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18.05.2024 | Zwerchfellhernie | Leitthema

Intrauterine Therapie – wie ist der Stand der Dinge?

verfasst von: Dr. Eva Christin Weber, Prof. Dr. Ingo Gottschalk, Dr. Ivonne Bedei, Prof. Dr. Christoph Berg

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Zusammenfassung

Die Fortschritte in der pränatalen Ultraschalldiagnostik der letzten 40 Jahre haben einerseits zu einer deutlichen Steigerung der Entdeckungsrate vorgeburtlicher Erkrankungen geführt, andererseits aber auch die Grundlage für die intrauterine Therapie einiger ausgewählter Erkrankungen geschaffen. Da die meisten vorgeburtlichen Interventionen mit Risiken sowohl für den Fetus als auch für die werdende Mutter verbunden sind, bleiben sie Erkrankungen vorbehalten, die unbehandelt eine tödliche Prognose haben oder im Laufe der intrauterinen Entwicklung eine deutliche Verschlechterung der Prognose erfahren. Bisher haben nur wenige dieser therapeutischen Konzepte ihren Wert im Rahmen kontrollierter Studien bewiesen. Dies sind insbesondere die Lasertherapie des fetofetalen Transfusionssyndroms, der intrauterine Verschluss der Spina bifida und die Trachealokklusion bei Zwerchfellhernien mit schwerer pulmonaler Hypoplasie. Andere intrauterine Therapieansätze sind weniger gut belegt, entweder aufgrund der Seltenheit der Erkrankung oder der mangelnden Verfügbarkeit des Instrumentariums und der entsprechend erfahrenen Therapeuten. Der Beitrag soll dem primär beratenden Gynäkologen einen Überblick über die etablierten Verfahren und die neueren Entwicklungen geben.

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Titel: Intrauterine Therapie – wie ist der Stand der Dinge?
verfasst von: Dr. Eva Christin Weber
Prof. Dr. Ingo Gottschalk
Dr. Ivonne Bedei
Prof. Dr. Christoph Berg
Publikationsdatum: 18.05.2024
Verlag: Springer Medizin
Schlagwörter: Zwerchfellhernie
Zwerchfellhernie
Fetofetales Transfusionssyndrom
Laser
Pleuraerguss
Valvulotomie
Valvulotomie
Valvulotomie
Erschienen in: Die Gynäkologie
Print ISSN: 2731-7102
Elektronische ISSN: 2731-7110
DOI: https://doi.org/10.1007/s00129-024-05231-z

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