett CB, Naqvi M, Esakoff TF, Diniz MA, Wong MS (2022) Incorporating personal-device-based point-of-care ultrasound into obstetric care: a validation study. Am J Obstet Gynecol 226:552.e1–552.e6CrossRefPubMed
Zurück zum Zitat Moore C, Todd WM, O’Brien E, Lin H (2007) Free fluid in Morison’s pouch on bedside ultrasound predicts need for operative intervention in suspected ectopic pregnancy. Acad Emerg Med 14:755–758CrossRefPubMed Moore C, Todd WM, O’Brien E, Lin H (2007) Free fluid in Morison’s pouch on bedside ultrasound predicts need for operative intervention in suspected ectopic pregnancy. Acad Emerg Med 14:755–758CrossRefPubMed
Zurück zum Zitat Nielsen M, Cantisani V, Sidhu P, Badea R, Batko T, Carlsen J, Claudon M, Ewertsen C, Garre C, Genov J, Gilja O, Havre R, Kosiak M, Kosiak W, Pilcher J, Prosch H, Radzina M, Rafailidis V, Rykkje A, Serra A, Sotiriadis A, Østergaard M, Dietrich C (2019) The use of handheld ultrasound devices – an EFSUMB position paper. Ultraschall Med 40:30–39CrossRefPubMed Nielsen M, Cantisani V, Sidhu P, Badea R, Batko T, Carlsen J, Claudon M, Ewertsen C, Garre C, Genov J, Gilja O, Havre R, Kosiak M, Kosiak W, Pilcher J, Prosch H, Radzina M, Rafailidis V, Rykkje A, Serra A, Sotiriadis A, Østergaard M, Dietrich C (2019) The use of handheld ultrasound devices – an EFSUMB position paper. Ultraschall Med 40:30–39CrossRefPubMed
Zurück zum Zitat Pachtman Shetty SL, Koenig S, Tenenbaum S, Meirowitz N (2021) Point-of-care lung ultrasound patterns in late third-trimester gravidas with and without preeclampsia. Am J Obstet Gynecol Mfm 3:100310CrossRefPubMed Pachtman Shetty SL, Koenig S, Tenenbaum S, Meirowitz N (2021) Point-of-care lung ultrasound patterns in late third-trimester gravidas with and without preeclampsia. Am J Obstet Gynecol Mfm 3:100310CrossRefPubMed
Zurück zum Zitat Qureshi IA, Ullah H, Akram MH, Ashfaq S, Nayyar S (2004) Transvaginal versus transabdominal sonography in the evaluation of pelvic pathology. J Coll Physicians Surg Pak JCPSP 14:390–393PubMed Qureshi IA, Ullah H, Akram MH, Ashfaq S, Nayyar S (2004) Transvaginal versus transabdominal sonography in the evaluation of pelvic pathology. J Coll Physicians Surg Pak JCPSP 14:390–393PubMed
Zurück zum Zitat Recker F, Weber E, Strizek B, Gembruch U, Seibel A (2020) Lung sonography in obstetrics during COVID-19. Geburtshilfe Frauenheilkd 80:1026–1032CrossRefPubMedPubMedCentral Recker F, Weber E, Strizek B, Gembruch U, Seibel A (2020) Lung sonography in obstetrics during COVID-19. Geburtshilfe Frauenheilkd 80:1026–1032CrossRefPubMedPubMedCentral
Zurück zum Zitat Recker F, Weber E, Strizek B, Gembruch U, Westerway SC, Dietrich CF (2021) Point-of-care ultrasound in obstetrics and gynecology. Arch Gynecol Obstet 303:871–876CrossRefPubMedPubMedCentral Recker F, Weber E, Strizek B, Gembruch U, Westerway SC, Dietrich CF (2021) Point-of-care ultrasound in obstetrics and gynecology. Arch Gynecol Obstet 303:871–876CrossRefPubMedPubMedCentral
Zurück zum Zitat Saran S, Preethi A, Jamuda B, Agrawal A (2021) Utility of point-of-care ultrasound (POCUS) for predicting risk of magnesium toxicity in critically ill pre-eclamptic patients. Indian J Anaesth 65:760CrossRefPubMedPubMedCentral Saran S, Preethi A, Jamuda B, Agrawal A (2021) Utility of point-of-care ultrasound (POCUS) for predicting risk of magnesium toxicity in critically ill pre-eclamptic patients. Indian J Anaesth 65:760CrossRefPubMedPubMedCentral
Zurück zum Zitat Sayasneh A, Preisler J, Smith A, Saso S, Naji O, Abdallah Y, Stalder C, Daemen A, Timmerman D, Bourne T (2012) Do pocket-sized ultrasound machines have the potential to be used as a tool to triage patients in obstetrics and gynecology? Ultrasound Obstet Gynecol 40:145–150CrossRefPubMed Sayasneh A, Preisler J, Smith A, Saso S, Naji O, Abdallah Y, Stalder C, Daemen A, Timmerman D, Bourne T (2012) Do pocket-sized ultrasound machines have the potential to be used as a tool to triage patients in obstetrics and gynecology? Ultrasound Obstet Gynecol 40:145–150CrossRefPubMed
