Geburtshilfe Und Frauenheilkunde最新文献

{"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}

{"title":"Shoulder Dystocia. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015/098, 10/2024).","authors":"Peter Jakubowski, Harald Abele, Christian Bamberg, Gerhard Bogner, Katharina Desery, Claudius Fazelnia, Julia Jückstock, Amr Sherif Hamza, Anne Heihoff-Klose, Luise Janning, Andrea Köbke, Ioannis Kyvernitakis, Wolf Lütje, Frank Reister, Anke Reitter, Sven Seeger, Peggy Seehafer, Laila Springer, Axel Valet, Stephanie Wallwiener, Nina Kimmich","doi":"10.1055/a-2490-2756","DOIUrl":"https://doi.org/10.1055/a-2490-2756","url":null,"abstract":"<p><p><b>Purpose</b> This is an official guideline of the German Society for Gynecology and Obstetrics ( <i>Deutsche Gesellschaft für Gynäkologie und Geburtshilfe</i> , DGGG), the Austrian Society for Gynecology and Obstetrics ( <i>Österreichische Gesellschaft für Gynäkologie und Geburtshilfe</i> , ÖGGG) and the Swiss Society for Gynecology and Obstetrics ( <i>Schweizerische Gesellschaft für Gynäkologie und Geburtshilfe</i> , SGGG). Shoulder dystocia is a rare but feared obstetric complication with potentially far-reaching medical consequences for mother and child. The purpose of this guideline is to standardize the processes which provide individual obstetric solutions for shoulder dystocia in accordance with current scientific knowledge and current clinical practice. The aim is also to emphasize that no matter how good the medical care, shoulder dystocia and its associated complications cannot be entirely prevented and are not fully controllable. <b>Methods</b> Representative members from different medical specialties were commissioned by the guidelines programm of the DGGG, OEGGG and SGGG to develop this S2k-guideline using a structured consensus process. <b>Recommendations</b> The guideline provides recommendations about the definition, diagnosis, epidemiology, risk factors and prevention, logistics, and measures to treat shoulder dystocia including an algorithm for action, and the associated complications, documentation requirements, debriefing, forensic aspects, education, training and simulation as well as follow-up discussions on the shoulder dystocia event.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 2","pages":"169-189"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381990","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":"Vaginal-operative Birth: Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry Number 015/023, 11/2023).","authors":"Peter Jakubowski, Harald Abele, Christian Bamberg, Gerhard Bogner, Katharina Desery, Claudius Fazelnia, Amr Sherif Hamza, Anne Heihoff-Klose, Luise Janning, Nina Kimmich, Ioannis Kyvernitakis, Wolf Lütje, Frank Reister, Anke Reitter, Sven Seeger, Peggy Seehafer, Laila Springer, Stephanie Wallwiener, Julia Jückstock","doi":"10.1055/a-2417-7833","DOIUrl":"https://doi.org/10.1055/a-2417-7833","url":null,"abstract":"<p><p><b>Purpose</b> This is an official guideline issued by the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (ÖGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The guideline aims to provide guidance and support for indication-based decisions in the context of vaginal-operative deliveries and the performance of these procedures. The intention is not to provide rigid standards for vaginal-operative deliveries but to show the range within which obstetric activities correspond to the current state of scientific knowledge and current clinical practice. <b>Methods</b> This S2k-guideline was developed based on the structured consensus of representative members from different medical professions who were commissioned by the guidelines program of the DGGG, OEGGG and SGGG. <b>Recommendations</b> The guideline provides recommendations on measures to avoid vaginal-operative births, the conditions in which these births should be carried out, the information provided to patients, the indications, contraindications, classifications, and choice of instruments, the procedure, antibiotic prophylaxis, complications, postnatal examinations, documentation and legal aspects, debriefing, and training and simulations.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 2","pages":"143-168"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382019","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":"Immunity Protection of Pregnant Employees Working in the Healthcare Sector.","authors":"Marie Seidling, Stephanie Goertzen, Klaus Schmid, Hans Drexler, Anna Wolfschmidt","doi":"10.1055/a-2462-5707","DOIUrl":"10.1055/a-2462-5707","url":null,"abstract":"<p><strong>Background: </strong>Infectious diseases during pregnancy can pose a serious health risk for mother and child. Employees with an occupational risk of infection are especially at risk. We investigated the immune status of pregnant employees working in the health service to determine the percentage of women who were adequately protected during pregnancy and the percentage of cases with a pregnancy-relevant risk.