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CONTENT 1. INTRODUCTION 7 2. PATIENTS AND METHODS 8 2.1. Patients 8 2.2. Control Group 8 2.3. Study Methods 9 2.4. Treatment of Patients 9 2.5. Outcome State 10 2.6. Statistical Data Analysis 10 3. RESULTS 10 3.1. Clinical Manifestations of Cerebral Arteriovenous Malformations 10 3.2. Consciousness according to Glasgow Coma Scale 10 3.3. Distribution of Patients According to Spetzler-Martin Classification 11 3.4. Localization of Cerebral Arteriovenous Malformations 11 3.5. The Localization of Intracranial Haemorrhages after the Rupture of Cerebral Arteriovenous Malformations 11 3.6. Distribution of Patients with Intracerebral Haemorrhages after the Ruptures of Cerebral Arteriovenous Malformations and without Haemorrhages according to Spetzler-Martin classification 12 3.7. The Relationships between Haemorrhagic Manifestation and Size of Cerebral Arteriovenous Malformations 13 3.8. Transcranial Doppler Sonography Sensitivity and Specificity in Patients with Cerebral Arteriovenous Malformations 13 3.9. Cerebral Haemodynamics in Patients with Cerebral Arteriovenous Malformations and Healthy Controls 15 3.10. Cerebral Haemodynamics Changes in Patients with Cerebral Arteriovenous Malformations before and after the Surgery 16 3.11. Transcranial Doppler evaluation of Different Localizations Cerebral Arteriovenous Malformations 18 3.12. Cerebral Haemodynamics in Patients with Intracerebral Haematomas after Ruptures of Cerebral Arteriovenous Malformations 19 3.13. Cerebral... [to full text]

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O tratamento das fraturas de mandíbulas edêntulas é motivo de controvérsias na literatura e um dos fatores que tornam seu tratamento complexo é o suprimento sanguíneo reduzido. Nesse contexto, o ultra-som Doppler consiste em exame nãoinvasivo o qual pode ser utilizado na análise de alterações da vascularização de diversos segmentos corpóreos e influenciar decisões clínicas. Este trabalho teve como objetivo avaliar a vascularização mandibular de pacientes edêntulos que foram submetidos a tratamento de fratura de mandíbula (grupo experimental), por meio de ultra-som doppler colorido. Possíveis correlações entre os dados clínicos, radiográficos e a vascularização mandibular foram analisadas. O fluxo arterial de vasos, como carótida externa, maxilar, facial, mentual, submentual e sublingual, após o tratamento, foi comparado ao fluxo arterial dos mesmos vasos em um grupo controle composto por pacientes edêntulos livres de fratura. Com o emprego do transdutor linear, de maneira extra-oral, foram obtidos velocidade pico-sistólica (VPS), velocidade diastólica final (VDF), índice de resistência (IR), índice de pulsatilidade (IP) e aceleração, de cada artéria. Além disso, foram obtidos detalhes do tratamento por meio de avaliação clínica e radiográfica, assim como da avaliação dos prontuários. Houve diferenças estatisticamente significantes para os valores de IR da artéria mentual, IP da artéria maxilar, VPS, IP e aceleração da artéria submentual. Além disso, na pesquisa de fatores vasculares locais obstrutivos, de acordo com a artéria e os fatores estudados, houve diferenças estatisticamente significantes para o VPS, VDF e IP da artéria facial, IR da artéria sublingual, os quais apresentaram valores menores quando da presença desses fatores. Os grupos experimental e controle foram semelhantes quanto à ocorrência de variações de sentido de fluxo. Na análise das correlações entre os fatores estudados e o grau de atrofia alveolar, foram observadas diferenças estatisticamente significantes para os valores de VPS e VDF da artéria submentual, maiores no grupo não-atrófico. O exame de ultra-som doppler colorido foi capaz de demonstrar alterações em algumas artérias que suprem a mandíbula de pacientes edêntulos submetidos a tratamento de fratura, havendo poucas correlações com o grau de atrofia alveolar. / The treatment of edentulous mandibular fractures is motive of controversies in literature and one of the factors that make this treatment complex is the reduced blood supply. In this context, the doppler ultrasound is a non-invasive method that can be used in the analysis of changes in the vascularization of several corporeous segments and influence clinical decisions. The purpose of this study is to assess the vascular supply of edentulous patients, that have been treated of mandibluar fracture (experimental group), using the colored Doppler ultrasound. Possible correlations between the alveolar atrophy degree and the mandibular blood supply were analyzed. The arterial flow of vessels like external carotid, maxilar, facial, mentual, submentual and sublingual, after treatment, was compared with the arterial flow of the same vessels in a control group, consisting of edentulous fracture-free patients. With the use of linear probe extra-orally, the systolic-peak maximum velocity (SPV), final diastolic velocity (FDV), resistive index (RI), pulsatility index (PI) and acceleration of each artery, was obtained. Also, treatment details were obtained through clinical, radiological investigations, and hospital notes assessments. There was significant statistic differences to the values mentual artery RI, maxilar artery PI, submentual artery SPV, PI and acceleration. Also, in the analysis of the presence of obstructive vascular local factors, according to the artery and studied factors, statistically significant differences were observed to facial artery SPV, FDV and PI, sublingual artery RI, that present lower values when these factors were present. The experimental and control groups were similar in respect to variations in flow direction occurrence. In the analysis of the correlations between the studied factors and alveolar atrophy degree, statistically significant differences were observed to the submentual artery SPV and FDV, higher in non-atrophic group. The color doppler sonography was able to show changes in some arteries that supply the mandible of edentulous patients submitted to fracture treatment, with few correlations with the alveolar atrophy degree.

