nach oben

Erschienen in:

2018 | OriginalPaper | Buchkapitel

18. Schwierigkeiten der pränatalen Diagnostik und fetalen Überwachung bei maternaler Adipositas

verfasst von : Prof. Dr. med. U. Gembruch

Erschienen in: Ultraschalldiagnostik in Geburtshilfe und Gynäkologie

Verlag: Springer Berlin Heidelberg

Einloggen, um Zugang zu erhalten

Zusammenfassung

Eine maternale Adipositas bedingt einerseits eine häufig deutlich schlechtere sonografische Darstellbarkeit der fetalen Organe, ist aber andererseits mit höheren Risiken bezüglich Schwangerschaft-spezifischer Komplikationen, wie Präeklampsie und Plazentainsuffizienz, aber auch bezüglich des Auftretens fetaler Fehlbildungen assoziiert. Ferner beeinträchtigt die maternale Adipositas auch die Diagnostik mittels biochemischer Parameter sowie der zellfreien DNA im maternalen Blut, aber auch die invasive Diagnostik und Therapie. Dies hat bedeutsame Implikationen für Beratung, Vorgehen und Interpretation im Rahmen pränataler diagnostischer Untersuchungen sowie für die fetale Überwachung. Möglichkeiten, die sonografische Darstellbarkeit des Feten zu verbessern, werden dargelegt.

Vorheriges Kapitel Fetale Magnetresonanztomographie

Nächstes Kapitel Prädiktiver Ultraschall für Präeklampsie und intrauterine Wachstumsrestriktion im II. und III. Trimester

Aagaard-Tillery KM, Flint Porter T, Malone FD, Nyberg DA, Collins J, Comstock CH, Hankins G, Eddleman K, Dugoff L, Wolfe HM, D’Alton ME (2010) Influence of maternal BMI on genetic sonography in the FaSTER trial. Prenat Diagn 30: 14–22

Adekola H, Soto E, Dai J, Lam-Rachlin J, Gill N, Leon-Peters J, Puder K, Abramowicz JS (2015) Optimal visualization of the fetal four-chamber and outflow tract views with transabdominal ultrasound in the morbidly obese: Are we there yet? J Clin Ultrasound 43: 548–555

Ahmadzia HK, Thomas SM, Dude AM, Grotegut CA, Boyd BK (2014) Prediction of birthweight from third-trimester ultrasound in morbidly obese women. Am J Obstet Gynecol 211: 431.e1–7

Arabin B, Stupin JH (2014) Overweight and obesity before, during and after pregnancy: Part 2: Evidence-based risk factors and interventions. Geburtshilfe Frauenheilkd 74: 646–655

Ashoor G, Syngelaki A, Poon LC, Rezende JC, Nicolaides KH (2013) Fetal fraction in maternal plasma cell-free DNA at 11–13 weeks’ gestation: relation to maternal and fetal characteristics. Ultrasound Obstet Gynecol 41: 26–32

Benacerraf B (2013) The use of obstetrical ultrasound in the obese gravida. Semin Perinatol 37: 345–347

Best KE, Tennant PW, Bell R, Rankin J (2012) Impact of maternal body mass index on the antenatal detection of congenital anomalies. BJOG 119: 1503–1511

Blanco R, Colombo A, Suazo J (2015) Maternal obesity is a risk factor for orofacial clefts: a meta-analysis. Br J Oral Maxillofac Surg 53: 699–704

Cai GJ, Sun XX, Zhang L, Hong Q (2014) Association between maternal body mass index and congenital heart defects in offspring: a systematic review. Am J Obstet Gynecol 211: 91–117

Chung JH, Pelayo R, Hatfield TJ, Speir VJ, Wu J, Caughey AB (2012) Limitations of the fetal anatomic survey via ultrasound in the obese obstetrical population. J Matern Fetal Neonatal Med 25: 1945–1949