</p><p><strong>Methods: </strong>This retrospective data collection was done using the standard records of the Occupational Health Department ( <i>Betriebsärztliche Dienststelle</i> ) of Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany. The data of employees with a pregnancy reported between 1 May 2018 and 31 May 2020 were collected. This resulted in a total study population of 406 cases. We collected data on the respective occupational groups, occupational risk profile, employment bans for expectant mothers, occupational-medical consultations, and immunity status with regards to measles, mumps, rubella, varicella zoster virus, parvovirus B19, CMV, hepatitis A and B, tetanus, diphtheria, pertussis, and poliomyelitis.</p><p><strong>Results: </strong>The investigated employees had attended a mean of three previous occupational-medical consultations; 45.8% had received advice about maternity protection from the occupational physician's office. The immunity rates of the total study population at the time of their last medical consultation prior to their due date varied, depending on the respective disease, from 77.3% (mumps) to 90.9% (varicella zoster virus). 182 cases (44.8%) were prohibited from working during their further pregnancy.</p><p><strong>Conclusion: </strong>Medical advice on infection risks and immunization combined with the offer of vaccinations are decisive in determining the immune status and ensure that immunizations can be carried out in good time. To achieve full immunization before becoming pregnant, girls and women should be advised early on about preventive maternity protection measures.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 2","pages":"200-209"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382005","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":"Laparoscopic Endometriosis Surgery in Patients with Infertility: Identifying Surgical and Non-Surgical Variables Affecting Postoperative Pregnancy. Long-term Follow-up in a University Endometriosis Center.","authors":"Morva Tahmasbi Rad, Nele Graf, Dilara Akpinar-Isci, Lisa Marie Wilhelm, Sven Becker, Khayal Gasimli","doi":"10.1055/a-2460-6470","DOIUrl":"https://doi.org/10.1055/a-2460-6470","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is a disease which affects the quality of life and fertility of many young women. Choosing the right time for surgery is important for the outcome of patients. We evaluated the surgical variables affecting postoperative pregnancy rates.</p><p><strong>Method: </strong>This study is a retrospective analysis of women treated for endometriosis in Frankfurt University Hospital between 2007 and 2017. A total of 695 patients underwent laparoscopic surgery, of whom 125 patients fulfilled the inclusion criteria of wanting to have a child for more than one year. Finally, 102 patients (82%) with surgery and infertility were followed up for 70 months.</p><p><strong>Results: </strong>We found a cumulative pregnancy rate of 69.6% after 38 months in our patients. The duration of infertility before surgery had a significant effect on postoperative pregnancy rates. There was no significant difference between the different kinds of surgical techniques, but complete treatment of all visible lesions significantly increased the chance of pregnancy (hazard ratio 2.2). Repeated abdominal operations reduced the chance of postoperative pregnancy and prolonged the time to pregnancy.</p><p><strong>Conclusions: </strong>In patients with endometriosis and infertility, both laparoscopic surgery with complete resection of all visible lesions and the timing of surgery are important to achieve pregnancy. Early intervention with careful planning of the operation is critical. It is important to avoid repeated operations to achieve the best results regarding pregnancy.