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2018 | OriginalPaper | Buchkapitel

14. Anämie – Blutgruppensensibilisierung

verfasst von : H. Steiner, G. Hasenöhrl

Erschienen in: Dopplersonographie in Geburtshilfe und Gynäkologie

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Die Abklärung einer möglichen fetalen Anämie hat bei Blutgruppensensibilisierungen, bei anämisierenden Infektionen (Parvovirus), bei fetomaternaler Transfusion sowie bei Hinweiszeichen im Rahmen der Ultraschalluntersuchung (Hydrops fetalis) oder bei auffälligen, anämieverdächtigen fetalen Herzfrequenzmustern zu erfolgen. Die Diagnosestellung der Anämie erfolgt mittels Chordozentese. In diesem Kapitel werden Untersuchungstechnik und Gefäßauswahl, diagnostische Wertigkeit und entsprechende Konsequenzen erläutert. Die Besonderheiten bei Hydrops und intrauteriner Transfusion werden beleuchtet.
Literatur
Zurück zum Zitat ACOG Practice Bulletin (2006) No. 75: management of alloimmunization. Obstet Gynecol, Aug 2006, 108(2)p457–64CrossRef ACOG Practice Bulletin (2006) No. 75: management of alloimmunization. Obstet Gynecol, Aug 2006, 108(2)p457–64CrossRef
Zurück zum Zitat Bilardo CM, Nicolaides KH, Campbell S (1989) Doppler studies in red cell isoimmunization. Clin Obstet Gynecol 32: 719‒727CrossRef Bilardo CM, Nicolaides KH, Campbell S (1989) Doppler studies in red cell isoimmunization. Clin Obstet Gynecol 32: 719‒727CrossRef
Zurück zum Zitat Copel JA, Grannum PA, Belanger K et al. (1988) Pulsed Doppler flow-velocity waveforms before and after intravascular transfusion for severe erythroblastosis fetalis. Am J Obstet Gynecol 158: 768‒774CrossRef Copel JA, Grannum PA, Belanger K et al. (1988) Pulsed Doppler flow-velocity waveforms before and after intravascular transfusion for severe erythroblastosis fetalis. Am J Obstet Gynecol 158: 768‒774CrossRef
Zurück zum Zitat Copel JA, Grannum PA, Green JJ et al. (1989) Pulsed Doppler flow-velocity waveforms in the prediction of fetal hematocrit of the severly isoimmunized pregnancy. Am J Obstet Gynecol 161: 341‒344CrossRef Copel JA, Grannum PA, Green JJ et al. (1989) Pulsed Doppler flow-velocity waveforms in the prediction of fetal hematocrit of the severly isoimmunized pregnancy. Am J Obstet Gynecol 161: 341‒344CrossRef
Zurück zum Zitat Copel JA, Grannum PA, Green JJ et al. (1989) Fetal cardiac output in the isoimmunized pregnancy: a pulsed Doppler-echocardiographic study of patients undergoing intravascular intrauterine transfusion. Am J Obstet Gynecol 161: 361‒365CrossRef Copel JA, Grannum PA, Green JJ et al. (1989) Fetal cardiac output in the isoimmunized pregnancy: a pulsed Doppler-echocardiographic study of patients undergoing intravascular intrauterine transfusion. Am J Obstet Gynecol 161: 361‒365CrossRef
Zurück zum Zitat Deren O, Onderoglu L (2002) The value of middle cerebral artery systolic velocity for initial and subsequent management in fetal anemia. Eur J Obstet Gynecol Reprod Biol 101(1): 26–30CrossRef Deren O, Onderoglu L (2002) The value of middle cerebral artery systolic velocity for initial and subsequent management in fetal anemia. Eur J Obstet Gynecol Reprod Biol 101(1): 26–30CrossRef
Zurück zum Zitat Detti L, Mari G, Akiyama M, et al. (2002) Longitudinal assessment of the middle cerebral artery peak systolic velocity in healthy fetuses and in fetuses at risk for anemia. Am J Obstet Gynecol 187(4): 937–9CrossRef Detti L, Mari G, Akiyama M, et al. (2002) Longitudinal assessment of the middle cerebral artery peak systolic velocity in healthy fetuses and in fetuses at risk for anemia. Am J Obstet Gynecol 187(4): 937–9CrossRef
