Download PDF
Ultraschall Med 2019; 40(03): 319-325
DOI: 10.1055/a-0800-8596
Guidelines & Recommendations

Dopplersonografie in der Schwangerschaft – Qualitätsanforderungen der DEGUM und klinischer Einsatz (Teil 1)

Article in several languages: English | deutsch
R. Faber
1   Center of Prenatal Medicine, Leipzig, Germany
,
Kai-Sven Heling
2   Praxis, prenetal diagnosis and human genetics, Berlin, Germany
,
Horst Steiner
3   Praxis prenatal medicine, Salzburg, Austria
,
Ulrich Gembruch
4   Obstetrics and Prenatal Medicine, University-Hospital, Bonn, Germany
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Zusammenfassung

Der Einsatz der Methode der Dopplersonografie in der Pränatal- und Geburtsmedizin hat sich allgemein durchgesetzt. Sie wird beim Screening auf Aneuploidie und Präeklampsie im 1. Trimester zunehmend angewendet, aber vor allem zur fetalen Zustandsdiagnostik bzw. Überwachung gefährdeter Feten bei IUGR, Anämie und anderen Erkrankungen im 2. und 3. Trimester eingesetzt. Die korrekte Anwendung der Methode der Dopplersonografie ist die Voraussetzung für die richtige Interpretation der Ergebnisse und daraus abgeleiteter klinischer Entscheidungen. Diese Qualitätsanforderungen sollen hiermit für alle Anwender formuliert werden und gleichzeitig als Grundlage für die durch die DEGUM zertifizierten Kurse dienen. Im 1. Teil werden die allgemeinen technischen Grundlagen, Gefäßgebiete, Auswertung der Spektralkurven, Fehlerquellen, Patientensicherheit und die Voraussetzungen für eine erfolgreiche Zertifizierung behandelt.

Key words

uterine arteries - fetal vessels - guideline - Doppler analysis


Publication History

Received: 30 March 2018

Accepted: 12 November 2018

Article published online:
20 March 2019

© Georg Thieme Verlag KG
Stuttgart · New York

 