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 1","pages":"80-88"},"PeriodicalIF":2.4,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931018","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":"Peripartum and Perinatal Outcomes in Pregnant Women with Elevated Preconceptional Body Mass Index in a Maternity Hospital (Care Level IV).","authors":"Ulf Dammer, Christine Gall, Jutta Pretscher, Michael O Schneider, Florian Faschingbauer, Christian R Loehberg, Matthias W Beckmann, Sven Kehl","doi":"10.1055/a-2423-4541","DOIUrl":"https://doi.org/10.1055/a-2423-4541","url":null,"abstract":"<p><strong>Introduction: </strong>Preconception obesity is a risk factor for pregnancy and delivery, which is why giving birth in a perinatal center (care levels I and II) is recommended. There are currently no studies which have investigated the birth outcomes of obese patients based on the care level of the maternity hospital. This study aims to assess the effect of a higher body mass index prior to conception on maternal and fetal outcomes in a maternity hospital (care level IV).</p><p><strong>Patients and methods: </strong>A total of 5616 pregnant women who gave birth between 2016 and 2023 were investigated in this retrospective cohort study, after taking the inclusion and exclusion criteria into account. Primary outcome parameter of this study was the transfer of the neonate to a neonatal intensive care unit. Other target parameters were the need to induce labor, delivery mode, Apgar score and pH value, and the incidence of complications (shoulder dystocia, higher-degree perineal tears, or peripartum hemorrhage).</p><p><strong>Results: </strong>Overweight and obesity were associated with a higher rate of hypertensive disorders of pregnancy and gestational diabetes and were accompanied by higher rates of induction of labor and elective and secondary caesarean sections. Maternal outcome parameters such as intrapartum fever, preterm placental abruption, uterine rupture, higher-degree birth injuries and peripartum hemorrhage did not occur significantly more often in obese pregnant women. Fetal outcome parameters such as Apgar score and pH value did not differ from those reported for normal-weight pregnant women. Multivariate regression analysis showed a high risk of transfer to a neonatal intensive care unit (OR = 1.97; p = 0.035) for neonates born to women in obesity class II (BMI 35-39.9 kg/m ² ), women with gestational diabetes (OR = 1.71; p = 0.033), and nulliparous women (OR = 1.59; p = 0.005).</p><p><strong>Conclusion: </strong>Obesity class II is associated with a slightly higher risk of transfer of the neonate to a pediatric intensive care unit but is not associated with worse Apgar scores or pH values. Pregnant women with a body mass index between 35 and 40 kg/m ² should be informed of this and should consider giving birth in a facility with a neonatal department (care level I-III).</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 1","pages":"36-46"},"PeriodicalIF":2.4,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931022","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":"Do the Antenatal Care and Perinatal Outcomes of Women with a Vietnamese Migration Background Differ from Those of Other Women?: A Retrospective Analysis.","authors":"Lisa Antonia Lorenz-Meyer, Clara Sziborra, Wolfgang Henrich, Matthias David","doi":"10.1055/a-2446-6504","DOIUrl":"https://doi.org/10.1055/a-2446-6504","url":null,"abstract":"<p><strong>Introduction: </strong>In Germany, 0.25% of the total population are persons with a Vietnamese migration background. There are almost no studies on this particular group of immigrants. We compared the perinatal data of women with a Vietnamese migration background with the pregnancy outcomes of non-Vietnamese women also living in Germany.</p><p><strong>Methods: </strong>After using name analysis to allocate women into different groups, the perinatal data of women with a Vietnamese migration background who gave birth between 1.1.2016 and 31.12.2019 in Campus Charité Mitte in Berlin were retrospectively evaluated. These data were compared in a 3:1 ratio with the data of women of non-Vietnamese origin and the same age and parity. Multivariate regression analysis was used to determine factors which influenced caesarean section rates, the transfer rates of neonates to the neonatal department, and the rates of higher degree perineal tears.</p><p><strong>Results: </strong>The perinatal data of 470 women with a Vietnamese migration background, 209 (44.5%) of whom were registered as living in a refugee shelter, were compared with those of 1410 controls. An \"ideal pregnancy outcome,\" which included giving birth after 37 + 0 weeks of gestation, a 5-minute Apgar score ≥ 8, arterial cord blood pH ≥ 7.20, no transfer of the newborn to the neonatal department, and spontaneous birth or vacuum extraction without a higher degree perineal tear, was recorded for 44.5% of women with and 38.1% of women without a Vietnamese migration background (p = 0.1), despite the lower attendance rates at antenatal screening appointments of Vietnamese women. Accommodation in a shelter for refugees was a protective factor against caesarean section (OR 0.5, 95% CI: 0.36-0.73) and transfer of the newborn to the neonatal department (OR 0.45, 95% CI: 0.23-0.89). A Vietnamese migration background was a risk factor for a third-degree perineal tear (OR 5.4, 95% CI: 1.4-21.30).