Zunächst wurden mit Hilfe eines neuen Injektionssystems die Vorteile der Bolusgabe und der kontinuierlichen Applikation d-galaktosehaltiger Ultraschallsignalverstärker kombiniert und an einem klein- (Æ 0,86mm) und einem großlumigen (Æ 16 mm) Gefäßmodell die optimale Basis- und Bolusflußratenkombination für die Powerdopplersonographie evaluiert. Der Powerdopplersignalintensitätsverlauf verschiedener Infusionsprotokolle wurde subjektiv von drei Beobachtern einer sechsstufigen Skala zugeordnet. Objektive Intensitätsmeßdaten wurden mit einer CW-Dopplersonde und einem Computersystem gewonnen. Die 1 ml/min.-Basisinfusionsrate kam dem Optimalzustand am nächsten (Großlumenmodell: 70 %, Kleinlumenmodell: 100 % Grad-4-Plateau trotz geringer Standardabweichung der mittleren Spektraldopplerverstärkungsmeßwerte im Plateaubereich). Sie ermöglichte eine annähernd optimale Gefäßdarstellung mit ausreichendem Spielraum für mehrfache, optisch gut wahrnehmbare Bolusgaben (Optimalbolus: 300mg/ml, 2 ml/s, 1 s Injektionsdauer). Diese Ergebnisse lassen eine medizinische und ökonomische Optimierung des Signalverstärkereinsatzes in der Powerdopplersonographie erwarten. Anhand von tierexperimentellen Untersuchungen wurde die Zuverlässigkeit der nativen und der signalverstärkten Farbdopplersonographie bei der Visualisierung der intratumorösen Angioneogenese im Vergleich zur histologischen Vaskularisationsquantifizierung evaluiert. Zu diesem Zweck wurden Melanomzellen des Typs B16-F1 Mäusen intra- bzw. subkutan imjiziert und nach einer Wachstumsperiode in 54 Fällen sonographisch im B-Modus bezüglich Größe, Homogenität, Echogenität und Grenzechoschärfe und in der Farbdopplersonographie bezüglich intratumorös erkennbarer Gefäßzahl, Gefäßarchtektur und Gefäßanteil an der Tumorquerschnittsfläche (= percentage vessel area, PVA) analysiert. Die anschließende histologische Aufarbeitung erbrachte Vergleichsdaten hinsichtlich Größe, Nekrotisierung und Vaskularisation der Tumoren. Es fand sich eine signifikante Korrelation (p < 0,01) zwischen den makroskopisch und den sonographisch ermittelten Tumordurchmessern, jedoch zwischen Histologie und Sonographie bezüglich sonographisch erkannter Nekrosen nur, wenn diese mehr als 40 % des Tumors erfaßten. Nach Signalverstärkerapplikation stiegen die sonographisch erkennbare Tumorgefäßzahl, -architektur und die PVA signifikant an (p < 0,01), letztere bei den intrakutanen Tumoren um 483 % und bei den subkutanen um 373 %. Der histologische Vaskularisationsgrad korrelierte am stärksten (r = 0,686) von allen Farbdopplerparametern mit der signalverstärkten PVA (p < 0,01). Somit trug die Signalverstärkergabe zur Verbesserung der Korrelation der Ergebnisse der sonographischen und histologischen Vaskularisations- und Angioneogenesebeurteilung bei. Im klinisch-experimentellen Teil wurde prospektiv bei 83 malignitätssuspekten, kutan oder subkutan lokalisierten Raumforderungen unterschiedlichen, meist epithelialen Ursprungsgewebes mittels nativer und signalverstärkter Farbduplexsonographie eine Dignitätseinschätzung vorgenommen. Als Einstufungskriterien wurden diverse B-Modus- und Farbdopplerkriterien, u.a. intratumorös erkennbare Gefäßzahl und PVA, verwendet. Die Diagnosesicherung erfolgte durch Histologie oder Verlaufskontrolle. Während weder die B-Modus-Kriterien noch die Dopplerspektralanalyse für die Dignitätseinschätzung geeignet erschienen, trugen die Farbdopplerparameter und besonders die PVA nach Signalverstärkergabe zur Dignitätsbestimmung bei, wobei die erkennbare Gefäßzahl nach Signalverstärkergabe signifikant (p < 0,01) zunahm. Als ungeeignet erwiesen sich diese Kriterien jedoch bei entzündlichen und angiomatösen Raumforderungen und epithelialen Rezidivtumoren. Insgesamt liefert die signalverstärkte Farbdopplersonographie wesentliche zusätzliche Informationen bezüglich Angioneogenese und Dignität von Raumforderungen der Haut und ihrer Anhangsgebilde, insbesondere die signalverstärkte semiquantitative Vaskularisationsanalyse. Sie ist der B-Modus-Sonographie und der Spektraldoppleranalyse überlegen. Die Signalverstärkergabe führt zu einer deutlichen Sensitivitätserhöhung. / A new injection