Geburtshilfe Und Frauenheilkunde最新文献

{"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}

{"title":"Differences between Current Clinical Practice and Evidence-Based Guideline Recommendations Regarding Tocolysis - an Austria-wide Survey.","authors":"Sabine Enengl, Werner Rath, Sven Kehl, Peter Oppelt, Andreas Mayr, Annika Stroemer, Teresa Eichinger, Julia Lastinger, Patrick Stelzl","doi":"10.1055/a-2446-1828","DOIUrl":"https://doi.org/10.1055/a-2446-1828","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the adherence of Austrian obstetricians to national guideline recommendations by investigating data on the current practice of tocolysis regarding indications, timing and monitoring of tocolysis, choice of tocolytics and serious side effects, maintenance tocolysis, support of decision-making and recommendations at patient's discharge from the hospital.</p><p><strong>Materials and methods: </strong>78 obstetric departments in Austria were invited to participate in a nationwide survey between June 5 ^th and August 31 ^st 2023 by answering a web-based questionnaire about clinical standards. The survey was conducted approximately one year after implementation of the AWMF Guideline \"Prevention and Therapy of Preterm Birth\" 015‑025. Collected data were analyzed descriptively by performing measures of frequency. Fisher's exact test was used for group comparison.</p><p><strong>Results: </strong>The response rate was 69.2% (33.3% perinatal centers, 66.7% standard care). The most important indication of tocolysis were ≥ 4 contractions within 20 minutes of CTG tracing, as stated by 26 (48.1%) of the respondents; the AWMF Guideline 015‑025 (2022) was the most important decision-making support for tocolytic treatment (61.1%). 19 (35.2%) of obstetric units started tocolysis earliest at 23 + 0 weeks of gestation. Atosiban was the first-line tocolytic drug used by 43 (79.6%) of obstetric units, followed by nifedipine (n = 7, 13.0%); 49 of 54 obstetric units (90.7%) stated to perform maintenance tocolysis, among these 46 (93.9%) not routinely but on special indications (e.g. placenta previa). Serious side effects were observed by 77.8% of the respondents, mostly associated with the use of hexoprenaline.</p><p><strong>Conclusions: </strong>Our survey revealed considerable discrepancies between evidence-based guideline recommendations and daily clinical practice in Austrian hospitals.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 1","pages":"47-55"},"PeriodicalIF":2.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931050","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":"Retrospective Evaluation of C-reactive Protein for Ruling Out Infection After Cesarean Section.","authors":"Sabine Enengl, Peter Oppelt, Richard Bernhard Mayer, Elisabeth Brandlmayr, Philip Sebastian Trautner","doi":"10.1055/a-2413-5449","DOIUrl":"https://doi.org/10.1055/a-2413-5449","url":null,"abstract":"<p><strong>Introduction: </strong>Infection after cesarean section is a major contributor to maternal morbidity. Measurement of C-reactive protein (CRP) is a laboratory test frequently conducted to rule out or confirm postoperative infection. The present study aimed to evaluate whether CRP is a suitable tool for ruling out infection after cesarean section and whether there are any reliable cut-off values.</p><p><strong>Materials and methods: </strong>2056 patients with cesarean section (CS) over a 3-year period were included in a retrospective analysis. Outcome parameters and risk factors for postoperative infection were collected. CRP values from preoperative and postoperative tests were compared. Cut-offs for ruling out infection were assessed.</p><p><strong>Results: </strong>Among 2056 CSs, postoperative infection occurred in 78 cases (3.8%). The prevalence of infection in emergency CS was lowest, at four out of 134 (2.9%), and the highest prevalence was seen in secondary CS, at 42 of 903 (4.6%; p = 0.35). CRP values in the infection group were significantly higher (preoperative, 1.01 mg/dl vs. 0.62 mg/dl; day 1 postoperative, 7.91 mg/dl vs. 6.44 mg/dl; day 4 postoperative, 8.44 mg/dl vs. 4.09 mg/dl; p = 0.01). A suitable cut-off value for ruling out infection was not identified.</p><p><strong>Conclusions: </strong>Although CRP values were significantly higher in the infection group, the clinical relevance of this appears to be negligible. CRP testing does not appear to be a reliable tool for diagnosing or ruling out postoperative infection.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 11","pages":"1066-1073"},"PeriodicalIF":2.