Geburtshilfe Und Frauenheilkunde最新文献

{"title":"Sentinel Lymphonodectomy in Early Vulvar Cancer in Daily Practice: a Multicenter Experience from Germany.","authors":"Philipp Soergel, Matthias Hempel, Julia Gallwas, Christian Dannecker, Linn Woelber, Ruediger Klapdor, Peer Hantschmann, Dirk M Forner, Paul Gass, Monika Hampl","doi":"10.1055/a-2541-2191","DOIUrl":"10.1055/a-2541-2191","url":null,"abstract":"<p><strong>Objective: </strong>Inguinal sentinel lymph node dissection has been shown to be safe in early vulvar cancer in several studies and is considered or even recommended in many guidelines. The prognosis of inguinal recurrence is often poor and associated with significant mortality. To ensure an acceptably low false-negative rate and recurrence, vulvar sentinel lymph node dissection should only be performed using high-quality standards. This retrospective study aims to investigate the incidence of isolated groin recurrence in daily practice in six large cancer centers in Germany.</p><p><strong>Methods: </strong>We identified all patients with early vulvar cancer in 2009-2015 who underwent inguinal sentinel lymphonodectomy and presented with node-negative final histologic results. Patient details regarding disease stage, sentinel procedure, and follow-up were examined using local cancer databases and patient registries.</p><p><strong>Results: </strong>A total of 414 patients with available follow-up data were found, with a mean follow-up time of 38.4 months. The mean tumor size, measured in the dermal plane before surgery, was 40.0 mm, with a median tumor size of 36 mm. Isolated groin recurrence was found in 13 of 414 cases, leading to an isolated groin recurrence rate of 3.1%. The mean time to isolated groin recurrence was 17.7 months. There was no statistically significant association of any of the different quality requirements (tumor size < 4 cm, unifocal tumor, histologic ultra-staging, and preoperative exclusion of suspicious groins) with isolated groin recurrence.</p><p><strong>Conclusion: </strong>Sentinel lymphadenectomy in vulvar cancer is a safe procedure in daily practice. The requirements of the cancer guidelines (unifocal tumor, ≤ 4 cm, histologic ultrastaging, and exclusion of suspicious groins preoperatively) should be followed to ensure a low isolated groin recurrence rate. However, in this study, we could not find any difference between the patients who fulfilled the guideline requirements and those who did not.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 5","pages":"533-540"},"PeriodicalIF":2.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093318","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":"The Role of Microcirculatory Dysfunction During Paclitaxel Treatment as a Critical Co-Factor for the Development of Chemotherapy-Induced Peripheral Neuropathy.","authors":"Susanne Reuter, Rika Bajorat, Fabian Müller-Graf, Amelie R Zitzmann, Volkmar Müller, Anna-Lena Pickhardt, Daniel A Reuter, Stephan H Böhm, Brigitte Vollmar","doi":"10.1055/a-2499-9856","DOIUrl":"10.1055/a-2499-9856","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) has a lasting impact on quality of life with a high prevalence and the lack of preventive and causal treatment options. In addition, they are often dose-limiting for curative and palliative oncological therapy. The aim of this study was to systematically investigate the occurrence of paclitaxel-induced peripheral microcirculatory dysfunction and its potential impact on peripheral neuropathy using an experimental <i>in vivo</i> approach.</p><p><strong>Methods: </strong>77 female 8-week-old mice were randomly assigned into three groups. Each group was exposed to the following intraperitoneal interventions in a blinded fashion: The therapy group was treated with six cycles of paclitaxel. In the control group, mice received six cycles of saline solution. In the vehicle group, animals received six cycles of cremophor. Various microscopic, neurological and biochemical analyses were performed to assess the effects on peripheral nerve function, microcirculation and inflammation.</p><p><strong>Results: </strong>Von Frey's neurological test showed a progressive peripheral neuropathy with a significant change in the sensitivity in the sense of hypesthesia of the hind paws in mice treated with paclitaxel. Beside signs of systemic inflammation, intravital microscopic analysis showed a significant reduction in functional capillary density, increased venular leukocyte adherence and endothelial permeability in the paclitaxel-treated mice compared to the control groups. In addition, serological tests and histopathological examinations underlined the paclitaxel-induced inflammation and nerve damage as well as the disturbance of the microcirculation.</p><p><strong>Conclusion: </strong>The presented findings suggest that paclitaxel-induced microcirculatory disturbances may contribute to the development and severity of CIPN, highlighting the importance of considering microvascular and inflammatory mechanisms in the pathogenesis and management of chemotherapy-induced neuropathy.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 7","pages":"710-723"},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539843","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":"Recommendations of the AGG (Obstetrics and Prenatal Medicine Working Group, Section Maternal Diseases) on Maternal Thrombocytopenia in Pregnancy.","authors":"Ute Margaretha Schaefer-Graf, Markus Schmidt, Ulrich Sachs, Maritta Kühnert","doi":"10.1055/a-2500-0185","DOIUrl":"10.1055/a-2500-0185","url":null,"abstract":"<p><p>Thrombocytopenia is a common hematologic disorder characterized by reduced platelet count in peripheral blood. Acquired and chronic thrombocytopenia is very important in obstetrics. A decreased platelet count of 15-20% is normal in uncomplicated pregnancies; platelet count decreases continuously from 1st trimester on, however usually remains within the normal ranges of between 150 and 450 G/L. The occurrence of mild thrombocytopenia (100-149 G/L) in pregnancy is usually due to gestational thrombocytopenia and does not require further evaluation. But a differential diagnostic examination should be carried out if the platelet count drops to < 100 G/L. Other forms of thrombocytopenia may also occur or become activated in pregnancy and they require special attention. This recommendation presents the diagnostic workup, differential diagnoses, and possible consequences of different thrombocytopenia conditions in pregnancy. The recommendations are based on current international recommendations (George 2023, Bussel 2023) and a search of the literature using the search terms \"thrombocytopenia\" and \"pregnancy\".