system combines the advantages of bolus and of continuous application of ultrasound contrast agents. This study evaluated the optimal combination of basic and bolus flow rates in power Doppler sonography using two different types of vitro vessel models. The flow of an in vitro circulation model consisting of a wide or small lumen vessels was visualized by power Doppler ultrasound. The intensity of colour Doppler signal was assessed subjectively by three observers using a six step scale (optimal: degree 5). The objective signal intensity was measured by a CW-Doppler probe and a computed sytem. Using a basic flow rate of 1 ml/min., approximately optimal results were reached. This basic flow rate enabled an almost optimal visualization of the vessel lumen with sufficient free range for repeated, well visible bolus injections. Thus, the use of the new injection system combining bolus and continous injection of contrast agent improves medical and economic use of signal enhancing agents in power Doppler sonography. The aim of the next study was to evaluate the reliability of plain and enhanced colour Doppler sonography in visualization of intratumoral vascularization as a sign of malignant angioneogenesis. Therefore, malignant melanomas of the histological type B16-F1 which had been implanted in mice were examined by sonography. The majority of these tumours was localized intracutaneously, the minority subcutaneously. Various B-mode aspects, colour Doppler criteria, and spectral Doppler parameter were evaluated before and after i.v.-application of an ultrasound signal enhancer. After sonographic examination, all tumors were analyzed histologically with semiquantitative grading of tumoral vascularization. Despite the higher mean volume of the subcutaneous tumours, the percentage of tumors with visible intratumoral vessels was not higher than in intracutaneous tumors on plain images. Enhanced, the sonographical vascularization of subcutaneous tumors seemed to be superior to this of the intracutaneous. The signal enhanced mode was definitely superior to plain Doppler in showing the intratumoral vessels as a sign of angioneogenesis. The intratumoral vascular structure could be sufficiently analyzed the minority of all tumors by plain Doppler, but in more than 90 % after application of the signal enhancing agent. Intracutaneous tumors had a more compact vascular structure than subcutaneous. Despite the missing direct correlation between the sonographically and the histologically determined degree of tumour vascularization the correlation was improved after application of the signal enhancer. Only the enhanced colour Doppler sonography provides valuable noninvasive information about angioneogenetic hypervascularization in experimental melanomas. The third study evaluated colour Doppler criteria to differentiate between malignant and benign skin tumors determining the extent of the intratumorous vascularization. The B-mode sonomorphology and the extent of the vascularization in color Doppler of clinically potentially malignant tumours of the cutaneous and subcutaneous structures were analyzed and quantified by different methods. After application of the signal enhancing agent, counting the intratumoral vessels visible on one ultrasound slice led to the highest sensitivity of all used criteria but the specificity was poor. The highest specificity and diagnostic accuracy of all used criteria were obtained using the criterion "percentage vessel area > 5,0 %" after excluding all inflamed lesions by clinical aspects. Plain colour Doppler increased the specificity but the sensitivity decreased to a not acceptable level. The analysis of the B-mode morphology and spectral Doppler parameter of intratumoral vessels did not contribute to differential diagnosis. Signal enhanced colour Doppler sonography is a valuable tool in pretherapeutic assessment of cutaneous lesions. This method can be relevant for therapy and prognosis. The application of the signal enhancing agent increases significantly (p < 0.01) the sensitivity. This method is not useful in assessing benignity or malignancy of inflamed lesions and angiomas.