Zurück zum Zitat Detti L, Oz U, Guney I, et al. (2001) Doppler ultrasound velocimetry for timing the second intrauterine transfusion in fetuses with anemia from red cell alloimmunization. Am J Obstet Gynecol 185(5): 1048–51CrossRef Detti L, Oz U, Guney I, et al. (2001) Doppler ultrasound velocimetry for timing the second intrauterine transfusion in fetuses with anemia from red cell alloimmunization. Am J Obstet Gynecol 185(5): 1048–51CrossRef
Zurück zum Zitat Economides DL, Selinger M, Ferguson J et al. (1992) Computerized measurements of heart rate variation in fetal anemia caused by rhesus alloimmunization. Am J Obstet Gynecol 167: 689‒693CrossRef Economides DL, Selinger M, Ferguson J et al. (1992) Computerized measurements of heart rate variation in fetal anemia caused by rhesus alloimmunization. Am J Obstet Gynecol 167: 689‒693CrossRef
Zurück zum Zitat Giles WB, Trudinger BJ (1986) Umbilical cord whole blood viscosity and the umbilical artery flow velocity time waveforms: a correlation. Br J Obstet Gynaecol 93: 466‒470CrossRef Giles WB, Trudinger BJ (1986) Umbilical cord whole blood viscosity and the umbilical artery flow velocity time waveforms: a correlation. Br J Obstet Gynaecol 93: 466‒470CrossRef
Zurück zum Zitat Gill RW, Warren PS, Kossof G et al. (1984) Umbilical venous flow in normal and complicated pregnancy. Ultrasound Med Biol 10: 346‒363CrossRef Gill RW, Warren PS, Kossof G et al. (1984) Umbilical venous flow in normal and complicated pregnancy. Ultrasound Med Biol 10: 346‒363CrossRef
Zurück zum Zitat Grannum PA, Copel JA, Moya FR et al. (1988) The reversal of hydrops fetalis by intravascular intrauterine transfusion in severe isoimmune fetal anemia. Am J Obstet Gynecol 158: 914‒919CrossRef Grannum PA, Copel JA, Moya FR et al. (1988) The reversal of hydrops fetalis by intravascular intrauterine transfusion in severe isoimmune fetal anemia. Am J Obstet Gynecol 158: 914‒919CrossRef
Zurück zum Zitat Hecher K, Snijders R, Campbell S et al. (1995) Fetal venous, arterial, and intracardiac bloow flows in red cell isoimmunization. Obstet Gynecol 85: 122‒128CrossRef Hecher K, Snijders R, Campbell S et al. (1995) Fetal venous, arterial, and intracardiac bloow flows in red cell isoimmunization. Obstet Gynecol 85: 122‒128CrossRef
Zurück zum Zitat Huikshoven FJ, Hope ID, Power GG et al. (1985) A comparison of sheep and human fetal oxygen delivery systems with use of a mathematical model. Am J Obstet Gynecol 151: 449‒455CrossRef Huikshoven FJ, Hope ID, Power GG et al. (1985) A comparison of sheep and human fetal oxygen delivery systems with use of a mathematical model. Am J Obstet Gynecol 151: 449‒455CrossRef
Zurück zum Zitat Jäger T, Steiner H (2014) Infektionen in der Schwangerschaft. Gyn Prax 38:22–35 Jäger T, Steiner H (2014) Infektionen in der Schwangerschaft. Gyn Prax 38:22–35
Zurück zum Zitat Jouppila P, Kirkinen P (1984) Umbilical vein blood flow in the human fetus in cases of maternal and fetal anemia and uterine bleeding. Ultrasound Med Biol 10: 365‒370CrossRef Jouppila P, Kirkinen P (1984) Umbilical vein blood flow in the human fetus in cases of maternal and fetal anemia and uterine bleeding. Ultrasound Med Biol 10: 365‒370CrossRef
Zurück zum Zitat Jouppila P, Kirkinen P, Puukka R (1986) Correlation between umbilical vein blood flow and umbilical blood viscosity in normal and complicated pregnancies. Arch Gynecol 237: 191‒197CrossRef Jouppila P, Kirkinen P, Puukka R (1986) Correlation between umbilical vein blood flow and umbilical blood viscosity in normal and complicated pregnancies. Arch Gynecol 237: 191‒197CrossRef
