Zeitschrift fur Geburtshilfe und Neonatologie最新文献

{"title":"Intrauterine Adhesion Band Causing Fetal Leg Compression: A Case Report of a Rare Asherman Syndrome Complication in Pregnancy.","authors":"Sara Gabriela Hangen Rodriguez, Tomáš Kupec, Nele Kristin Freerksen-Kirschner, Julia Wittenborn, Laila Najjari, Elmar Stickeler, Philipp Meyer-Wilmes","doi":"10.1055/a-2580-1098","DOIUrl":"https://doi.org/10.1055/a-2580-1098","url":null,"abstract":"<p><p>Asherman syndrome (AS), characterized by intrauterine adhesions, can lead to various pregnancy complications. We report a case of a 31-year-old woman who was admitted at 29+2 weeks due to preterm premature rupture of membranes at our university hospital. The woman had a history of AS following emergency curettage. Ultrasonography revealed an adhesion band in the lower uterine segment, closely positioned to the fetus's leg. Antibiotic therapy and antenatal corticosteroids were administered to prevent infection and neonatal respiratory distress syndrome. Two weeks later, the woman developed labor contractions and pathological cardiotocography, leading to a secondary cesarean section. During surgery, the fetus was found to be in an incomplete breech position, with one leg trapped beneath the adhesion band. Delivery was achieved by releasing the other leg and cutting the adhesion band. The neonate was born with significant right leg edema, likely due to chronic intrauterine compressionby the adhesion band. Postoperatively, the neonate required intensive care. Regular orthopedic visits confirmed intact circulation, sensory, and motor function of the leg and the edema gradually resolved. This case highlights a rare pregnancy complication due to an intrauterine adhesion band and emphasizes the importance of accurate and early adhesion band detection such as the differential diagnostic exclusion of the more common amniotic band via ultrasound. It is a good example of multidisciplinary care provided by obstetricians, neonatologists and orthopedic surgeons in a perinatal care center.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Academization of the midwifery profession: expanded fields of work and new roles].","authors":"Claudia F Plappert, Stephan Zipfel, