Geburtshilfe Und Frauenheilkunde最新文献

{"title":"Sarcoma of the Uterus. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015/074, June 2024).","authors":"Markus Wallwiener, Marco Johannes Battista, Eike-Christian Burandt, Wolfgang Cremer, Gerlinde Egerer, Mathias K Fehr, Markus Follmann, Paul Gass, Heidemarie Haase, Philipp Harter, Florian Heitz, Simone Hettmer, Lars-Christian Horn, Ingolf Juhasz-Böss, Karin Kast, Günther Köhler, Thomas Kröncke, Katja Lindel, Alexander Mustea, Jan Philipp Novotny, Edgar Petru, Peter Reichardt, Kerstin Rhiem, Hans-Georg Strauß, Clemens Tempfer, Falk C Thiel, Uwe Andreas Ulrich, Thomas Vogl, Dirk Vordermark, Dominik Denschlag","doi":"10.1055/a-2496-2591","DOIUrl":"10.1055/a-2496-2591","url":null,"abstract":"<p><p><b>Purpose</b> This is an official, recently updated guideline published and coordinated by the German Society of Gynecology and Obstetrics ( <i>Deutsche Gesellschaft für Gynäkologie und Geburtshilfe</i> , DGGG) together with the Austrian Society of Gynecology and Obstetrics ( <i>Österreichische Gesellschaft für Gynäkologie und Geburtshilfe</i> , OEGGG) and the Swiss Society of Gynecology and Obstetrics ( <i>Schweizerische Gesellschaft für Gynäkologie und Geburtshilfe</i> , SGGG) as part of the guidelines program. Because of their rarity and heterogeneous histopathology, uterine sarcomas are challenging in terms of their clinical management, and treatment requires a multidisciplinary approach. <b>Methods</b> This S2k guideline was first published in 2015. The update published here is again the result of a structured consensus of a representative interdisciplinary group of mandate holders and experts who carried out a selective search of the literature on uterine sarcomas. Members of the participating professional societies achieved a formal consensus on recommendations and statements after a structured consensus process. <b>Recommendations</b> Recommendations were made about the epidemiology, classification, staging of uterine sarcomas, symptoms, general diagnostic workup, general pathology and genetic predisposition for uterine sarcomas, leiomyosarcomas, endometrial stromal sarcomas (low-grade and high-grade), undifferentiated uterine sarcomas, adenosarcomas, and rhabdomyosarcoma of the uterus in children and adolescents. The guideline also discusses the follow-up of uterine sarcomas, the management of morcellated uterine sarcomas, and the information provided to patients.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 4","pages":"378-394"},"PeriodicalIF":2.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Results for the Evaluation of the Cervical Cancer Screening Carried Out in 2021 and 2022 in the Context of the Organized Cancer Screening Program (oKFE): Part 1 - Primary Screening.","authors":"Juliane Hellfritsch, Marieluise Panzer, Sebastian Wagner, Kathleen Nieschke, Martin Grohmann","doi":"10.1055/a-2502-6915","DOIUrl":"10.1055/a-2502-6915","url":null,"abstract":"<p><p>Organized cancer screening programs (oKFE) aim to detect and treat various cancers in their early stages. The German oKFE Directive has set out the requirements for evaluating the efficacy, quality, and safety of such programs. The first evaluation report on the cervical cancer screening program in Germany was published in May 2024 and covers the years 2021 and 2022. Women with statutory health insurance who are above the age of 20 and live in Germany are entitled to be screened for cervical cancer. Between the ages of 20 and 34 years, women are offered an annual cytology-based examination. From the age of 35 years and above, screening consists of a cytology examination and an HPV test (co-testing). The current evaluable data consists of pseudonymized data obtained from statutory health insurance companies and service providers as defined by the specifications of the IQTIG. The evaluation shows that around three million women between 20 and 34 years of age undergo cervical cancer screening every year, which corresponds to a response rate of 45%. As regards the co-testing carried out in women aged 35 years and above, around 2.3 million women with statutory health insurance had cytological examinations and co-testing in 2021 and 1.3 million women were similarly examined in 2022. The participation rate for this cohort cannot yet be determined as the three-year interval for persons eligible for this type of screening cannot be depicted using only two years of data. 97% of cytology smears were unremarkable. Fewer than 0.1% of smears resulted in cytological findings indicating precancerous cervical lesions or cervical malignancies. The average positive rate for HPV tests carried out as part of co-testing was 8.56%. The high-risk human papilloma viruses 16/18 were identified in 30% of cases with positive HPV tests, and the presence of these high-risk viruses increased in parallel with an increase in the severity of cytological findings. More than 30% of insured women aged between 20 and 34 years have been fully vaccinated against HPV. The limitations of this evaluation are the short observation period, some data gaps, and the not yet implemented combination of screening data with data from the cancer registries of the German federal states. It is not yet possible to make valid statements about the acceptance of the screening program and the long-term impact of this program.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 4","pages":"417-433"},"PeriodicalIF":2.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy, Childbirth and Puerperium in Women with Spinal Cord Injury: Guideline of the DGGG and DMGP (S2k-Level, AWMF Registry No. 179/002, August 2024.","authors":"Markus Schmidt, Anke Jaekel, Sue Bertschy, Ute Lange, Simone Kues, Kai Fiebag, Gesa Cohrs, Ulrich Mehnert, Doris Knorr, Marlies Onken, Amke Baum, Barbara Schilcher, Ines Kurze","doi":"10.1055/a-2490-2876","DOIUrl":"10.1055/a-2490-2876","url":null,"abstract":"<p><p>This guideline on pregnancy, childbirth and puerperium for women with spinal cord injury (SCI) presents general issues relating to the wish to have children and pregnancy in the context of SCI. The guideline was developed by the German-speaking Medical Society for Paraplegia ( <i>Deutschsprachige Medizinische Gesellschaft für Paraplegiologie</i> , DMGP) and the German Society for Gynecology and Obstetrics ( <i>Deutsche Gesellschaft für Gynäkologie und Geburtshilfe</i> , DGGG). As there were no generally available evidence-based guidelines about this complex set of problems, this new guideline aims to standardize procedures using a structured consensus-of-experts approach. The aim is to establish general interdisciplinary standards and provide practical assistance for the care and counseling of women with SCI who wish to have children/are pregnant and thereby close the identified gaps in medical care, information, interdisciplinary cooperation and research.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 3","pages":"265-281"},"PeriodicalIF":2.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Technology-Supported Ultrasound Training in Prenatal Diagnosis through an Adaptive Image Recognition Training System (AdaptUS).","authors":"Talia Sachs, Stefan Michel, Katarina Koziol, Alex Kunz, Agnes Wittek, Ricarda Neubauer, Hannah Klinkhammer, Johannes Weimer, Brigitte Strizek, Florian Recker","doi":"10.1055/a-2510-7185","DOIUrl":"10.1055/a-2510-7185","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Prenatal diagnostics, particularly ultrasound examinations, are vital for monitoring fetal development and detecting potential complications. Traditional ultrasound training often lacks adequate focus on image recognition and interpretation, which are crucial for accurate diagnostics. This study evaluates the effectiveness of the AdaptUS module, a technology-supported, adaptive learning platform designed to enhance ultrasound diagnostic skills in prenatal medicine.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective cross-sectional study was conducted with 76 medical students from the German University Hospital, divided into an intervention group (n = 37) and a control group (n = 39). The intervention group engaged with the AdaptUS module, which adjusts its content based on individual performance. More precisely, it is a learning program for ultrasound images that, while not directly adaptive to the user's skill level, can be considered adaptive in the sense that incorrectly answered images are presented again for re-interpretation. However, the images are currently shown at random and are not yet adjusted to the user's abilities, ensuring that the challenge is consistent but not tailored to skill level. It is important to note that this is not an ultrasound image software, but rather an image interpretation software designed to help users improve their diagnostic skills through repeated exposure to medical images. In contrast, the control group did not receive this training. Both groups were assessed on their ultrasound diagnostic skills at the beginning and end of the semester using a series of 16 questions, which involved interpreting images correctly rather than a standard multiple-choice format. Statistical analysis was performed to compare the pre- and post-test results within and between the groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The intervention group showed a significant improvement in their mean test scores, increasing from 70.9% to 86.0% (p &lt; 0.001), while the control group's scores decreased slightly from 62.0% to 59.0%, though this change was not statistically significant. The difference in score improvements between the intervention and control groups was statistically significant (p &lt; 0.001). The feedback from students in the intervention group was overwhelmingly positive, highlighting the system's flexibility in addressing individual learning needs and suggesting its potential for broader integration into medical curricula.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The AdaptUS training module significantly enhances ultrasound diagnostic skills, particularly in prenatal medicine, by providing a personalized learning experience that addresses the gaps in traditional training methods. The success of AdaptUS underscores the importance of integrating adaptive learning technologies into medical education to bridge the gap between theoretical knowledge and practical application. Future research should explore the long","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 3","pages":"323-332"},"PeriodicalIF":2.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Undergraduate Medical Students' Perceptions and Career Choices in Obstetrics and Gynecology.","authors":"Lina Duhm, Agnes Wittek, Ruben Plöger, Nicolas Haverkamp, Milka Marinova, Brigitte Strizek, Florian Recker","doi":"10.1055/a-2500-0078","DOIUrl":"10.1055/a-2500-0078","url":null,"abstract":"<p><strong>Introduction: </strong>There is a global shortage of obstetricians and gynecologists (OB/GYN), raising concerns about patient care and workforce sustainability. Germany faces a particularly acute shortage, exacerbated by the impending retirement of many senior consultants. This study explores the career perceptions of graduate-entry medical students at the University of Bonn, focusing on their attitudes toward a career in OB/GYN.</p><p><strong>Methods: </strong>A cohort of fifth year medical students (n = 213) participated in this study. Surveys were administered directly via QR codes at two points in the 10th semester: pre-rotation (pre-clerkship) and post-rotation, at the time of the OSCE (OSCE = objective structured clinical examination) in OB/GYN. The questionnaires assessed multiple dimensions of students' career preferences, understanding of the specialty, and the impact of clinical exposure on their perceptions. Statistical analyses, including McNemar's test, were performed to evaluate changes in students' perspectives.</p><p><strong>Results: </strong>The findings revealed that prior to clinical exposure, only 32% of students expressed interest in a career in OB/GYN. After completing the rotation, this interest remained unchanged. Notably, concerns about night shifts increased significantly post-rotation, with 75% of students citing it as a key deterrent. Furthermore, financial considerations gained importance, with 54% of students highlighting future income as a critical factor post-rotation compared to 43% pre-rotation. Despite improved understanding of OB/GYN following hands-on experience, concerns about workload and stress persisted.</p><p><strong>Discussion: </strong>While clinical exposure increased students' knowledge of OB/GYN, it did not significantly affect their interest in the specialty, likely due to concerns about work-life balance and the demanding nature of the field. The study underscores the need for reforms in OB/GYN training and practice environments to address these deterrents and improve recruitment into this essential specialty.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 3","pages":"333-343"},"PeriodicalIF":2.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Pregnancy Loss in the 1st Trimester: Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015/076; August 2024).","authors":"Matthias David, Nicolas von Ahsen, Ibrahim Alkatout, Franz Bahlmann, Peter Martin Fehr, Katharina Hancke, Ruth Hiller, Markus Hodel, Markus Hoopmann, Matthias Korell, Gwendolin Manegold-Brauer, Filiz Markfeld-Erol, Annette M Müller, Peter Oppelt, Sabine Rudnik-Schöneborn, Barbara Sonntag, Susanne Starkmuth, Axel Valet, Stephanie Wallwiener, Jan Weichert, Simone Witzel, Sven Becker","doi":"10.1055/a-2466-2778","DOIUrl":"10.1055/a-2466-2778","url":null,"abstract":"<p><p><b>Purpose</b> This guideline aims to improve and standardize the diagnostic and therapeutic approaches for different types of miscarriages, pregnancies of unclear localization, and ectopic pregnancies in the 1st trimester. <b>Methods</b> In accordance with the requirements for an S2k-guideline, this guideline was compiled following a search of the literature, and the various recommendations and statements were formally agreed upon by an interdisciplinary group of representative experts from Germany (DGGG, etc.), Austria (OEGGG) and Switzerland (SGGG) who met up several times under the aegis of the German Society for Gynecology and Obstetrics ( <i>Deutsche Gesellschaft für Gynäkologie und Geburtshilfe</i> , DGGG). <b>Recommendations</b> The guideline provides 129 recommendations on clinical, laboratory-based, ultrasonographical, pathomorphological and genetic diagnostics and describes and assesses different therapeutic options in terms of their success and complication rates and the continued fertility of the patient as well as aspects of the grieving process and coming to terms with the loss after an early loss of pregnancy.