Zurück zum Zitat Krikinen P, Jouppila P (1983) Umbilical vein blood flow in rhesus-isoimmunization. Br J Obstet Gynecol 90: 640‒643CrossRef Krikinen P, Jouppila P (1983) Umbilical vein blood flow in rhesus-isoimmunization. Br J Obstet Gynecol 90: 640‒643CrossRef
Zurück zum Zitat Makh DS, Harman CR, Baschat AA (2003) Is Doppler prediction of anemia effective in the growth-restricted fetus? Ultrasound Obstet Gynecol 22(5): 489–92CrossRef Makh DS, Harman CR, Baschat AA (2003) Is Doppler prediction of anemia effective in the growth-restricted fetus? Ultrasound Obstet Gynecol 22(5): 489–92CrossRef
Zurück zum Zitat Mari G, Adrignolo A, Abuhamad AZ et al. (1995) Diagnosis of fetal anemia with Doppler ultrasound in the pregnancy complicated by maternal blood group immunization. Ultrasound Obstet Gynecol 5: 400–405CrossRef Mari G, Adrignolo A, Abuhamad AZ et al. (1995) Diagnosis of fetal anemia with Doppler ultrasound in the pregnancy complicated by maternal blood group immunization. Ultrasound Obstet Gynecol 5: 400–405CrossRef
Zurück zum Zitat Mari G, Rahman F, Olofsson P et al. (1997) Increase of fetal hematocrit decreases the middle cerebral artery peak systolic velocity in pregnancies complicated by Rhesus alloimmunization. J Maternal-Fetal Med 6: 206‒208 Mari G, Rahman F, Olofsson P et al. (1997) Increase of fetal hematocrit decreases the middle cerebral artery peak systolic velocity in pregnancies complicated by Rhesus alloimmunization. J Maternal-Fetal Med 6: 206‒208
Zurück zum Zitat Mari G, Deter RL, Carpenter RL, et al. (2000) Noninvasive diagnosis by Doppler ultrasonography of fetal anemia due to maternal red-cell alloimmunization. Collaborative Group for Doppler Assessment of the Blood Velocity in Anemic Fetuses. N Engl J Med 6;342(1): 9–14CrossRef Mari G, Deter RL, Carpenter RL, et al. (2000) Noninvasive diagnosis by Doppler ultrasonography of fetal anemia due to maternal red-cell alloimmunization. Collaborative Group for Doppler Assessment of the Blood Velocity in Anemic Fetuses. N Engl J Med 6;342(1): 9–14CrossRef
Zurück zum Zitat Mari G, Hanif F, Drennan K, Kruger M. (2007) Staging of intrauterine growth-restricted fetuses. J Ultrasound Med Nov;26(11):1469–77CrossRef Mari G, Hanif F, Drennan K, Kruger M. (2007) Staging of intrauterine growth-restricted fetuses. J Ultrasound Med Nov;26(11):1469–77CrossRef
Zurück zum Zitat Mari G, Norton ME, Stone J, Berghella V, Sciscione AC, Tate D, Schenone MH (2015) Society for Maternal-Fetal Medicine (SMFM) Clinical Guideline #8: the fetus at risk for anemia–diagnosis and management. Am J Obstet Gynecol. 2015 Jun;212(6):697–710.CrossRef Mari G, Norton ME, Stone J, Berghella V, Sciscione AC, Tate D, Schenone MH (2015) Society for Maternal-Fetal Medicine (SMFM) Clinical Guideline #8: the fetus at risk for anemia–diagnosis and management. Am J Obstet Gynecol. 2015 Jun;212(6):697–710.CrossRef
Zurück zum Zitat Moise KJ (2008) Management of rhesus alloimmunization in pregnancy. Obstet Gynecol 112(1): 164–76CrossRef Moise KJ (2008) Management of rhesus alloimmunization in pregnancy. Obstet Gynecol 112(1): 164–76CrossRef
Zurück zum Zitat Moise KJ et al. (2009) Management of Rhesus alloimmunization in pregnancy. UpToDate 18.1.2009 Moise KJ et al. (2009) Management of Rhesus alloimmunization in pregnancy. UpToDate 18.1.2009
Zurück zum Zitat Moise KJ et al. (2012) Management and Prevention of Red Cell Alloimmunization in Pregnancy. Obstet Gynecol 2012;120:1132–39PubMed Moise KJ et al. (2012) Management and Prevention of Red Cell Alloimmunization in Pregnancy. Obstet Gynecol 2012;120:1132–39PubMed