  • References

  • 1 Standards in der Perinatalmedizin – Dopplersonographie in der Schwangerschaft. AWMF-Leitlinie 2012
    Search in Google Scholar
  • 2 Stampalija T, Gyte GM, Alfirevic Z. Utero-placental Doppler ultrasound for improving pregnancy outcome. Cochrane Database Syst Rev 2010; 8: CD008363
    PubMedSearch in Google Scholar
  • 3 Alfirevic Z, Stampalija T, Gyte GM. Fetal and umbilical Doppler ultrasound in normal pregnancy. Cochrane Database Syst Rev 2015; 15: CD001450
    PubMedSearch in Google Scholar
  • 4 Bhide A, Acharya G, Bilardo CM. et al. ISUOG Practice Guidelines: use of Doppler ultrasonography in obstetrics. Ultrasound Obstet Gynecol 2013; 41: 233-239
    CrossrefPubMedSearch in Google Scholar
  • 5 Bahada-Singh RO, Jodicke C. Uterine Artery Doppler in First-trimester Pregnancy Screening. Clin Obstet Gynecol 2010; 53: 879-887
    CrossrefPubMedSearch in Google Scholar
  • 6 Gómez O, Figueras F, Fernández S. et al. Reference ranges for uterine artery mean pulsatility index at 11–41 weeks of gestation. Ultrasound Obstet Gynecol 2008; 32: 128-132
    CrossrefPubMedSearch in Google Scholar
  • 7 Bahlmann F, Fittschen M, Reinhard I. et al. Reference values for blood flow velocity in the uterine artery in normal pregnancies from 18 weeks to 42 weeks of gestation calculated by automatic Doppler waveform analysis. Ultraschall in Med 2012; 33: 258-264
    Thieme ConnectPubMedSearch in Google Scholar
  • 8 Weichert A, Hagen A, Tchirikov M. et al. Reference Curve for the Mean Uterine Artery Pulsatility Index in Singleton Pregnancies. Geburtshilfe Frauenheilkd 2017; 77: 516-523
    Thieme ConnectPubMedSearch in Google Scholar
  • 9 Stridsklev S, Salvesen Ø, Salvesen KÅ. et al. Uterine artery Doppler measurements during first and second trimesters of normal pregnancy. Acta Obstet Gynecol Scand 2017; 96: 366-371
    CrossrefPubMedSearch in Google Scholar
  • 10 Arduini D, Rizzo G. Normal values of Pulsatility Index from fetal vessels: a cross-sectional study on 1556 healthy fetuses. J Perinat Med 1990; 18: 165-172
    CrossrefPubMedSearch in Google Scholar
  • 11 van Zalen-Sprock MM, van Vugt JM, Colenbrander GJ. et al. First-trimester uteroplacental and fetal blood flow velocity waveforms in normally developing fetuses: a longitudinal study. Ultrasound Obstet Gynecol 1994; 4: 284-288
    CrossrefPubMedSearch in Google Scholar
  • 12 Acharya G, Wilsgaard T, Berntsen GK. et al. Reference ranges for serial measurements of umbilical artery Doppler indices in the second half of pregnancy. Am J Obstet Gynecol 2005; 192: 937-944
    CrossrefPubMedSearch in Google Scholar
  • 13 Acharya G, Wilsgaard T, Berntsen GK. et al. Reference ranges for serial measurements of blood velocity and pulsatility index at the intra-abdominal portion, and fetal and placental ends of the umbilical artery. Ultrasound Obstet Gynecol 2005; 26: 162-169
    CrossrefPubMedSearch in Google Scholar
  • 14 Bahlmann F, Fittschen M, Reinhard I. et al. Blood flow velocity waveforms of the umbilical artery in a normal population: reference values from 18 weeks to 42 weeks of gestation. Ultraschall in Med 2012; 33: 80-87
    Thieme ConnectPubMedSearch in Google Scholar
  • 15 Ebbing G, Rasmussen S, Kiserud T. Middle cerebral artery blood flow velocities and pulsatility index and the cerebroplacental pulsatility ratio: longitudinal reference ranges and terms for serial measurements. Ultrasound Obstet Gynecol 2007; 30: 287-296
    CrossrefPubMedSearch in Google Scholar
  • 16 Hsieh YY, Chang CC, Tsai HD. et al. Longitudinal survey of blood flow at three different locations in the middle cerebral artery in normal fetuses. Ultrasound Obstet Gynecol 2001; 17: 125-128
    CrossrefPubMedSearch in Google Scholar
  • 17 Bahlmann F. Blood flow velocity waveforms of the fetal middle cerebral artery in a normal population: reference values from 18 weeks to 42 weeks of gestation. J Perinat Med 2002; 30: 490-501
    CrossrefPubMedSearch in Google Scholar
  • 18 Mari G. Noninvasive diagnosis by Doppler ultrasonography of fetal anemia due to maternal red-cell alloimmunization. N Engl J Med 2000; 342: 9-14
    CrossrefPubMedSearch in Google Scholar
  • 19 Detti L, Mari G. Noninvasive diagnosis of fetal anemia. Clin Obstet Gynecol 2003; 46: 923-930
    CrossrefPubMedSearch in Google Scholar
  • 20 Mari G, Norton ME, Stone J. et al. Society for Maternal-Fetal Medicine (SMFM) Clinical Guideline #8: the fetus at risk for anemia – diagnosis and management. Am J Obstet Gynecol 2015; 212: 697-710
    CrossrefPubMedSearch in Google Scholar
  • 21 Swartz AE, Ruma MS, Kim E. et al. The effect of fetal heart rate on the peak systolic velocity of the fetal middle cerebral artery. Obstet Gynecol 2009; 113: 1225-1229
    CrossrefPubMedSearch in Google Scholar
  • 22 Hecher K, Campbell S, Snijders R. et al. Reference ranges for fetal venous and atrioventricular blood flow parameters. Ultrasound Obstet Gynecol 1994; 4: 381-390
    CrossrefPubMedSearch in Google Scholar
  • 23 Kessler J, Rasmussen S, Hanson M. et al. Longitudinal reference ranges for ductus venosus flow velocities and waveform indices. Ultrasound Obstet Gynecol 2006; 28: 890-898
    CrossrefPubMedSearch in Google Scholar
  • 24 Acharya G, Wilsgaard T, Berntsen GKR. et al. Reference ranges for umbilical vein blood flow in the second half of pregnancy based on longitudinal data. Prenat Diagn 2005; 25: 99-111
    CrossrefPubMedSearch in Google Scholar
  • 25 Lenz F, Chaoui R. Reference ranges for Doppler-assessed pulmonary venous blood flow velocities and pulsatility indices in normal human fetuses. Prenat Diagn 2002; 22: 786-791
    CrossrefPubMedSearch in Google Scholar
  • 26 Dong FQ, Zhang Y, Li Z. et al. Evaluation of normal fetal pulmonary veins from the early second trimester by enhanced-flow (e-flow) echocardiography. Ultrasound Obstet Gynecol 2011; 38: 652-657
    CrossrefPubMedSearch in Google Scholar
  • 27 Lenz F, Chaoui R. Changes in pulmonary venous Doppler parameters in fetal cardiac defects. Ultrasound Obstet Gynecol 2006; 28: 63-70
    CrossrefPubMedSearch in Google Scholar
  • 28 Divanović A, Hor K, Cnota J. et al. Prediction and perinatal management of severely restrictive atrial septum in fetuses with critical left heart obstruction: clinical experience using pulmonary venous Doppler analysis. J Thorac Cardiovasc Surg 2011; 141: 988-994
    CrossrefPubMedSearch in Google Scholar
  • 29 Salvesen K, Lees C, Abramowicz J. et al. ISUOG statement on the safe use of Doppler in the 11 to 13+6-week fetal ultrasound examination. Ultrasound Obstet Gynecol 2011; 37: 625-628
    CrossrefPubMedSearch in Google Scholar