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Frauenheilkunde up2date 2010; 4(3): 163-178
DOI: 10.1055/s-0030-1247378
Geburtshilfe und Perinatalmedizin

© Georg Thieme Verlag KG Stuttgart ˙ New York

Intrauterine fetale Chirurgie

M. Tchirikov
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Publication History

Publication Date:
24 June 2010 (online)

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Kernaussagen

Die fetale Chirurgie stellt ein neues interdisziplinäres Fachgebiet dar, welches das Ziel verfolgt, die fetale und neonatale Mortalität und Morbidität zu reduzieren und die durch Malformationen verursachten Organschäden während der embryonalen und fetalen Entwicklung zu minimieren. Beispiele für Indikationen zur fetalen Chirurgie sind u. a. folgende Erkrankungen:

  • fetofetales Transfusionssyndrom in monochorialen Zwillingsschwangerschaften

  • angeborene Zwerchfellhernie mit einer Lung-to-Head (L / H) Ratio < 1

  • obstruktive Uropathie, die unbehandelt oft zu einer Niereninsuffizienz und bei Anhydramnion zur Lungenhypoplasie führt

  • große kongenitale zystische adenomatoide Malformationen der Lunge

  • sakrokokzygeales Teratom mit Hydrops fetalis

  • hypoplastisches Linksherz-Syndrom

Regelmäßiges Training des Operationsteams und eine zunehmende Verfeinerung der intrauterinen fetoskopischen Technik ermöglichen eine signifikante Verbesserung des fetalen Outcomes. Die ständige Fortentwicklung von Methoden der Diagnostik und Patientenselektion sowie der chirurgischen Techniken etablieren die intrauterine mikroinvasive fetale Chirurgie zu einem Bestandteil der therapeutischen Möglichkeiten für diese Patienten in spezialisierten Zentren.

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Univ.-Prof. Dr. med. M. Tchirikov

Klinik für Geburtshilfe und Frauenheilkunde Universitätsmedizin der Johannes Gutenberg-Universität Mainz

Langenbeckstraße 1

55131 Mainz

Email: tchirikov@uni-mainz.de