Demencija yra vienas iš dažniausiai sutinkamų psichikos sutrikimų vyresniame amžiuje. Pastebėta, kad dalis vyresnio amžiaus pacientų, kuriems vėliau išsivysto demencija, dažniau nei bendraamžiai skundžiasi pažinimo sutrikimais, tačiau kasdieninė veikla yra nesutrikusi. Ši būklė buvo pavadinta lengvu kognityviniu sutrikimu (LKS). Neurosonografiniai tyrimai pateikia daug naudingos informacijos apie funkcinius galvos ir kaklo kraujagyslių parametrus. Tyrimo tikslas buvo nustatyti neurosonografinių galvos ir kaklo arterijų parametrų vertę prognozuojant demenciją lengvu kognityviniu sutrikimu sergantiems pacientams. Tyrimo uždaviniai: 1) ištirti LKS turinčių pacientų demografines ir klinikines charakteristikas ir įvertinti jų ir progresavimo į demenciją ryšį; 2) ištirti LKS turinčių pacientų ekstrakranijinės kraujotakos parametrus ir įvertinti jų ir progresavimo į demenciją ryšį; 3) ištirti LKS turinčių pacientų intrakranijinės kraujotakos parametrus ir įvertinti jų ir pogresavimo į demenciją ryšį; 4) ištirti LKS turinčių pacientų miego arterijų sienelių parametrus ir įvertinti jų ir pogresavimo į demenciją ryšį; 5) ištirti LKS turinčių pacientų miego arterijų aterosklerozinius požymius ir įvertinti jų ir pogresavimo į demenciją ryšį; 6) įvertinti bendrą tiriamųjų demografinių ir klinikinių charakteristikų bei neurosonografinių parametrų diagnostinę reikšmę prognozuojant progresavimą iš lengvo kognityvinio sutrikimo į demenciją. / Dementia is one of the most commonly occurring mental disorders in older age. It was noticed that some of the elderly patients who later develop dementia, more often than contemporaries complained of cognitive impairment, but daily activities were not affected. This condition was called mild cognitive impairment (MCI). Neurosonographic studies provide a lot of useful information about the functional head and neck vascular parameters. The aim of our study was to provide more information about the significance of the extra- and intracranial arterial blood flow and carotid arterial wall parameters for prediction of dementia for patients with MCI. Objectives of the study is 1) to investigate the demographic and clinical characteristics of MCI patients and to assess their relation with progression to dementia; 2) to investigate blood flow parameters of the extracranial arteries and to assess their relation with progression to dementia; 3) to investigate blood flow parameters of the intracranial arteries and to assess their relation with progression to dementia; 4) to investigate the intima-media thickness and stiffness of carotid arteries walls and to assess their relation with progression to dementia, 5) to investigate the atherosclerotic changes and to assess their relation with progression to dementia; 6) to assess the value of demographic and clinical characteristics and neurosonographic parameters for prediction of dementia.