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618261","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":"Firsttrimester Diagnosis and Therapy @ 11 - 13 ⁺⁶ Weeks of Gestation - Part 1 : Guideline of the DEGUM, ÖGUM, SGUMGG, DGGG, ÖGG, Gynecologie Suisse, DGPM, DGPGM, BVF, ACHSE (AWMF S2e LL 085-002 1.1.2024) (https://register.awmf.org/de/leitlinien/detail/085-002).","authors":"Constantin von Kaisenberg, Peter Kozlowski, Karl-Oliver Kagan, Markus Hoopmann, Kai-Sven Heling, Rabih Chaoui, Philipp Klaritsch, Barbara Pertl, Tilo Burkhardt, Sevgi Tercanli, Jochen Frenzel, Christine Mundlos","doi":"10.1055/a-2280-8772","DOIUrl":"https://doi.org/10.1055/a-2280-8772","url":null,"abstract":"<p><p>This extensive AWMF 085-002 S2e-guideline \"First Trimester Diagnosis and Therapy @ 11 - 13 ⁺⁶ of Gestation\" has systematically analyzed high-quality studies and publications and the existing evidence (evidence tables) and produced recommendations (level of recommendation, level of evidence, strength of consensus). This guideline deals with the following topics in the context of the 11 - 13 ⁺⁶ weeks scan: the legal basis, screening for anatomical malformations, screening for chromosomal defects, quality assessment and audit, screening for preeclampsia and FGR, screening for preterm birth, screening for abnormally invasive placenta (AIP) and placenta accreta spectrum (PAS), screening for velamentous cord insertion and vasa praevia, screening for diabetes mellitus and LGA. Screening for complications of pregnancy can best be carried out @ 11 - 13 ⁺⁶ weeks of gestation. The issues of how to identify malformations, chromosomal abnormalities and certain disorders of placentation (high blood pressure and proteinuria, intrauterine growth retardation) have been solved. The problem of how to identify placenta percreta and vasa previa has been partially solved. What is still unsolved is how to identify disorders of glucose metabolism and preterm birth. In the first trimester, solutions to some of these problems are available: parents can be given extensive counselling and the risk that a pregnancy complication will manifest at a later stage can be delayed and reduced. This means that screening is critically important as it helps in decision-making about the best way to manage pregnancy complications (prevention and intervals between follow-up examinations). If no treatment is available and if a termination of pregnancy is considered, the intervention can be carried out with far lower complications compared to the second trimester of pregnancy. In most cases, further examinations are not required and the parents can be reassured. A repeat examination at around week 20 of gestation to complete the screening for malformations is recommended. <b>Note:</b> The guideline will be published simultaneously in the official journals of both professional societies (i.e. Ultraschall in der Medizin/European Journal of Ultrasound for the DEGUM and Geburtshilfe und Frauenheilkunde for the DGGG).</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 10","pages":"928-941"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364991","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":"Structural Requirements for the Outpatient Treatment of Benign Diseases of the Uterus.","authors":"Cosima Brucker, Thomas Dimpfl, Anton Scharl","doi":"10.1055/a-2376-9748","DOIUrl":"10.1055/a-2376-9748","url":null,"abstract":"<p><p>In many cases, outpatient surgical treatment of benign diseases of the uterus has advantages over inpatient care. This has been demonstrated by the healthcare situation in other countries. However, the prerequisite for the provision of outpatient services is that this does not lead to any impairment in the quality of care or of patient safety. The ultimate goal should not be to reduce costs but rather to maintain and, ideally, improve the quality of care. This requires that services are not just defined by the surgical procedure but also by the entire treatment chain, including, for example, psychosocial support, and are remunerated accordingly. It is particularly worrying that the final decision as to whether an outpatient operation is possible is not the responsibility of the operating unit, but of the \"Medizinischer Dienst,\" with the corresponding options and threats of sanctions. This situation is unique internationally and requires a paradigm shift. Furthermore, structural prerequisites must be maintained which currently only exist inadequately in Germany. Since a substantial proportion of planned outpatient operations require immediate or secondary inpatient treatment, there must be a barrier-free transition between the outpatient and inpatient sectors. This will require the creation of networks between outpatient service providers and one or more hospitals that are equipped and competent to manage even complex complications. It is important to create structures that, with intensive involvement of the operating unit, include adequate preoperative evaluation and patient education as well as needs-oriented postoperative care at home. The current separation of sectors is a significant hinderance. Moreover, when expanding and promoting outpatient surgery, the aspect of training and further education of specialist staff must be taken into account, as well as cross-sectoral quality assurance. Based on a review of the international literature, this article presents 13 recommendations for adequate structures when providing outpatient services which should serve as a prerequisite for the greatest possible guarantee of patient safety.