Diagnostik und fetale überwachung be intrauteriner wachstumsrestriktion

Perinatal mortality as well as short-term and long-term morbidity of fetuses are markedly increased in cases of intrauterine growth restriction (IUGR) especially when this occurs as an early manifestation. The combination of different methods of fetal surveillance [cardiotocogram (non-stress-test),biophysical profile, and fetal, umbilical and uterine Doppler sonography] provides different information on the function of the physiological adaptive processes in the fetus and, therefore, allows a more exact assessment of fetal condition compared with the application of only one method. Even though the fetal condition deteriorates continuously following a relatively fixed pattern within uteroplacental dysfunction, inter-individual differences are found at each step. Furthermore, there are major differences in the value and interpretation of the different methods of fetal surveillance due to fetal physiological development and the different underlying pathological mechanisms of IUGR. The protocols of integrated fetal surveillance and management use all of the methods mentioned above in cases of IUGR; but, depending on gestational age, these must be applied and interpreted in different ways.