O tratamento das fraturas de mandíbulas edêntulas é motivo de controvérsias na literatura e um dos fatores que tornam seu tratamento complexo é o suprimento sanguíneo reduzido. Nesse contexto, o ultra-som Doppler consiste em exame nãoinvasivo o qual pode ser utilizado na análise de alterações da vascularização de diversos segmentos corpóreos e influenciar decisões clínicas. Este trabalho teve como objetivo avaliar a vascularização mandibular de pacientes edêntulos que foram submetidos a tratamento de fratura de mandíbula (grupo experimental), por meio de ultra-som doppler colorido. Possíveis correlações entre os dados clínicos, radiográficos e a vascularização mandibular foram analisadas. O fluxo arterial de vasos, como carótida externa, maxilar, facial, mentual, submentual e sublingual, após o tratamento, foi comparado ao fluxo arterial dos mesmos vasos em um grupo controle composto por pacientes edêntulos livres de fratura. Com o emprego do transdutor linear, de maneira extra-oral, foram obtidos velocidade pico-sistólica (VPS), velocidade diastólica final (VDF), índice de resistência (IR), índice de pulsatilidade (IP) e aceleração, de cada artéria. Além disso, foram obtidos detalhes do tratamento por meio de avaliação clínica e radiográfica, assim como da avaliação dos prontuários. Houve diferenças estatisticamente significantes para os valores de IR da artéria mentual, IP da artéria maxilar, VPS, IP e aceleração da artéria submentual. Além disso, na pesquisa de fatores vasculares locais obstrutivos, de acordo com a artéria e os fatores estudados, houve diferenças estatisticamente significantes para o VPS, VDF e IP da artéria facial, IR da artéria sublingual, os quais apresentaram valores menores quando da presença desses fatores. Os grupos experimental e controle foram semelhantes quanto à ocorrência de variações de sentido de fluxo. Na análise das correlações entre os fatores estudados e o grau de atrofia alveolar, foram observadas diferenças estatisticamente significantes para os valores de VPS e VDF da artéria submentual, maiores no grupo não-atrófico. O exame de ultra-som doppler colorido foi capaz de demonstrar alterações em algumas artérias que suprem a mandíbula de pacientes edêntulos submetidos a tratamento de fratura, havendo poucas correlações com o grau de atrofia alveolar. / The treatment of edentulous mandibular fractures is motive of controversies in literature and one of the factors that make this treatment complex is the reduced blood supply. In this context, the doppler ultrasound is a non-invasive method that can be used in the analysis of changes in the vascularization of several corporeous segments and influence clinical decisions. The purpose of this study is to assess the vascular supply of edentulous patients, that have been treated of mandibluar fracture (experimental group), using the colored Doppler ultrasound. Possible correlations between the alveolar atrophy degree and the mandibular blood supply were analyzed. The arterial flow of vessels like external carotid, maxilar, facial, mentual, submentual and sublingual, after treatment, was compared with the arterial flow of the same vessels in a control group, consisting of edentulous fracture-free patients. With the use of linear probe extra-orally, the systolic-peak maximum velocity (SPV), final diastolic velocity (FDV), resistive index (RI), pulsatility index (PI) and acceleration of each artery, was obtained. Also, treatment details were obtained through clinical, radiological investigations, and hospital notes assessments. There was significant statistic differences to the values mentual artery RI, maxilar artery PI, submentual artery SPV, PI and acceleration. Also, in the analysis of the presence of obstructive vascular local factors, according to the artery and studied factors, statistically significant differences were observed to facial artery SPV, FDV and PI, sublingual artery RI, that present lower values when these factors were present. The experimental and control groups were similar in respect to variations in flow direction occurrence. In the analysis of the correlations between the studied factors and alveolar atrophy degree, statistically significant differences were observed to the submentual artery SPV and FDV, higher in non-atrophic group. The color doppler sonography was able to show changes in some arteries that supply the mandible of edentulous patients submitted to fracture treatment, with few correlations with the alveolar atrophy degree.

