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Erschienen in: Die Gynäkologie 1/2019

05.11.2018 | Mehrlingsschwangerschaft | CME

Mehrlingsschwangerschaften

verfasst von: Prof. Dr. med. Nicole Ochsenbein-Kölble

Erschienen in: Die Gynäkologie | Ausgabe 1/2019

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Zusammenfassung

Mehrlingsschwangerschaften, ein Hochrisikokollektiv, haben in den letzten 20 Jahren aufgrund des steigenden mütterlichen Alters und des Einsatzes sterilitätsmedizinischer Maßnahmen weiter zugenommen. Das korrekte Datieren der Schwangerschaft, die Bestimmung der Anzahl Feten (ab 7 Schwangerschaftswochen [SSW]) und der Chorionizität/Amnionizität im ersten Trimester (idealerweise zwischen 8 und 10 SSW) sind Grundvoraussetzungen für die Betreuung von Mehrlingsschwangeren, die in Zusammenarbeit mit oder an einem Perinatalzentrum stattfinden sollte. Nackentransparenzmessungen (11–13 SSW) und fetale DNA-Tests sind mögliche pränatale nichtinvasive Screeningmethoden. Die Einnahme von niedrigdosierter Acetylsalicylsäure ab 12 SSW kann das Präeklampsierisiko reduzieren. Um 20 SSW sollte ein Fehlbildungsscreening angeboten werden. Eine Zervixlängenmessung bei 22–24 SSW hilft, das Frühgeburtsrisiko abzuschätzen und eine Progesterontherapie einzuleiten. Bei monochorialen Mehrlingen sind Ultraschallkontrollen ab 16 SSW mindestens alle 2 Wochen durchzuführen, bei dichorialen alle 3–4 Wochen zur Wachstumskontrolle.
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Metadaten
Titel
Mehrlingsschwangerschaften
verfasst von
Prof. Dr. med. Nicole Ochsenbein-Kölble
Publikationsdatum
05.11.2018
Verlag
Springer Medizin
Erschienen in
Die Gynäkologie / Ausgabe 1/2019
Print ISSN: 2731-7102
Elektronische ISSN: 2731-7110
DOI
https://doi.org/10.1007/s00129-018-4355-9

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