</p><p><strong>Conclusion: </strong>Despite lower levels of antenatal care, women with a Vietnamese migration background did not have poorer pregnancy outcomes.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 1","pages":"56-68"},"PeriodicalIF":2.4,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930979","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":"Current Developments from Silicon Valley - How Artificial Intelligence is Changing Gynecology and Obstetrics.","authors":"Sebastian Griewing, Niklas Gremke, Uwe Wagner, Markus Wallwiener, Sebastian Kuhn","doi":"10.1055/a-2335-6122","DOIUrl":"10.1055/a-2335-6122","url":null,"abstract":"<p><p>Artificial intelligence (AI) has become an omnipresent topic in the media. Lively discussions are being held on how AI could revolutionize the global healthcare landscape. The development of innovative AI models, including in the medical sector, is increasingly dominated by large high-tech companies. As a global technology epicenter, Silicon Valley hosts many of these technological giants which are muscling their way into healthcare provision with their advanced technologies. The annual conference of the American College of Obstetrics and Gynecology (ACOG) was held in San Francisco from 17 - 19 May 2024. ACOG celebrated its AI premier, hosting two sessions on current AI topics in gynecology at their annual conference. This paper provides an overview of the topics discussed and permits an insight into the thinking in Silicon Valley, showing how technology companies grow and fail there and examining how our American colleagues perceive increased integration of AI in gynecological and obstetric care. In addition to the classification of various, currently popular AI terms, the article also presents three areas where artificial intelligence is being used in gynecology and looks at the current developmental status in the context of existing obstacles to implementation and the current digitalization status of the German healthcare system.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 12","pages":"1118-1125"},"PeriodicalIF":2.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794591","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":"Effects of Systematically Guided vs. Self-Directed Laparoscopic Box Training on Learning Performances: An Observational Study.","authors":"Melissa Neubacher, Dogus Darici, Natalia Krawczyk, Max Arslan, Maximilian Pruss, Tanja Fehm, Ines Beyer","doi":"10.1055/a-2415-5929","DOIUrl":"10.1055/a-2415-5929","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive surgery is increasing in all fields of surgery. It is currently unknown whether structured training is superior to self-directed training. The aim of this study is to analyze the enhancement of surgical skills in laparoscopy box trainers in a systematically guided training program compared to self-directed training.</p><p><strong>Material and methods: </strong>Two groups of 40 medical students were included in the study between 04/2021 and 01/2023. Each training session on the laparoscopic box trainer (Medishield BV, NL) was automatically protocolled, including time, force, and path length. The structured group consisted of 21 students working in peer tandem, while the self-directed group consisted of 19 last-year students in their four-month elective. The observational study was conducted in an ecological study design.</p><p><strong>Results: </strong>The self-directed cohort completed an average of 15 training sessions compared to the structured cohort's 10 sessions. All participants in both groups improved in time, path length, and force. The structured cohort showed nearly linear improvement, while the self-directed cohort had high deviation in results.</p><p><strong>Conclusion: </strong>Supervision and collaborative work positively influence laparoscopic training success. Mere availability of training does not exploit the potential of laparoscopic box trainers. Curriculums for young surgeons or medical students should include institutionalized training with a structured schedule and a training partner for improved outcomes.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 12","pages":"1135-1142"},"PeriodicalIF":2.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794593","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}