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2025 | OriginalPaper | Buchkapitel

33. Postpartaler Ultraschall

verfasst von : Prof. Dr. med. Wolfgang Henrich, Prof. Dr. med. Boris Tutschek

Erschienen in: Ultraschalldiagnostik in Geburtshilfe und Gynäkologie

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Dieses Kapitel beschreibt die Anwendungen des postpartalen Ultraschalls an klinischen Beispielen. Hierzu gehören unter anderem die Überwachung der Plazentarperiode mit Beurteilung von Plazentaresten, die ultraschallgesteuerte Kürettage, im Wochenbett die Überwachung der Involution und eines möglichen Lochialstaus, die Diagnostik von intraabdominalen, retroperitonealen oder Bauchdeckenhämatomen. Zusammen mit der klinischen Untersuchung ist die postpartale Sonographie eine ideale Methode zur Klärung der gestörten Plazentarperiode, von Blutungsursachen sowie von Geburtsverletzungen. Der Einsatz mobiler Ultraschallgeräte im Geburtsraum ermöglicht rasch die Differenzialdiagnostik und erhöht die Sicherheit bei ultraschallgesteuerten Eingriffen. Der Ultraschall im Geburtsraum ist im Notfall als „Bedside-Methode“ im Gegensatz zu anderen bildgebenden Verfahren (z. B. CT oder MRT) mit geringem Aufwand und Zeitverlust verfügbar.
Literatur
Zurück zum Zitat Amorim-Costa C, Mota R, Rebelo C, Silva PT (2011) Uterine compression sutures for postpartum hemorrhage: is routine postoperative cavity evaluation needed? Acta Obstet Gynecol Scand 90:701–706CrossRefPubMed Amorim-Costa C, Mota R, Rebelo C, Silva PT (2011) Uterine compression sutures for postpartum hemorrhage: is routine postoperative cavity evaluation needed? Acta Obstet Gynecol Scand 90:701–706CrossRefPubMed
Zurück zum Zitat Bazeries P, Paisant-Thouveny F, Yahya S, Bouvier A, Nedelcu C, Boussion F, Sentilhes L, Willoteaux S, Aubé C (2017) Uterine artery embolization for retained products of conception with marked vascularity: a safe and efficient first-line treatment. Cardiovasc Intervent Radiol 40:520–529CrossRefPubMed Bazeries P, Paisant-Thouveny F, Yahya S, Bouvier A, Nedelcu C, Boussion F, Sentilhes L, Willoteaux S, Aubé C (2017) Uterine artery embolization for retained products of conception with marked vascularity: a safe and efficient first-line treatment. Cardiovasc Intervent Radiol 40:520–529CrossRefPubMed
Zurück zum Zitat Benito CW, Guzman ER, Vintzileos AM (1996) The use of ultrasonography in the labor and delivery suite. Clin Perinatol 23:117–139CrossRefPubMed Benito CW, Guzman ER, Vintzileos AM (1996) The use of ultrasonography in the labor and delivery suite. Clin Perinatol 23:117–139CrossRefPubMed
Zurück zum Zitat Biele C, Radtke L, Kaufner L, Hinkson L, Braun T, Henrich W, Dückelmann AM (2022) Does the use of chitosan covered gauze for postpartum hemorrhage reduce the need for surgical therapy including hysterectomy? A databased historical cohort study. J Perinat Med 50:1078-1086CrossRefPubMed Biele C, Radtke L, Kaufner L, Hinkson L, Braun T, Henrich W, Dückelmann AM (2022) Does the use of chitosan covered gauze for postpartum hemorrhage reduce the need for surgical therapy including hysterectomy? A databased historical cohort study. J Perinat Med 50:1078-1086CrossRefPubMed
