Pränatale Diagnostik und Therapie bei kongenitaler Zwerchfellhernie

Zusammenfassung

Die Diagnose kongenitale Zwerchfellhernien umfasst eine inhomogene Gruppe unterschiedlicher Schweregrade dieser Erkrankung. Eine möglichst genaue vorgeburtliche Einschätzung der Prognose ist für die Beratung der betroffenen Eltern und für weitere Therapieentscheidungen von zentraler Bedeutung. Die fetale Therapie der kongenitalen Zwerchfellhernie (FETO) kann erwiesenermaßen die Prognose verbessern. Vor allem bei einer zu erwartenden ECMO-Pflichtigkeit ist die frühzeitige Anbindung an ein entsprechendes Zentrum wichtig.

Abstract

Congenital diaphragmatic hernia is a malformation presenting with varying degrees of severity. An accurate prediction of outcome is crucial for parental counselling and therapeutic planning. In selected cases, foetal endoscopic tracheal occlusion (FETO) can improve foetal outcome. Timely referral to a highly specialised centre is important when the requirement for extracorporeal membrane oxygenation (ECMO) is expected.

Schlüsselwörter

kongenitale Zwerchfellhernie - pränatale Diagnose - Prognosekriterien - fetale Echokardiografie - Trachealokklusion

Key words

congenital diaphragmatic hernia - prenatal diagnosis - antenatal predictors of ­survival - echocardiography - foetal tracheal occlusion

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