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 3","pages":"282-310"},"PeriodicalIF":2.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathologically Tumor-free Resection Margin Distance as a Surrogate Parameter in Primary Vulvar Squamous Cell Cancer: Analysis of a Large Two-Center Patient Cohort.","authors":"Eva Balog, Frederik A Stuebs, Ronald Berndt, Anna K Dietl, Carol Geppert, Arndt Hartmann, Oliver Thunich, Matthias W Beckmann, Martin C Koch","doi":"10.1055/a-2508-8628","DOIUrl":"10.1055/a-2508-8628","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the role of tumor-free margin distances and other prognostic factors, including age, lymph-node metastases, lymphatic vessel invasion, and local recurrence, on the survival of patients with vulvar squamous cell carcinoma (VSCC) undergoing primary surgical treatment.</p><p><strong>Methods: </strong>A retrospective analysis reviewed the records of 232 VSCC patients who had undergone primary radical local excision with R0 resection between 2009 and 2021 at ANregiomed Hospital Ansbach and Erlangen University Hospital (Germany). Patients, aged 18 and older with no distant metastases, were grouped by resection margin distances (1 to ≤ 3 mm, 3 to ≤ 8 mm, > 8 mm) for survival analysis using the Kaplan-Meier and log-rank tests. A Cox proportional hazards regression model incorporating multiple covariates, selected using the best-subset selection method and guided by the Akaike information criterion (AIC), was used. In the next step, we conducted a separate analysis of the patients who experienced a local recurrence.</p><p><strong>Results: </strong>The median age of the 232 patients analyzed was 69 years, with a median follow-up period of 10.5 years; 82 patients died. Survival varied significantly relative to resection margin distance (p = 0.0022), with the highest rates in the 1 to ≤ 3 mm group and the lowest in the > 8 mm group. Multivariate analysis revealed that age, lymphatic vessel invasion, and resection margin distance significantly influenced survival, with higher values associated with increased mortality. Out of 232 patients analyzed, 43 developed a local recurrence. In the group with resection margins of 1 to ≤ 3 mm, 37% of patients experienced a local recurrence. Among those with margins of 3 to ≤ 8 mm, 44% had a recurrence, while only 19% of patients with margins > 8 mm showed a local recurrence.</p><p><strong>Conclusion: </strong>The study underscored the significance of tumor-free margin distance as a surrogate marker for survival in VSCC patients. In addition to lymphatic vessel invasion as the most critical prognostic factor, tumor-free resection margin distance and age emerged as significant predictors of overall survival. The findings advocate for tailored, function-preserving surgical approaches to improve patient outcomes.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 4","pages":"443-453"},"PeriodicalIF":2.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preferred Working Time Models and Equal Opportunities in Gynecology and Obstetrics: Results of the Systematic Trinational FARBEN Survey.","authors":"Nikolas Tauber, Niklas Amann, Philipp Foessleitner, Amanda Klee, Claudia Becker, Rama Kiblawi, Martin Göpfert, Nora Kiessling, Nadja Taumberger, Evelin Beizermann, Natalia Krawczyk, Solveig Simowitsch, Barbara Schmalfeldt, Bettina Toth, Michael Müller, Martin Weiss, Elisabeth Reiser, Thomas Eggimann, Achim Rody, Maggie Banys-Paluchowski","doi":"10.1055/a-2510-7031","DOIUrl":"10.1055/a-2510-7031","url":null,"abstract":"<p><strong>Introduction: </strong>The trinational survey project conducted by the Young Forums of the German, Austrian, and Swiss Societies for Gynecology and Obstetrics aims to assess the preferences of prospective and practicing gynecologists regarding various work-time models, the compatibility of family and career, as well as parental leave.</p><p><strong>Materials and methods: </strong>Between October 2023 and May 2024, a total of 1364 participants took part in the survey. The questionnaire consisted of 62 questions covering topics such as the workplace in general, work-time models, training priorities, team compositions, and professional goals. Participation was voluntary and anonymous.</p><p><strong>Results: </strong>Of the 1364 participants, 75.3% were employed in Germany, 12.9% in Austria, and 11.8% in Switzerland. Men were significantly more likely to aspire to a chief physician position compared to women (26.5% vs. 3.6%; p < 0.001). Only 12.5% of participants overall preferred full-time employment, although 63.0% of residents worked full-time. Additionally, 65.4% of respondents stated that their workplace did not provide childcare with flexible hours. At the same time, 76.0% valued workplace-proximate childcare as an important factor in choosing an employer.