Einsatz von Nabelschnur-Doppler bei vorzeitiger Plazentalösung: zwei klinische Fallberichte

BACKGROUND: Umbilical artery Doppler measurement is an established method of estimating fetal wellbeing in high risk pregnancies. The usefulness of umbilical artery waveforms in an emergency situation such as placental abruption is controversial and poorly documented. CASE REPORTS: We report on two patients, who were referred to our obstetrics department with vaginal bleeding at 31 + 2 weeks and 34 + 3 weeks of gestation. No clinical or ultrasonographic signs of placental abruption could be detected. In both patients umbilical artery blood flow measurements were normal during several examinations. Abnormal cardiotocography and fetal growth restriction in one case hinted at the first signs of fetal asphyxia. Two asphyctic infants were delivered by caesarean section. The final histological examination showed retroplacental clots, confirming the diagnosis of placental abruption. CONCLUSION: In these two cases, in which pregnancies were complicated by early placental abruption, we found that measuring umbilical artery Doppler waveforms does not provide additional information for the diagnosis of placental abruption.