Zurück zum Zitat Singh Bajwa S, Kurdi M, Sutagatti J, Bajwa S, Theerth K (2021) Point-of-care ultrasound (POCUS) for the assessment of volume status and fluid management in patients with severe pre-eclampsia: a systematic review and meta-analysis. Indian J Anaesth 65:716CrossRef Singh Bajwa S, Kurdi M, Sutagatti J, Bajwa S, Theerth K (2021) Point-of-care ultrasound (POCUS) for the assessment of volume status and fluid management in patients with severe pre-eclampsia: a systematic review and meta-analysis. Indian J Anaesth 65:716CrossRef
Zurück zum Zitat Skendi M, Liard R, Besacier C, Correas JM, Moussaoui S, Chastang J, Ibanez G (2022) Intrauterine pregnancy detection and gestational age assessment during early pregnancy by a handheld point-of-care ultrasound device compared to a high-end ultrasound system. Accuracy Reliab Study Pocus J 7:225–231 Skendi M, Liard R, Besacier C, Correas JM, Moussaoui S, Chastang J, Ibanez G (2022) Intrauterine pregnancy detection and gestational age assessment during early pregnancy by a handheld point-of-care ultrasound device compared to a high-end ultrasound system. Accuracy Reliab Study Pocus J 7:225–231
Zurück zum Zitat Smallwood N, Dachsel M (2018) Point-of-care ultrasound (POCUS): unnecessary gadgetry or evidence-based medicine? Clin Med 18:219–224CrossRef Smallwood N, Dachsel M (2018) Point-of-care ultrasound (POCUS): unnecessary gadgetry or evidence-based medicine? Clin Med 18:219–224CrossRef
Zurück zum Zitat Stein JC, Wang R, Adler N, Boscardin J, Jacoby VL, Won G, Goldstein R, Kohn MA (2010) Emergency physician ultrasonography for evaluating patients at risk for ectopic pregnancy: a meta-analysis. Ann Emerg Med 56:674–683CrossRefPubMed Stein JC, Wang R, Adler N, Boscardin J, Jacoby VL, Won G, Goldstein R, Kohn MA (2010) Emergency physician ultrasonography for evaluating patients at risk for ectopic pregnancy: a meta-analysis. Ann Emerg Med 56:674–683CrossRefPubMed
Zurück zum Zitat Tolsgaard MG, Ringsted C, Dreisler E, Klemmensen A, Loft A, Sorensen JL, Ottesen B, Tabor A (2014) Reliable and valid assessment of ultrasound operator competence in obstetrics and gynecology: assessment of ultrasound competence. Ultrasound Obstet Gynecol 43:437–443CrossRefPubMed Tolsgaard MG, Ringsted C, Dreisler E, Klemmensen A, Loft A, Sorensen JL, Ottesen B, Tabor A (2014) Reliable and valid assessment of ultrasound operator competence in obstetrics and gynecology: assessment of ultrasound competence. Ultrasound Obstet Gynecol 43:437–443CrossRefPubMed
Zurück zum Zitat Toscano M, Szlachetka K, Whaley N, Thornburg LL (2020) Evaluating the use of handheld point-of-care ultrasound testing for gynecologic pathology: a pilot study for use in low resource settings. BMC Med Imaging 20:121CrossRefPubMedPubMedCentral Toscano M, Szlachetka K, Whaley N, Thornburg LL (2020) Evaluating the use of handheld point-of-care ultrasound testing for gynecologic pathology: a pilot study for use in low resource settings. BMC Med Imaging 20:121CrossRefPubMedPubMedCentral
Zurück zum Zitat Valentin L (2009) Characterising acute gynaecological pathology with ultrasound: an overview and case examples. Best Pract Res Clin Obstet Gynaecol 23:577–593CrossRefPubMed Valentin L (2009) Characterising acute gynaecological pathology with ultrasound: an overview and case examples. Best Pract Res Clin Obstet Gynaecol 23:577–593CrossRefPubMed
Zurück zum Zitat Van De Putte P, Vernieuwe L, Bouchez S (2020) Point-of-care ultrasound in pregnancy: gastric, airway, neuraxial, cardiorespiratory. Curr Opin Anaesthesiol 33:277–283CrossRefPubMed Van De Putte P, Vernieuwe L, Bouchez S (2020) Point-of-care ultrasound in pregnancy: gastric, airway, neuraxial, cardiorespiratory. Curr Opin Anaesthesiol 33:277–283CrossRefPubMed
Zurück zum Zitat Vinayak S, Sande J, Nisenbaum H, Nolsøe CP (2017) Training midwives to perform basic obstetric point-of-care ultrasound in rural areas using a tablet platform and mobile phone transmission technology – a WFUMB COE project. Ultrasound Med Biol 43:2125–2132CrossRefPubMed Vinayak S, Sande J, Nisenbaum H, Nolsøe CP (2017) Training midwives to perform basic obstetric point-of-care ultrasound in rural areas using a tablet platform and mobile phone transmission technology – a WFUMB COE project. Ultrasound Med Biol 43:2125–2132CrossRefPubMed
Metadaten
Titel
Point-of-Care-Ultraschall in Geburtshilfe und Gynäkologie
verfasst von
Priv.-Doz. Dr. med., MME Florian Recker
Copyright-Jahr
2025
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-67373-7_39