Cohen JM, Hutcheon JA, Kramer MS, Joseph KS, Abenhaim H, Platt RW (2010) Influence of ultrasound-to-delivery interval and maternal-fetal characteristics on validity of estimated fetal weight. Ultrasound Obstet Gynecol 35: 434–441

Correa A, Gilboa SM, Besser LM, Botto LD, Moore CA, Hobbs CA, Cleves MA, Riehle-Colarusso TJ, Waller DK, Reece EA (2008) Diabetes mellitus and birth defects. Am J Obstet Gynecol 199: 237.e1–9

Dashe JS, McIntire DD, Twickler DM (2009a) Maternal obesity limits the ultrasound evaluation of fetal anatomy. J Ultrasound Med 28: 1025–1030

Dashe JS, McIntire DD, Twickler DM (2009b) Effect of maternal obesity on the ultrasound detection of anomalous fetuses. Obstet Gynecol 113: 1001–1007

Fuchs F, Houllier M, Voulgaropoulos A, Levaillant JM, Colmant C, Bouyer J, Senat MV (2013) Factors affecting feasibility and quality of second-trimester ultrasound scans in obese pregnant women. Ultrasound Obstet Gynecol 41: 40–46

Gandhi M, Fox NS, Russo-Stieglitz K, Hanley ME, Matthews G, Rebarber A (2009) Effect of increased body mass index on first-trimester ultrasound examination for aneuploidy risk assessment. Obstet Gynecol 114: 856–859

Gupta S, Timor-Tritsch IE, Oh C, Chervenak J, Monteagudo A (2014) Early second-trimester sonography to improve the fetal anatomic survey in obese patients. J Ultrasound Med 33: 1579–1583

Haghiac M, Vora NL, Basu S, Johnson KL, Presley L, Bianchi DW, Hauguel-de Mouzon S (2012) Increased death of adipose cells, a path to release cell-free DNA into systemic circulation of obese women. Obesity (Silver Spring) 20: 2213–2219

Harper LM, Cahill AG, Smith K, Macones GA, Odibo AO (2012) Effect of maternal obesity on the risk of fetal loss after amniocentesis and chorionic villus sampling. Obstet Gynecol 119: 745–751

Hendler I, Blackwell SC, Bujold E, Treadwell MC, Wolfe HM, Sokol RJ, Sorokin Y (2004) The impact of maternal obesity on midtrimester sonographic visualization of fetal cardiac and craniospinal structures. Int J Obes Relat Metab Disord 28: 1607–1611

Hendler I, Blackwell SC, Bujold E, Treadwell MC, Mittal P, Sokol RJ, Sorokin Y (2005) Suboptimal second-trimester ultrasonographic visualization of the fetal heart in obese women: should we repeat the examination? J Ultrasound Med 24: 1205–1209

Hildebrand E, Gottvall T, Blomberg M (2013) Maternal obesity and detection rate of fetal structural anomalies. Fetal Diagn Ther 33: 246–251

Hunsley C, Farrell T (2014) The influence of maternal body mass index on fetal anomaly screening. Eur J Obstet Gynecol Reprod Biol 182: 181–184

Kennedy NJ, Peek MJ, Quinton AE, Lanzarone V, Martin A, Benzie R, Nanan R (2016) Maternal abdominal subcutaneous fat thickness as a predictor for adverse pregnancy outcome: a longitudinal cohort study. BJOG 123: 225–232

Khoury FR, Ehrenberg HM, Mercer BM (2009) The impact of maternal obesity on satisfactory detailed anatomic ultrasound image acquisition. J Matern Fetal Neonatal Med 22: 337e41

Kritzer S, Magner K, Warshak CR (2014) Increasing maternal body mass index and the accuracy of sonographic estimation of fetal weight near delivery. J Ultrasound Med 33: 2173–2189

Krishna I, Badell M, Loucks TL, Lindsay M, Samuel A (2016) Adverse perinatal outcomes are more frequent in pregnancies with a low fetal fraction result on noninvasive prenatal testing. Prenat Diagn 36: 210–215

