Störungen der Plazentation und Nabelschnurinsertion

 

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Kernaussagen

• Nicht jede im ersten Trimenon festgestellte Placenta praevia persistiert bis zum Termin. Das Risiko einer Persistenz ist abhängig vom Gestationsalter sowie dem Grad der Überlappung des inneren Muttermundes!

• Bei Placenta praevia ist eine genaue sonografische Dokumentation und Berücksichtigung der Wandlokalisation wichtig!

• Bei Placenta praevia oder Schwangeren mit Uterusvoroperationen sollte die Implantationstiefe der Plazenta sonografisch untersucht werden!

• Bei tiefer Plazentaimplantation ist ein konservatives Management mit Belassen der Placenta in utero möglich!

• Bei allen Schwangeren, insbesondere bei Schwangeren mit Placenta praevia oder Implantationsstörungen sowie bei Feten mit singulärer Nabelschnurarterie sollte der Nabelschnuransatz untersucht werden, um Vasa praevia auszuschließen!

• Bei Vasa praevia ist eine Hospitalisation im dritten Trimenon zu empfehlen und wie bei Placenta praevia eine primäre Sectio caesarea zwingend!

Main statements

• Not every case of placenta previa identified in the first trimester persists to the time of delivery. The risk of persistence depends on the gestational age and the degree of overlapping of the internal cervical os.

• Exact sonographic documentation and consideration of the wall location are important for placenta previa.

• The implantation depth of the placenta should be sonographically examined in the case of placenta previa or pregnancies with previous uterus operations.

• In the case of deep placenta implantation, conservative management without removal of the placenta is possible.

• The umbilical cord insertion should be examined in all pregnant women, in particular in those with placenta previa or implantation disorders, and in fetuses with a single umbilical artery in order to rule out vasa previa.

• Hospitalization in the third trimester is recommended for vasa previa and a primary cesarean section is absolutely necessary as in the case of placenta previa.

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Dr. Ilka Fuchs

Obstetrics, Charité C. Virchow

Augustenburger Platz 1

12047 Berlin

Phone: ++ 49/30/4 50 66 43 65

Fax: ++ 49/30/4 50 56 49 32

Email: ilka.fuchs@charite.de