Zurück zum Zitat Nicolaides KH, Fontanarosa M, Grabbe SG et al (1988) Failure of ultrasonographic parameters to predict the severity of fetal anemia in rhesus isoimmunization. Am J Obstet Gynecol 158: 920‒926CrossRef Nicolaides KH, Fontanarosa M, Grabbe SG et al (1988) Failure of ultrasonographic parameters to predict the severity of fetal anemia in rhesus isoimmunization. Am J Obstet Gynecol 158: 920‒926CrossRef
Zurück zum Zitat Nicolaides KH, Bilardo CM, Campbell S (1990) Prediction of fetal anemia by measurement of the mean blood velocity in the fetal aorta. Am J Obstet Gynecol 162: 209‒212CrossRef Nicolaides KH, Bilardo CM, Campbell S (1990) Prediction of fetal anemia by measurement of the mean blood velocity in the fetal aorta. Am J Obstet Gynecol 162: 209‒212CrossRef
Zurück zum Zitat Oepkes D, Vandenbussche FP, Van Bel F et al (1993) Fetal ductus venosus blood flow velocities before and after transfusion in red cell alloimmunized pregnancies. Obstet Gynecol 82: 237‒241PubMed Oepkes D, Vandenbussche FP, Van Bel F et al (1993) Fetal ductus venosus blood flow velocities before and after transfusion in red cell alloimmunized pregnancies. Obstet Gynecol 82: 237‒241PubMed
Zurück zum Zitat Oepkes D, Seaward PG, Vandenbussche FP, et al. (2006) Doppler ultrasonography versus amniocentesis to predict fetal anemia. N Engl J Med 355(2): 156–64CrossRef Oepkes D, Seaward PG, Vandenbussche FP, et al. (2006) Doppler ultrasonography versus amniocentesis to predict fetal anemia. N Engl J Med 355(2): 156–64CrossRef
Zurück zum Zitat Pretlove SJ, Fox CE, Khan KS, et al. (2009) Noninvasive methods of detecting fetal anaemia: a systematic review and meta-analysis. BJOG 116(12): 1558–67CrossRef Pretlove SJ, Fox CE, Khan KS, et al. (2009) Noninvasive methods of detecting fetal anaemia: a systematic review and meta-analysis. BJOG 116(12): 1558–67CrossRef
Zurück zum Zitat Rightmire DA, Nicolaides KH, Rodeck CH et al (1986) Fetal blood velocities in Rh isoimmunization: Relationship to gestational age and to fetal hematocrit. Obstet Gynecol 68: 233‒236 Rightmire DA, Nicolaides KH, Rodeck CH et al (1986) Fetal blood velocities in Rh isoimmunization: Relationship to gestational age and to fetal hematocrit. Obstet Gynecol 68: 233‒236
Zurück zum Zitat Rizzo G, Nicolaides KH, Arduini D et al (1990) Effects of intravascular fetal blood transfusion on fetal intracardiac Doppler velocity waveforms. Am J Obstet Gynecol 163: 1231‒1238CrossRef Rizzo G, Nicolaides KH, Arduini D et al (1990) Effects of intravascular fetal blood transfusion on fetal intracardiac Doppler velocity waveforms. Am J Obstet Gynecol 163: 1231‒1238CrossRef
Zurück zum Zitat Scheier M, Hernandez-Andrade E, Carmo A, Dezerega V, Nicolaides KH (2004) Prediction of fetal anemia in rehesus disease by measurement of fetal middle cerebral peak systolic velocity. Ultrasound Obstet Gynecol 23: 432–6CrossRef Scheier M, Hernandez-Andrade E, Carmo A, Dezerega V, Nicolaides KH (2004) Prediction of fetal anemia in rehesus disease by measurement of fetal middle cerebral peak systolic velocity. Ultrasound Obstet Gynecol 23: 432–6CrossRef
Zurück zum Zitat Scheier M, Hernandez-Andrade E, Fonseca EB, et al. (2006) Prediction of severe fetal anemia in red blood cell alloimmunization after previous intrauterine transfusions. Am J Obstet Gynecol 195(6): 1550–6CrossRef Scheier M, Hernandez-Andrade E, Fonseca EB, et al. (2006) Prediction of severe fetal anemia in red blood cell alloimmunization after previous intrauterine transfusions. Am J Obstet Gynecol 195(6): 1550–6CrossRef