</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 10","pages":"1024-1032"},"PeriodicalIF":1.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291796","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":"Developing and Assessing an Integrated Comprehensive Obstetric Ultrasound Training Program for Undergraduate Medical Students - the Fetal Assessment in Medical Education Study (FAME study).","authors":"Julia Matschl, Ruben Plöger, Agnes Wittek, Adeline Walter, Ulrich Gembruch, Brigitte Strizek, Florian Recker","doi":"10.1055/a-2531-2707","DOIUrl":"10.1055/a-2531-2707","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of a prenatal ultrasound course for medical students, focusing on enhancing competencies in fetal sonography through the integration of theoretical knowledge and hands-on practice.</p><p><strong>Design: </strong>This was a longitudinal study conducted over the winter semester of 2023/24.</p><p><strong>Setting: </strong>Study took place in a medical education setting, with practical sessions conducted in a clinical environment and theoretical instruction.</p><p><strong>Population or sample: </strong>Twenty medical students participated in the course.</p><p><strong>Methods: </strong>The course was taught by expert faculty and included practical training with live models in real-life conditions, supplemented by online video lectures. The study used Objective Structured Clinical Examinations administered before and after the course, along with multiple-choice questionnaires following each of the six course modules, to assess learning outcomes. Learning success was measured using pre- and post-course OSCE results and MCQ scores. Statistical analysis was performed using the Wilcoxon signed-rank test for OSCE scores and the Spearman correlation test to examine relationships between MCQ results and practical skills.</p><p><strong>Main outcome measures: </strong>Primary outcomes included the change in OSCE scores and the correlation between MCQ scores and practical skills.</p><p><strong>Results: </strong>Median OSCE scores improved from 18.94% pre-course to 95.45% post-course, indicating significant enhancement in practical skills. However, no significant correlation was found between MCQ and post-course OSCE scores. Students expressed high satisfaction with the course.</p><p><strong>Conclusions: </strong>The study demonstrates effectiveness of a practice-oriented educational approach in improving medical students' competencies in fetal sonography, providing valuable insights for optimizing future medical curricula in prenatal imaging.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 9","pages":"976-986"},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992122","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 Breech Birth: Learnings from 21 Years of Retrospective Data Analysis.","authors":"Johanna Buechel, Jennifer Obermayer, Linda Hertlein, Thomas Kolben, Sven Mahner, Teresa Starrach","doi":"10.1055/a-2532-9410","DOIUrl":"10.1055/a-2532-9410","url":null,"abstract":"<p><strong>Introduction: </strong>Optimal delivery mode for vaginal breech birth at term remains controversial, with varying recommendations across international guidelines. This study aimed to evaluate common perceptions and outcomes associated with VBB using retrospective data, including benefits of cesarean section, maternal and neonatal risks.</p><p><strong>Material and methods: </strong>We conducted a monocentric, retrospective cohort study over 21 years at a German tertiary perinatal center, examining term breech deliveries. Outcomes were compared between planned cesarean section and intended vaginal breech birth, with the latter group further categorized by successful and unsuccessful vaginal breech birth attempts.</p><p><strong>Results: </strong>Of all deliveries, 3.6% (3172) were singleton breech presentations beyond 36 weeks gestation. Among these, 2501 cases (78.8%) were planned cesarean sections, while 671 cases (21.2%) were intended vaginal breech births. Within the intended vaginal breech birth group, 524 (78%) achieved vaginal delivery, whereas 147 (22%) required secondary cesarean section. Maternal outcomes showed significant differences in blood loss (p < 0.001) and hospital stay (p < 0.001), favoring the vaginal breech birth group with lower blood loss and shorter hospital stays. However, neonatal interventions, including bag-mask ventilation and resuscitation, were significantly more frequent in the vaginal breech birth group (p < 0.001), along with increased short-term neonatal morbidity such as neonatal infections (p < 0.001), transient tachypnea (p = 0.002), and hypoxic-ischemic encephalopathy (p = 0.008).</p><p><strong>Conclusion: </strong>The findings highlight an increase in intended vaginal breech births with a high rate of successful vaginal deliveries. Vaginal breech birth was associated with fewer maternal complications but elevated short-term neonatal morbidity. The results underscore the importance of individualized counseling and skilled provider presence when considering vaginal breech birth, supporting informed maternal choice and optimized delivery outcomes.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 11","pages":"1150-1168"},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12591833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145481466","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}