Zurück zum Zitat Cosmi E, Saccardi C, Litta P, Nardelli GB, Dessole S (2010) Transvaginal ultrasound and sonohysterography for assessment of postpartum residual trophoblastic tissue. Int J Gynaecol Obstet 110:262–264CrossRefPubMed Cosmi E, Saccardi C, Litta P, Nardelli GB, Dessole S (2010) Transvaginal ultrasound and sonohysterography for assessment of postpartum residual trophoblastic tissue. Int J Gynaecol Obstet 110:262–264CrossRefPubMed
Zurück zum Zitat Dabelea V, Schultze PM, McDuffie RS Jr (2007) Intrauterine balloon tamponade in the management of postpartum hemorrhage. Am J Perinatol 24:359–364CrossRefPubMed Dabelea V, Schultze PM, McDuffie RS Jr (2007) Intrauterine balloon tamponade in the management of postpartum hemorrhage. Am J Perinatol 24:359–364CrossRefPubMed
Zurück zum Zitat Diemert A, Ortmeyer G, Hollwitz B, Lotz M, Somville T, Glosemeyer P, Diehl W, Hecher K (2012) The combination of intrauterine balloon tamponade and the B-Lynch procedure for the treatment of severe postpartum hemorrhage. Am J Obstet Gynecol 206:65.e1–65.e4CrossRefPubMed Diemert A, Ortmeyer G, Hollwitz B, Lotz M, Somville T, Glosemeyer P, Diehl W, Hecher K (2012) The combination of intrauterine balloon tamponade and the B-Lynch procedure for the treatment of severe postpartum hemorrhage. Am J Obstet Gynecol 206:65.e1–65.e4CrossRefPubMed
Zurück zum Zitat Dueckelmann AM, Hinkson L, Nonnenmacher A, Siedentopf JP, Schoenborn I, Weizsaecker K, Kaufner L, Henrich W, Braun T (2019) Uterine packing with chitosan-covered gauze compared to balloon tamponade for managing postpartum hemorrhage. Eur J Obstet Gynecol Reprod Biol 240:151–155 Dueckelmann AM, Hinkson L, Nonnenmacher A, Siedentopf JP, Schoenborn I, Weizsaecker K, Kaufner L, Henrich W, Braun T (2019) Uterine packing with chitosan-covered gauze compared to balloon tamponade for managing postpartum hemorrhage. Eur J Obstet Gynecol Reprod Biol 240:151–155
Zurück zum Zitat Ferreira CWS, Atan IK, Martin A, Shek KL, Dietz HP (2017) Pelvic organ support several years after a first birth. Int Urogynecol J 28:1499–1505CrossRefPubMed Ferreira CWS, Atan IK, Martin A, Shek KL, Dietz HP (2017) Pelvic organ support several years after a first birth. Int Urogynecol J 28:1499–1505CrossRefPubMed
Zurück zum Zitat Henrich W, Fuchs I, Luttkus A, Hauptmann S, Dudenhausen JW (2002) Pseudoaneurysm of the uterine artery after cesarean delivery: sonographic diagnosis and treatment. J Ultrasound Med 21:1431–1434CrossRefPubMed Henrich W, Fuchs I, Luttkus A, Hauptmann S, Dudenhausen JW (2002) Pseudoaneurysm of the uterine artery after cesarean delivery: sonographic diagnosis and treatment. J Ultrasound Med 21:1431–1434CrossRefPubMed
Zurück zum Zitat Henrich W, Surbek D, Kainer F, Grottke O, Hopp H, Kiesewetter H, Koscielny J, Maul H, Schlembach D, von Tempelhoff GF, Rath W (2008) Diagnosis and treatment of peripartum bleeding. J Perinat Med 36:467–478CrossRefPubMed Henrich W, Surbek D, Kainer F, Grottke O, Hopp H, Kiesewetter H, Koscielny J, Maul H, Schlembach D, von Tempelhoff GF, Rath W (2008) Diagnosis and treatment of peripartum bleeding. J Perinat Med 36:467–478CrossRefPubMed
Zurück zum Zitat Henrich W, Dückelmann A, Braun T, Hinkson L (2024) Uterine packing with chitosan-covered tamponade to treat postpartum hemorrhage. Am J Obstet Gynecol 230:S1061–S1065CrossRefPubMed Henrich W, Dückelmann A, Braun T, Hinkson L (2024) Uterine packing with chitosan-covered tamponade to treat postpartum hemorrhage. Am J Obstet Gynecol 230:S1061–S1065CrossRefPubMed
