Konsequenzen aus intrauterin erkannter plazentarer Versorgungsstörung

The intrauterine milieu can have an impact on an individualʼs entire life. Restricted supply not only causes reduced growth, but also irreparable damage, e.g., cardiovascular or neurocognitive. Issues to be addressed by prenatal medicine include not only possible therapeutic aspects, but also the question of the optimal medical strategy, which aims to minimize damage from undersupply on the one hand and from premature birth on the other. In addition to increased perinatal mortality and morbidity, intrauterine growth restriction (IUGR) fetuses with abnormal Doppler findings in the umbilical artery show suboptimal postnatal neurological, intellectual, and vascular development. An active approach by the entire perinatological team, regardless of gestational age, can help to improve results in the case of absent or reversed end-diastolic (ARED) flow in the umbilical arteries—even in extremely premature situations—before the appearance of a pathological cardiotocogram (CTG) or changes in ductus venosus blood flow. For a good result, it is beneficial to ensure that disadvantages arising despite timely interventions are recognized as early as possible to limit their negative effects after birth and later in life. In the case of pathological findings, an obstetric approach with the sole aim of producing a surviving child is no longer an option.