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6. Kardiale Funktionsanalyse beim Feten: Schritt für Schritt

Author

Graupner, O. and Enzensberger, C.

Abstract

Hintergrund: Die Untersuchung der fetalen kardialen Funktion mithilfe spezieller Ultraschalltechniken hat in den letzten Jahren zunehmend an Bedeutung gewonnen. Hintergründig steht zum einen die frühzeitige Erfassung einer subklinischen kardialen Dysfunktion bei perinatalen Risikokonstellationen mit möglicher Auswirkung auf die fetale Hämodynamik und Mortalität. Zum anderen erlaubt die kardiale Funktionsanalyse die Detektion eines funktionellen kardialen Remodeling im Sinne der intrauterinen Grundsteinlegung für spätere kardiovaskuläre Erkrankungen. Ziel der Arbeit: In dieser Übersicht sollen gängige Messmethoden (Doppler basierend und Doppler unabhängig) zur Bestimmung der fetalen kardialen Funktion sowie deren klinischen Anwendungsgebiete dargestellt werden. Zur Vertiefung soll das konkrete messtechnische Vorgehen schrittweise erläutert und pathophysiologische Aspekte in den Messergebnissen beleuchtet werden.

Published
2024
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10. EP10.02: Pathophysiology and intrauterine appearance of unusual causes of fetal acrania‐exencephaly‐anencephaly sequence

Author

Weichert, J., primary, Gembicki, M.A., additional, Welp, A., additional, Scharf, J., additional, Dracopoulos, C., additional, Krapp, M., additional, Becker, W., additional, Enzensberger, C., additional, Graupner, O., additional, Ritgen, J., additional, Schröer, A., additional, Weichert, A., additional, and Degenhardt, J., additional

Published
2022
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12. Fetal cerebral Doppler changes and outcome in late preterm fetal growth restriction : prospective cohort study

Author

Stampalija, T., Thornton, J., Marlow, N., Napolitano, R., Bhide, A., Pickles, T., Bilardo, C. M., Gordijn, S. J., Gyselaers, W., Valensise, H., Hecher, K., Sande, R. K., Lindgren, P., Bergman, E., Arabin, B., Breeze, A. C., Wee, L., Ganzevoort, W., Richter, J., Berger, A., Brodszki, J., Derks, J., Mecacci, F., Maruotti, G. M., Myklestad, K., Lobmaier, S. M., Prefumo, F., Klaritsch, P., Calda, P., Ebbing, C., Frusca, T., Raio, L., Visser, G. H. A., Krofta, L., Cetin, I., Ferrazzi, E., Cesari, E., Wolf, H., Lees, C. C., Brezinka, C., Casagrandi, D., Cerny, A., Dall'Asta, A., Devlieger, R., Duvekot, J., Eggebo, T. M., Fantasia, I., Ferrari, F., Fratelli, N., Ghi, T., Graupner, O., Greimel, P., Hofstaetter, C., Presti, D. Lo, Georg, M., Macsali, F., Marsal, K., Martinelli, P., Mylrea-Foley, B., Mullins, E., Ostermayer, E., Papageorghiou, A., Peasley, R., Ramoni, A., Sarno, L., Seikku, L., Simeone, S., Thilaganathan, B., Tiralongo, G., Valcamonico, A., van Holsbeke, C., Vietheer, A., APH - Quality of Care, ARD - Amsterdam Reproduction and Development, Obstetrics and Gynaecology, APH - Digital Health, Stampalija, T., Thornton, J., Marlow, N., Napolitano, R., Bhide, A., Pickles, T., Bilardo, C. M., Gordijn, S. J., Gyselaers, W., Valensise, H., Hecher, K., Sande, R. K., Lindgren, P., Bergman, E., Arabin, B., Breeze, A. C., Wee, L., Ganzevoort, W., Richter, J., Berger, A., Brodszki, J., Derks, J., Mecacci, F., Maruotti, G. M., Myklestad, K., Lobmaier, S. M., Prefumo, F., Klaritsch, P., Calda, P., Ebbing, C., Frusca, T., Raio, L., Visser, G. H. A., Krofta, L., Cetin, I., Ferrazzi, E., Cesari, E., Wolf, H., Lees, C. C., Brezinka, C., Casagrandi, D., Cerny, A., Dall'Asta, A., Devlieger, R., Duvekot, J., Eggebo, T. M., Fantasia, I., Ferrari, F., Fratelli, N., Ghi, T., Graupner, O., Greimel, P., Hofstaetter, C., Presti, D. L., Georg, M., Macsali, F., Marsal, K., Martinelli, P., Mylrea-Foley, B., Mullins, E., Ostermayer, E., Papageorghiou, A., Peasley, R., Ramoni, A., Sarno, L., Seikku, L., Simeone, S., Thilaganathan, B., Tiralongo, G., Valcamonico, A., Van Holsbeke, C., Vietheer, A., and HUS Gynecology and Obstetrics