In der vorliegenden Arbeit werden am Beispiel visuell evozierter Flussgeschwindigkeitsänderungen die Anpassung der zerebralen Hämodynamik an Änderungen der Gehirnaktivität untersucht. Dazu wurde das nichtinvasive Verfahren der transkraniellen Dopplersonographie angewendet. Ziele der Arbeit waren das Erstellen von Normwerten der Latenzen und Amplituden visuell evozierter Geschwindigkeitsänderungen an einer Gruppe von Normalprobanden sowie die Prüfung der Sensitivität der zeitlichen Auflösung dieses Verfahrens. Die Untersuchungen wurden an einer Gruppe von 20 Normalprobanden und an einer Gruppe von 16 Patienten, welche eine Leitungsverzögerung im vorderen Sehbahnbereich (nachgewiesen mit den Visuell Evozierten Potentialen anhand der P100) zeigten, vorgenommen. Die Lichtstimulation erfolgte mit einer LED-Blitzbrille und einer Stimulationszeit von jeweils 10 s "on" und "off" mit einer Frequenz von 15 Hz bei konstanter Lichtintensität. In der Kontrollgruppe ermittelten wir einen reaktiven Geschwindigkeitsanstieg von 16 %. Der Anstieg der Flussgeschwindigkeit erfolgte nach 1,4 s bzw. nach 1 s bei Flussantworten, die gleich mit einem Anstieg der Geschwindigkeit begannen. Das initiale Maximum wurde nach 5,6 s erreicht, 2,9 s nach Stimulationsende begann die Geschwindigkeit wieder abzufallen. Außer bei den Latenzwerten bis zum Anstieg ohne vorherigen Abfall der Flussgeschwindigkeit gab es keine signifikanten Unterschiede zwischen den beiden untersuchten Gruppen. Die von uns ermittelten Werte lagen in den Größenordnungen der Ergebnisse anderer Studien mit ähnlichem Versuchsaufbau. Auch die unterschiedlichen Verläufe der Flussantworten wurden bis auf das "initiale undershoot" auch von anderen Autoren beschrieben. Als Erklärung dafür diskutierten wir Aktivierungen anderer Hirnareale und eine Umverteilung des Blutflusses dorthin zu Beginn. Die zeitliche Auflösung der Dopplersonographie ist gut geeignet zeitliche Abläufe der zerebralen Hämodynamik zu untersuchen. Sie ist aber nicht sensitiv genug Leitungsverzögerungen im vorderen Sehbahnbereich zu erfassen. Die Möglichkeiten der Anwendung in der klinischen Routine liegen daher in der Untersuchung von Störungen der neurovaskulären Kopplung. / In this paper we present an investigation about the adaption of the cerebral hemodynamic to changing of the brain activation at the example of visual evoked blood flow response. Therefore we used the transcranial Doppler sonography as a noninvasive method. The aim of the work was to determine normal values of the latencies and amplitudes of visual evoked flow changing and to investigate the sensitivity of the temporal resolution of this method. We examined a group of 20 healthy volunteers and a group of 16 volunteers who had a conduction disturbance in the anterior part of the visual pathway (shown with a prolongation of the latency P100 in the visual evoked potentials). The light stimulation was performed with a LED-goggle and a stimulation time each of 10 s "on" and "off" with a frequency of 15 Hz and constant light intensity. We found a reactive increase of the flow velocity of 16% in the control group. The increase begun after a latency of 1,4 s and 1s respectively in this cases who had an increase of flow velocity at the beginning of the flow response. The initial maximum was reached after 5,6 s. Flow velocity begun to decrease 2,9 s after end of light stimulation. There were no significant differences between both groups except for the latencies with increase of flow velocity at the beginning but without initial decrease. Our values were comparable to the values of other studies with similar experimental conditions. Similar patterns of the flow response were described except of the phenomen of the "initial undershoot". We discussed activation of other areas of the brain and a distribution of blood flow there as an explanation. The time resolution of the functional Doppler sonography is suitable to investigate the time course of the cerebral hemodynamic. But it is not sensitive enough to get conduction disturbances in the anterior part of the visual pathway. The method might be used to investigate disturbances in the neurovascular coupling.

Eine Dysbalance zwischen Sauerstoffradikalen und der plasmatischen antioxidativen Kapazität sowie eine gesteigerte Aktivität der neutrophilen Granulozyten werden als mögliche pathophysiologische Faktoren der Schwangerschaftserkrankungen Präeklampsie (PE) und intrauterine Wachstumsretardierung (IUGR) diskutiert. Das Ziel der Studie war, zu prüfen, ob der plasmatische antioxidative Status und die Plasmaspiegel der neutrophilen Granulozyten Myeloperoxidase und PMN Elastase bei Schwangerschaften mit uteriner Perfusionsstörung, die ein Hochrisikokollektiv für die oben genannten Schwangerschaftskomplikationen darstellen, verändert sind. Die Messungen mit dem immundiagnostischen ELISA zur Bestimmung der antioxidativen Kapazität (ImAnOx) ergaben, dass eine signifikante Erniedrigung der Totalen Antioxidativen Kapazität im Hochrisikokollektiv vorlag. Eine Verbesserung der Risikobeurteilung war durch den ImAnOx-Test nicht möglich. Die Berechnung des Antioxidativen Quotienten durch die zusätzliche Bestimmung des Harnsäurespiegels konnte die Voraussage nicht verbessern. Zur inflammatorischen Komponente mit Hilfe der Enzymspiegelmessungen zeigten die Ergebnisse weder einen Zusammenhang mit der uterinen Perfusionsstörung noch verbesserten sie die Einschätzung des Risikos. Anhand der Ergebnisse wird deutlich, dass mit der uterinen Dopplersonographie insbesondere für das fetale Geburtsgewicht eine Kalkulation möglich ist.