Zurück zum Zitat Slaghekke F, Kist WJ, Oepkes D, et al. TAPS and TOPS: two distinct forms of feto-fetal transfusion in monochorionic twins (Level III). Z Geburtshilfe Neonatol 2009;213:248–54.CrossRef Slaghekke F, Kist WJ, Oepkes D, et al. TAPS and TOPS: two distinct forms of feto-fetal transfusion in monochorionic twins (Level III). Z Geburtshilfe Neonatol 2009;213:248–54.CrossRef
Zurück zum Zitat Spinnato JA (1992) Hemolytic disease of the fetus: a plea for restraint. Obstet Gynecol 80: 873‒877PubMed Spinnato JA (1992) Hemolytic disease of the fetus: a plea for restraint. Obstet Gynecol 80: 873‒877PubMed
Zurück zum Zitat Steiner H, Schaffer H, Spitzer D et al. (1995) The relationship between peak velocity in the fetal descending aorta and hematocrit in rhesus isoimmunization. Obstet Gynecol 85: 659‒662CrossRef Steiner H, Schaffer H, Spitzer D et al. (1995) The relationship between peak velocity in the fetal descending aorta and hematocrit in rhesus isoimmunization. Obstet Gynecol 85: 659‒662CrossRef
Zurück zum Zitat Steiner H, Schaffer H, Spitzer D et al. (1995) Überwachung von Nabelschnurpunktionen und intravaskulären Transfusionen mittels Dopplersonographie. Geburtshilfe Frauenheilkd 55: 204‒206CrossRef Steiner H, Schaffer H, Spitzer D et al. (1995) Überwachung von Nabelschnurpunktionen und intravaskulären Transfusionen mittels Dopplersonographie. Geburtshilfe Frauenheilkd 55: 204‒206CrossRef
Zurück zum Zitat Warren PS, Gill RW, Fisher CC (1987) Doppler flow studies in rhesus isoimmunization. Semin Perinatol 11: 375‒378PubMed Warren PS, Gill RW, Fisher CC (1987) Doppler flow studies in rhesus isoimmunization. Semin Perinatol 11: 375‒378PubMed
Zurück zum Zitat Weiner CP, Williamson RA, Wenstrom KD et al. (1991) Management of fetal hemolytic disease by cordocentesis: 1. Prediction of fetal anemia. Am J Obstet Gynecol 165: 546‒553CrossRef Weiner CP, Williamson RA, Wenstrom KD et al. (1991) Management of fetal hemolytic disease by cordocentesis: 1. Prediction of fetal anemia. Am J Obstet Gynecol 165: 546‒553CrossRef
Zurück zum Zitat Weiner CP (1993) Umbilical pressure measurement in the evaluation of nonimmune hydrops. Am J Obstet Gynecol 168: 347‒352 Weiner CP (1993) Umbilical pressure measurement in the evaluation of nonimmune hydrops. Am J Obstet Gynecol 168: 347‒352
Zurück zum Zitat Weiner CP (1994) Fetal hemolytic disease. In: James DK, Steer PJ, Weiner CP, Gonik B (eds) High risk pregnancy. WB Saunders, London Philadelphia, pp 783‒801 Weiner CP (1994) Fetal hemolytic disease. In: James DK, Steer PJ, Weiner CP, Gonik B (eds) High risk pregnancy. WB Saunders, London Philadelphia, pp 783‒801
Zurück zum Zitat Zimmermann R, Durig P, Carpenter RJ, Mari G (2002) Longitudinal measurement of peak systolic velocity in the fetal middle cerebral artery for monitoring pregnancies complicated by red-cell alloimmunization – a prospective multi-center trial with intention to treat. BJOG 109: 746–52CrossRef Zimmermann R, Durig P, Carpenter RJ, Mari G (2002) Longitudinal measurement of peak systolic velocity in the fetal middle cerebral artery for monitoring pregnancies complicated by red-cell alloimmunization – a prospective multi-center trial with intention to treat. BJOG 109: 746–52CrossRef
Metadaten
Titel
Anämie – Blutgruppensensibilisierung
verfasst von
H. Steiner
G. Hasenöhrl
Copyright-Jahr
2018
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-54966-7_14

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