Subjects
Technology, adverse outcome, umbilical-cerebral ratio, Umbilical Arteries, umbilical artery, TRUFFLE-2 Group, Fetal Development, 0302 clinical medicine, Obstetrics and gynaecology, Pregnancy, Reference Values, 3123 Gynaecology and paediatrics, Interquartile range, Birth Weight, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Fetal Growth Retardation, 030219 obstetrics & reproductive medicine, Radiological and Ultrasound Technology, Obstetrics, Radiology, Nuclear Medicine & Medical Imaging, Doppler, Obstetrics & Gynecology, Obstetrics and Gynecology, Gestational age, General Medicine, Stillbirth, 3. Good health, ddc, Europe, Fetal Weight, Pulsatile Flow, Infant, Small for Gestational Age, Female, Waist Circumference, Rheology, Life Sciences & Biomedicine, Live Birth, middle cerebral artery, neonatal, umbilicocerebral ratio, Radiology, Nuclear Medicine and Medical Imaging, Adult, medicine.medical_specialty, Birth weight, education, 610 Medicine & health, Gestational Age, Reproduktionsmedicin och gynekologi, DIAGNOSIS, Ultrasonography, Prenatal, 03 medical and health sciences, Fetus, Obstetrics, Gynecology and Reproductive Medicine, medicine, MANAGEMENT, Humans, Radiology, Nuclear Medicine and imaging, Risk factor, Obstetrics & Reproductive Medicine, Science & Technology, business.industry, CEREBROPLACENTAL RATIO, Infant, Newborn, Ultrasonography, Doppler, Acoustics, Reproductive Medicine, Relative risk, 1114 Paediatrics and Reproductive Medicine, Radiologi och bildbehandling, business
Abstract

OBJECTIVES: To explore the association between fetal umbilical and middle cerebral artery (MCA) Doppler abnormalities and outcome in late preterm pregnancies at risk of fetal growth restriction. METHODS: This was a prospective cohort study of singleton pregnancies at risk of fetal growth restriction at 32 + 0 to 36 + 6 weeks of gestation, enrolled in 33 European centers between 2017 and 2018, in which umbilical and fetal MCA Doppler velocimetry was performed. Pregnancies were considered at risk of fetal growth restriction if they had estimated fetal weight and/or abdominal circumference (AC)

Published
2020

17. Induction of left ventricular hypoplasia by occluding the foramen ovale in the fetal lamb.

Author

Schranz D., Chan Y., Graupner O., Enzensberger C., Axt-Fliedner R., Black M.J., Wong F.Y., Veldman A., Sasi A., Teoh M., Edwards A., Schranz D., Chan Y., Graupner O., Enzensberger C., Axt-Fliedner R., Black M.J., Wong F.Y., Veldman A., Sasi A., Teoh M., and Edwards A.

Abstract

Disturbed fetal haemodynamics often affects cardiac development and leads to congenital cardiac defects. Reduced left ventricular (LV) preload in the fetus may result in hypoplastic LV, mitral and aortic valve, mimicking a moderate form of hypoplastic left heart complex. We aimed to induce LV hypoplasia by occluding the foramen ovale (FO) to reduce LV preload in the fetal sheep heart, using percutaneous trans-hepatic catheterisation. Under maternal anaesthesia and ultrasound guidance, hepatic venous puncture was performed in six fetal lambs (0.7-0.75 gestation). A coronary guidewire was advanced into the fetal inferior vena cava, right and left atrium. A self-expandable stent was positioned across the FO. An Amplatzer Duct Occluder was anchored within the stent for FO occlusion. Euthanasia and post-mortem examination was performed after 3 weeks. Nine fetuses were used as age-matched controls. Morphometric measurements and cardiac histopathology were performed. Compared with controls, fetal hearts with occluded FO had smaller LV chamber, smaller mitral and aortic valves, lower LV-to-RV ratio in ventricular weight and wall volume, and lower number of LV cardiomyocyte nuclei. We conclude that fetal FO occlusion leads to a phenotype simulating LV hypoplasia. This large animal model may be useful for understanding and devising therapies for LV hypoplasia.

Published
2021

30. Fetale kardiovaskuläre Funktionsnormwerte

Author

Wildner, N, additional, Ried, C, additional, Graupner, O, additional, Ortiz, JU, additional, Kuschel, B, additional, Haller, B, additional, Oberhoffer, R, additional, Wacker-Gussmann, A, additional, and Lobmaier, S, additional

Published
2019
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32. OC26.08: Prediction for biventricular outcome in prenatally diagnosed pulmonary atresia with intact ventricular septum/critical pulmonary stenosis

Author

Wolter, A., primary, Markert, N., additional, Wolter, J., additional, Kurkevych, A., additional, Degenhardt, J., additional, Ritgen, J., additional, Stressig, R., additional, Enzensberger, C., additional, Graupner, O., additional, Götte, M., additional, Vorisek, C., additional, Khalil, M., additional, Thul, J., additional, and Axt‐Fliedner, R., additional

Published
2019
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35. EP19.23: INTERGROWTH‐21st and customised growth charts in fetuses with left heart obstruction: perinatal biometry, cerebroplacental hemodynamics and outcome

Author

Helfrich, F., primary, Graupner, O., additional, Ostermayer, E., additional, Lobmaier, S.M., additional, Ortiz, J.U., additional, Ewert, P., additional, Wacker‐Gussmann, A., additional, Haller, B., additional, Axt‐Fliedner, R., additional, Enzensberger, C., additional, Abel, K., additional, Karge, A., additional, Oberhoffer, R., additional, and Kuschel, B., additional

Published
2019
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