</p><p><strong>Conclusions: </strong>The results highlight heterogeneous and individual needs and priorities among all (prospective) gynecologists. At a time when individuality and equality are becoming increasingly significant, it is essential to promote work environments that meet the demands and needs of all physicians. The results should therefore be critically discussed to implement potential adjustments and improvements in practice.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 3","pages":"311-322"},"PeriodicalIF":2.4,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-dose Oral Misoprostol after Cervical Ripening with a Double-balloon Catheter: 25 µg or 50 µg?","authors":"Sven Kehl, Zeynep Selen Karademir, Christel Weiss, Adriana Titzmann, Michael Schneider, Matthias W Beckmann, Simon Bader","doi":"10.1055/a-2499-7897","DOIUrl":"10.1055/a-2499-7897","url":null,"abstract":"<p><strong>Purpose: </strong>Misoprostol is used in low doses for the induction of labor. It is still not clear, however, which of the approved doses (25 µg or 50 µg) is more beneficial. The aim of this study was to investigate whether oral misoprostol at a dose of 25 µg or at a dose of 50 µg should be preferred to induce labor after cervical ripening with a double-balloon catheter.</p><p><strong>Material and methods: </strong>This retrospective cohort study analyzed full-term pregnancies (≥ 37 + 0 GW) in which sequential induction of labor was carried out using a double-balloon catheter followed by oral administration of misoprostol. The patients were divided into two groups: Group 1 received 50 µg misoprostol every four hours and Group 2 received 25 µg misoprostol every two hours. The primary target parameter was the rate of caesarean sections. Secondary target parameters included the interval from induction to delivery, the rate of spontaneous births, vaginal operative deliveries, and neonatal outcomes.</p><p><strong>Results: </strong>967 patients were included in the study: 514 in Group 1 and 453 in Group 2. There was no significant difference in the rate of caesarean sections between the two groups (p = 0.688). However, significantly more women in Group 2 had unsuccessful induction of labor, defined as a vaginal birth after 72 hours (15.8% vs. 8.1%, p = 0.001). But fewer neonates from Group 2 required transfer to the neonatal department (10.6% vs. 18.5%, p < 0.001).</p><p><strong>Conclusion: </strong>The study found no difference in the rate of caesarean sections for the different doses of misoprostol. However the rate of vaginal deliveries only occurring after 72 hours was higher in the group treated with 25 µg misoprostol, while more neonates required transfer to the neonatal department in the group receiving 50 µg misoprostol.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 2","pages":"210-218"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk for Imminent Delivery in Preeclampsia Based on the sFlt-1/PlGF Ratio: Do We Need New Cut-Offs?","authors":"Sabine Enengl, Peter Oppelt, Patrick Stelzl, Iris Scharnreitner, Reinhard Altmann, Julia Grienberger, Philipp Hermann, Helga Wagner, Marlene Rezk-Füreder, Ilinca Damian, Lena Maghörndl","doi":"10.1055/a-2497-8104","DOIUrl":"10.1055/a-2497-8104","url":null,"abstract":"<p><strong>Introduction: </strong>It is still difficult to predict the outcome of preeclampsia and determine the individual procedure with regards to the time of birth. Cut-offs of the sFlt-1/PlGF ratio with a high risk for imminent delivery have been previously published and analyzed by our study group, but could not be confirmed. The aim of the current study is to re-evaluate the described cut-off values again in a new period of time.</p><p><strong>Materials and methods: </strong>We performed a retrospective analysis (IRB 1279/2020) including all preeclampsia patients delivering in our department over a 3-year period. Patients were divided into 2 groups - gestational week 24+0-33+6 with an s-Flt1/PlGF > 655.2 and 34+0-37+0 weeks with an sFlt-1/PlGF > 201 and were compared with preeclampsia patients of the same weeks with sFlt-1/PlGF values below the described cut-offs. Correlation between sFlt-1/PlGF ratio and time to delivery was assessed.</p><p><strong>Results: </strong>The association between sFlt-1/PlGF above the threshold and delivery within 48 h is significant for the high ratio early group (p < 0.01) but not for the high ratio late group (p = 0.62). In the early group, 60% of patients with sFlt-1/PlGF > 655.2 but only 8% in the low ratio group delivered within 48 h. In both the early and the late preeclampsia group, a high number of patients remained pregnant even though they showed elevated ratios.</p><p><strong>Conclusion: </strong>High sFlt-1/PlGF ratios seem to correlate with a shorter pregnancy duration to some extent. Nevertheless, not all patients need to be delivered within 48 h, so the decision should never be based on the laboratory test alone.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 2","pages":"190-199"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}