Geburtshilfe Und Frauenheilkunde最新文献

{"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":1.9,"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":"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":"Successful Trial of Labor After Two Caesarean Sections (TOLA2C): Analysis of a Delivery Protocol with Feto-Maternal Outcome.","authors":"Maximilian Brandstetter, Andreas Brandstetter, Sabine Kainz-Schultes, Volker R Jacobs, Claudius Fazelnia, Thorsten Fischer, Gerhard Bogner","doi":"10.1055/a-2513-6562","DOIUrl":"10.1055/a-2513-6562","url":null,"abstract":"<p><strong>Introduction: </strong>The majority of obstetrical clinics do not offer a trial of labor after two Caesarean sections (TOLA2C) due to concerns about fetal and maternal complications such as uterine rupture or asphyxia. This study aimed to establish a delivery protocol for safely undergoing TOLA2C and analyzed predictors for a successful vaginal delivery.</p><p><strong>Methods: </strong>Analysis of retrospectively collected data of all pregnant women after two consecutive Caesarean sections was performed at the Obstetrics Department of a tertiary community hospital from January 2013 until December 2022. Those who desired TOLA2C were screened by a senior obstetrician and had to consent to a delivery protocol consisting of five pre- and eight peripartum criteria. Maternal demographic data, indications for previous Caesarean sections and feto-maternal outcome parameters were compared between the successful TOLA2C group and the intrapartum Third-Caesarean section group.</p><p><strong>Results: </strong>In the study period, 385 women planned a delivery after two consecutive CS. Following the protocol, 358 patients (93.0%) were scheduled as elective repeat CS, while 27 (7.0%) attempted vaginal delivery. In this TOLA2C group, 17 women (63.0%) successfully delivered vaginally. In contrast, ten failed vaginal attempts (37.0%) resulted in nine intrapartum repeat CS and one intrapartum emergency CS. Women with prior vaginal delivery had a higher chance of a successful TOLA2C (p = 0.04). In comparison, women with a previous CS due to the indication of arrested labor had a higher risk for intrapartum repeat CS (p = 0.02). No fetal or maternal death occurred, and no major complications were observed.</p><p><strong>Conclusion: </strong>Under the specified conditions, TOLA2C is safe for mother and fetus, and successful vaginal delivery is feasible.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 8","pages":"862-869"},"PeriodicalIF":1.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793987","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}

{"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}