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Transfusionsmedizin 2018; 8(02): 95-110
DOI: 10.1055/s-0043-121102
CME-Fortbildung
Georg Thieme Verlag KG Stuttgart · New York

Hämolytische Erkrankung des Fetus und Neugeborenen

Teil 1: Ätiologie, Pathogenese, Diagnostik und Therapie in der Schwangerschaft
Roland Axt-Fliedner
,
Sandra Wienzek-Lischka
,
Ulrich J. Sachs
,
Nina Cooper
,
Klaus-Peter Zimmer
,
Harald Ehrhardt
,
Gregor Bein
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
06. Juni 2018 (online)

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Die Schwangerschaftskomplikation „Hämolytische Erkrankung des Fetus und Neugeborenen“ kann unbehandelt zum Kindstod führen. Lesen Sie in Teil 1 des Beitrags über Ätiologie, Pathogenese, Diagnostik und Therapie in der Schwangerschaft. Der Teil 2 stellt die Diagnose und Therapie der hämolytischen Erkrankung des Neugeborenen sowie die Primärprophylaxe vor.
Kernaussagen

  • Während der Schwangerschaft kann die werdende Mutter Antikörper gegen Antigene auf fetalen Erythrozyten bilden.

  • Die fetale hämolytische Anämie wird durch maternale IgG-Antikörper bei fetomaternaler Blutgruppeninkompatibilität hervorgerufen.

  • Fortschritte in der Pränatalmedizin, der Neonatologie und Transfusionsmedizin führten in den letzten Jahren zu einem Paradigmenwechsel: Die frühzeitige Erkennung von Risikoschwangerschaften, Komplikationen und deren Management erfolgt heute weitgehend nicht invasiv.

  • Bei der Diagnostik der fetalen Anämie durch Doppler-Sonografie wird sich der Zusammenhang zwischen fetalem Hämatokrit und der Blutflussgeschwindigkeit in fetalen Gefäßen zunutze gemacht.

  • Hydrops fetalis ist eine Manifestation von Morbus haemolyticus fetalis.

  • Unbehandelt kann die seltene Schwangerschaftskomplikation „hämolytische Erkrankung des Fetus und Neugeborenen“ zum Kindstod führen.

  • Bei einer behandlungsbedürftigen fetalen Anämie ist die intrauterine Bluttransfusion die einzige therapeutische Option.

Schlüsselwörter

fetale Anämie - fetaler Hydrops - intrauterine Transfusion - erythrozytäre Antikörper - molekulargenetische Blutgruppenbestimmung, hämolytische Erkrankung des Fetus und Neugeborenen
 

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