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 10","pages":"920-927"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364996","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":"Firsttrimester Diagnosis and Therapy @ 11 - 13 ⁺⁶ Weeks of Gestation - Part 2 : Guideline of the DEGUM, ÖGUM, SGUMGG, DGGG, ÖGG, Gynecologie Suisse, DGPM, DGPGM, BVF, ACHSE (AWMF S2e LL 085-002 1.1.2024) (https://register.awmf.org/de/leitlinien/detail/085-002).","authors":"Constantin von Kaisenberg, Peter Kozlowski, Karl-Oliver Kagan, Markus Hoopmann, Kai-Sven Heling, Rabih Chaoui, Philipp Klaritsch, Barbara Pertl, Tilo Burkhardt, Sevgi Tercanli, Jochen Frenzel, Christine Mundlos","doi":"10.1055/a-2280-8852","DOIUrl":"https://doi.org/10.1055/a-2280-8852","url":null,"abstract":"<p><p>This extensive AWMF 085-002 S2e-guideline \"First Trimester Diagnosis and Therapy @ 11 - 13 ⁺⁶ Weeks of Gestation\" has systematically analyzed high-quality studies and publications and the existing evidence (evidence tables) and produced recommendations (level of recommendation, level of evidence, strength of consensus). This guideline deals with the following topics in the context of the 11 - 13 ⁺⁶ weeks scan: the legal basis, screening for anatomical malformations, screening for chromosomal defects, quality assessment and audit, screening for preeclampsia and FGR, screening for preterm birth, screening for abnormally invasive placenta (AIP) and placenta accreta spectrum (PAS), screening for velamentous cord insertion and vasa praevia, screening for diabetes mellitus and LGA. Screening for complications of pregnancy can best be carried out @ 11 - 13 ⁺⁶ weeks of gestation. The issues of how to identify malformations, chromosomal abnormalities and certain disorders of placentation (high blood pressure and proteinuria, intrauterine growth retardation) have been solved. The problem of how to identify placenta percreta and vasa previa has been partially solved. What is still unsolved is how to identify disorders of glucose metabolism and preterm birth. In the first trimester, solutions to some of these problems are available: parents can be given extensive counselling and the risk that a pregnancy complication will manifest at a later stage can be delayed and reduced. This means that screening is critically important as it helps in decision-making about the best way to manage pregnancy complications (prevention and intervals between follow-up examinations). If no treatment is available and if a termination of pregnancy is considered, the intervention can be carried out with far lower complications compared to the second trimester of pregnancy. In most cases, further examinations are not required and the parents can be reassured. A repeat examination at around week 20 of gestation to complete the screening for malformations is recommended. <b>Note:</b> The guideline will be published simultaneously in the official journals of both professional societies (i.e. Ultraschall in der Medizin/European Journal of Ultrasound for the DEGUM and Geburtshilfe und Frauenheilkunde for the DGGG).</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 10","pages":"943-960"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364992","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":"Guideline Program.","authors":"","doi":"10.1055/a-2333-6543","DOIUrl":"https://doi.org/10.1055/a-2333-6543","url":null,"abstract":"","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 10","pages":"961"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364994","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 Progesterone on Vasomotor Symptoms in Postmenopausal Women (PROGEST) - a Prospective Multi-Center Randomized Double-Blind Placebo-Controlled Trial (RDPCT).","authors":"Sissi Valentina Beinert, Frauke Kleinsorge, Julia Worm, Katharina Victoria Tropschuh, Vanadin Seifert-Klauss","doi":"10.1055/a-2322-0967","DOIUrl":"10.1055/a-2322-0967","url":null,"abstract":"<p><p><b>Introduction</b> Monotherapy with progesterone for treatment of vasomotor symptoms (VMS) was more effective than placebo treatment of postmenopausal healthy women in a Canadian trial. The PROGEST-trial was initiated to fulfill FDA-approval criteria for the indication of treatment of postmenopausal VMS. <b>Methods</b> This prospective randomized, double-blind placebo-controlled clinical trial studied three doses of oral micronized progesterone (200 mg, 300 mg, 400 mg) and placebo for 12 weeks. Postmenopausal women with moderate to severe VMS (> 50 per week) were screened for one week for VMS frequency, then randomized to 200, 300 or 400 mg progesterone daily or placebo for a double-blinded trial of 12 weeks duration. <b>Results</b> 74 women were recruited in 12 study centers. 