Zurück zum Zitat Herman A (2000) Complicated third stage of labor: time to switch on the scanner. Ultrasound Obstet Gynecol 15:89–95CrossRefPubMed Herman A (2000) Complicated third stage of labor: time to switch on the scanner. Ultrasound Obstet Gynecol 15:89–95CrossRefPubMed
Zurück zum Zitat Kamaya A, Petrovitch I, Chen B, Frederick CE, Jeffrey RB (2009) Retained products of conception: spectrum of color Doppler findings. J Ultrasound Med 28:1031–1041CrossRefPubMed Kamaya A, Petrovitch I, Chen B, Frederick CE, Jeffrey RB (2009) Retained products of conception: spectrum of color Doppler findings. J Ultrasound Med 28:1031–1041CrossRefPubMed
Zurück zum Zitat Krapp M, Baschat AA, Hankeln M, Gembruch U (2000) Gray scale and color Doppler sonography in the third stage of labor for early detection of failed placental separation. Ultrasound Obstet Gynecol 15:138–142CrossRefPubMed Krapp M, Baschat AA, Hankeln M, Gembruch U (2000) Gray scale and color Doppler sonography in the third stage of labor for early detection of failed placental separation. Ultrasound Obstet Gynecol 15:138–142CrossRefPubMed
Zurück zum Zitat Krapp M, Katalinic A, Smrcek J, Geipel A, Berg C, Germer U, Gembruch U (2003) Study of the third stage of labor by color Doppler sonography. Arch Gynecol Obstet 267:202–204CrossRefPubMed Krapp M, Katalinic A, Smrcek J, Geipel A, Berg C, Germer U, Gembruch U (2003) Study of the third stage of labor by color Doppler sonography. Arch Gynecol Obstet 267:202–204CrossRefPubMed
Zurück zum Zitat Krapp M, Axt-Fliedner R, Berg C, Geipel A, Germer U, Gembruch U (2007) Clinical application of grey scale and colour Doppler sonography during abnormal third stage of labour. Ultraschall Med 28:63–66CrossRefPubMed Krapp M, Axt-Fliedner R, Berg C, Geipel A, Germer U, Gembruch U (2007) Clinical application of grey scale and colour Doppler sonography during abnormal third stage of labour. Ultraschall Med 28:63–66CrossRefPubMed
Zurück zum Zitat Leparco S, Viot A, Benachi A, Deffieux X (2013) Migration of Bakri balloon through an unsuspected uterine perforation during the treatment of secondary postpartum hemorrhage. Am J Obstet Gynecol 208:e6–e7CrossRefPubMed Leparco S, Viot A, Benachi A, Deffieux X (2013) Migration of Bakri balloon through an unsuspected uterine perforation during the treatment of secondary postpartum hemorrhage. Am J Obstet Gynecol 208:e6–e7CrossRefPubMed
Zurück zum Zitat Malvasi A, Tinelli A, Tinelli R, Rahimi S, Resta L, Tinelli FG (2007) The post-cesarean section symptomatic bladder flap hematoma: a modern reappraisal. J Matern Fetal Neonatal Med 20:709–714CrossRefPubMed Malvasi A, Tinelli A, Tinelli R, Rahimi S, Resta L, Tinelli FG (2007) The post-cesarean section symptomatic bladder flap hematoma: a modern reappraisal. J Matern Fetal Neonatal Med 20:709–714CrossRefPubMed
Zurück zum Zitat Rosenstein MG, Vargas JE, Drey EA (2014) Ultrasound-guided instrumental removal of the retained placenta after vaginal delivery. Am J Obstet Gynecol 211:180.e1–180.e3CrossRefPubMed Rosenstein MG, Vargas JE, Drey EA (2014) Ultrasound-guided instrumental removal of the retained placenta after vaginal delivery. Am J Obstet Gynecol 211:180.e1–180.e3CrossRefPubMed
Zurück zum Zitat Sanguin S, Lanta-Delmas S, Le Blanche A, Grardel-Chambenoit E, Merviel P, Gondry J, Fauvet R (2011) Uterine arteriovenous malformations: diagnosis and treatment in 2011. Gynecol Obstet Fertil 39:722–727CrossRefPubMed Sanguin S, Lanta-Delmas S, Le Blanche A, Grardel-Chambenoit E, Merviel P, Gondry J, Fauvet R (2011) Uterine arteriovenous malformations: diagnosis and treatment in 2011. Gynecol Obstet Fertil 39:722–727CrossRefPubMed