Kutbi H, Wehby GL, Moreno Uribe LM, Romitti PA, Carmichael S, Shaw GM, Olshan AF, DeRoo L, Rasmussen SA, Murray JC, Wilcox A, Lie RT, Munger RG (2017) Maternal underweight and obesity and risk of orofacial clefts in a large international consortium of population-based studies. Int J Epidemiol 46: 190–199

Marchi J, Berg M, Dencker A, Olander EK, Begley C (2015) Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes Rev 16: 621–638

McDonald SD, McKinney B, Foster G, Taylor V, Lutsiv O, Pullenayegum E (2015) The combined effects of maternal depression and excess weight on neonatal outcomes. Int J Obes (Lond) 39: 1033–1040

Paladini D (2009) Sonography in obese and overweight pregnant women: clinical, medicolegal and technical issues. Ultrasound Obstet Gynecol 33: 720–729

Parker SE, Yazdy MM, Tinker SC, Mitchell AA, Werler MM (2013) The impact of folic acid intake on the association among diabetes mellitus, obesity, and spina bifida. Am J Obstet Gynecol 209: 239.e1–8

Racusin D, Stevens B, Campbell G, Aagaard KM (2012) Obesity and the risk and detection of fetal malformations. Semin Perinatol 36: 213–221

Rasmussen SA, Chu SY, Kim SY, Schmid CH, Lau J (2008) Maternal obesity and risk of neural tube defects: a metaanalysis. Am J Obstet Gynecol 198: 611–619

Revello R, Sarno L, Ispas A, Akolekar R, Nicolaides KH (2016) Screening for trisomies by cell-free DNA testing of maternal blood: consequences of failed result. Ultrasound Obstet Gynecol 47: 698–704

Rose NC (2016) Genetic screening and the obese gravida. Semin Obstet Gynecol 59: 140–147

Schaefer-Graf U (2016) Adipositas und Schwangerschaft. Diabetologe 12: 6–12

Stothard KJ, Tennant PW, Bell R, Rankin J (2009) Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis. JAMA 30: 636–650

Thornburg LL, Mulconry M, Post A, Carpenter A, Grace D, Pressman EK (2009a) Fetal nuchal translucency thickness evaluation in the overweight and obese gravida. Ultrasound Obstet Gynecol 33: 665–669

Thornburg LL, Miles K, Ho M, Pressman EK (2009b) Fetal anatomic evaluation in the overweight and obese gravida. Ultrasound Obstet Gynecol 33: 670–675

Tsai LJ, Ho M, Pressman EK, Thornburg LL (2010) Ultrasound screening for fetal aneuploidy using soft markers in the overweight and obese gravida. Prenat Diagn 30: 821–826

Tsai PJ, Loichinger M, Zalud I (2015) Obesity and the challenges of ultrasound fetal abnormality diagnosis. Best Pract Res Clin Obstet Gynaecol 29: 320–327

Uhden M, Knippel AJ, Stressig R, Hammer R, Siegmann H, Froehlich S, Kozlowski P (2011) Impact of maternal obesity and maternal overweight on the detection rate of fetal heart defects and the image quality of prenatal echocardiography. Ultraschall Med 32 Suppl 2: E108–114

Watkins ML, Rasmussen SA, Honein MA, Botto LD, Moore CA (2003) Maternal obesity and risk for birth defects. Pediatrics 111: 1152–1158

Yogev Y, Visser GH (2008) Obesity, gestational diabetes and pregnancy outcome. Semin Fetal Neonatal Med 14: 77–84

Titel: Schwierigkeiten der pränatalen Diagnostik und fetalen Überwachung bei maternaler Adipositas
verfasst von: Prof. Dr. med. U. Gembruch
Verlag: Springer Berlin Heidelberg
Buch: Ultraschalldiagnostik in Geburtshilfe und Gynäkologie
Print ISBN: 978-3-662-53661-2

Electronic ISBN: 978-3-662-53662-9

Copyright-Jahr: 2018
DOI: https://doi.org/10.1007/978-3-662-53662-9_18

Springerpflege

Zusammenfassung

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