44 terminated the study as per protocol (PP). Moderate to severe hot flushes decreased by 7.4/d in the placebo arm, 7.7 VMS/d with 200 mg/d progesterone (P4), 8.3 VMS/d on 300 mg/d and 9.0 VMS/d on 400 mg/d P4, respectively by week 12. 32 treatment emergent adverse events were documented in 18 participants, mostly minor AEs. The only SAE was a syncope requiring hospitalization on the day after treatment initiation, leading to discontinuation of the drug. <b>Discussion</b> Baseline VMS frequency was much higher in the German than in the Canadian study and the course of the placebo group had a markedly stronger decrease in VMS-frequency during the PROGEST study (-7.4/d) than in the Canadian trial (-1.4/d). Trial populations differed by age, BMI, the number of women with natural menopause, and comorbidities, mainly hypertension. <b>Conclusion</b> Premature discontinuation of the trial due to insufficient subject accrual rate led to only 55 randomized participants for analysis, therefore the study results lack statistical power. Still, a slight dose-dependent improvement in VMS was seen for all doses, while AE frequency did not increase with progesterone dose.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 10","pages":"969-978"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364989","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":"Guideline Program.","authors":"","doi":"10.1055/a-2333-6447","DOIUrl":"https://doi.org/10.1055/a-2333-6447","url":null,"abstract":"","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 10","pages":"942"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364993","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 Transabdominal Needle-free Emergency Cerclage in the Early Second Trimester of Pregnancy after Failed Transvaginal Cerclage: Two Case Reports and a Review of the Literature.","authors":"Davut Dayan, Marinus Schmid, Florian K Ebner, Wolfgang Janni, Frank Reister, Beate Hüner, Krisztian Lato, Ulrike Friebe-Hoffmann, Stefan Lukac","doi":"10.1055/a-2373-0639","DOIUrl":"10.1055/a-2373-0639","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to describe the preventive option and safety of laparoscopic transabdominal emergency cerclage in pregnant women with advanced cervical shortening after failed vaginal cerclage or in whom vaginal cerclage is no longer possible.</p><p><strong>Method: </strong>Laparoscopic isthmo-cervical emergency cerclage was carried out in two patients at 13+0 and 15+5 weeks of gestation (GW) respectively. Both patients had cervical shortening and it was no longer possible to expose the cervix after conization or re-conization. The attempts to carry out transvaginal cerclage were unsuccessful. The technical aspects, feasibility, safety, and pregnancy outcomes after laparoscopic transabdominal cerclage are presented here, based on two case reports.</p><p><strong>Results: </strong>The cerclages were placed after blunt dissection of the uterine vessels and careful introduction of a KELLY forceps through the avascular space between the ascending and descending branches of the uterine vessels without using a needle. The operating times were 93 and 134 minutes (min), respectively. The estimated blood loss during the procedure was less than 50 ml and neither perioperative nor postoperative complications occurred. The subsequent course of both pregnancies was uneventful and fetal development in both cases was normal. In the first case, the baby was delivered by secondary cesarean section following premature rupture of membranes in week 35+4 of gestation. The baby had a birthweight of 2786 g, APGAR scores of 8/9/10 and an umbilical cord arterial pH of 7.36. In the second case, delivery was by primary cesarean section in week 39+5 of gestation. The infant had a birth weight of 4160 g, APGAR scores of 5/9/10 and an umbilical cord arterial pH of 7.20.</p><p><strong>Conclusion: </strong>Laparoscopic transabdominal cerclage is a safe and effective treatment option, even early in the second trimester of pregnancy, for patients in whom transvaginal cerclage is no longer possible due to anatomical factors. The method is technically very feasible and is associated with positive obstetric outcomes. The overall risk of perioperative complications is within acceptable limits.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"84 10","pages":"989-998"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364995","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}