Zurück zum Zitat Schmid BC, Rezniczek GA, Rolf N, Saade G, Gebauer G, Maul H (2013) Uterine packing with chitosan-covered gauze for control of postpartum hemorrhage. Am J Obstet Gynecol 209:225.e1–225.e5CrossRefPubMed Schmid BC, Rezniczek GA, Rolf N, Saade G, Gebauer G, Maul H (2013) Uterine packing with chitosan-covered gauze for control of postpartum hemorrhage. Am J Obstet Gynecol 209:225.e1–225.e5CrossRefPubMed
Zurück zum Zitat Sherer DM, Abulafia O, Anyaegbunam AM (1998a) Intra- and early postpartum ultrasonography: a review. Part I. Obstet Gynecol Surv 53:107–116CrossRefPubMed Sherer DM, Abulafia O, Anyaegbunam AM (1998a) Intra- and early postpartum ultrasonography: a review. Part I. Obstet Gynecol Surv 53:107–116CrossRefPubMed
Zurück zum Zitat Sherer DM, Abulafia O, Anyaegbunam AM (1998b) Intra- and early postpartum ultrasonography: a review. Part II. Obstet Gynecol Surv 53:181–190CrossRefPubMed Sherer DM, Abulafia O, Anyaegbunam AM (1998b) Intra- and early postpartum ultrasonography: a review. Part II. Obstet Gynecol Surv 53:181–190CrossRefPubMed
Zurück zum Zitat Seidel V, Braun T, Weizsäcker K, Henrich W (2018) Application of chitosan-covered gauze in combination with intrauterine balloon tamponade for postpartum hemorrhage treatment – Case report of a novel “uterine sandwich” approach. Int J Surg Case Rep 48:101–103CrossRefPubMedPubMedCentral Seidel V, Braun T, Weizsäcker K, Henrich W (2018) Application of chitosan-covered gauze in combination with intrauterine balloon tamponade for postpartum hemorrhage treatment – Case report of a novel “uterine sandwich” approach. Int J Surg Case Rep 48:101–103CrossRefPubMedPubMedCentral
Zurück zum Zitat Valsky V, Cohen SM, Lipschuetz M, Hochner-Celnikier D, Yagel S (2012) Three-dimensional transperineal ultrasound findings associated with anal incontinence after intrapartum sphincter tears in primiparous women. Ultrasound Obstet Gynecol 39:83–90CrossRefPubMed Valsky V, Cohen SM, Lipschuetz M, Hochner-Celnikier D, Yagel S (2012) Three-dimensional transperineal ultrasound findings associated with anal incontinence after intrapartum sphincter tears in primiparous women. Ultrasound Obstet Gynecol 39:83–90CrossRefPubMed
Zurück zum Zitat Vasudeva A, Amin SV, Prakashini K, Bharatnur S, Mundkur A (2016) Post-caesarean haematomas, septic collections and wound disruptions – re-laparotomy based on abdominal imaging. J Clin Diagn Res 10:QJ1–QJ2PubMedPubMedCentral Vasudeva A, Amin SV, Prakashini K, Bharatnur S, Mundkur A (2016) Post-caesarean haematomas, septic collections and wound disruptions – re-laparotomy based on abdominal imaging. J Clin Diagn Res 10:QJ1–QJ2PubMedPubMedCentral
Zurück zum Zitat Vintzileos AM, Chavez MR, Kinzler WL (2010) Use of ultrasound in the labor and delivery. J Matern Fetal Neonatal Med 23:469–475CrossRefPubMed Vintzileos AM, Chavez MR, Kinzler WL (2010) Use of ultrasound in the labor and delivery. J Matern Fetal Neonatal Med 23:469–475CrossRefPubMed
Metadaten
Titel
Postpartaler Ultraschall
verfasst von
Prof. Dr. med. Wolfgang Henrich
Prof. Dr. med. Boris Tutschek
Copyright-Jahr
2025
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-67373-7_33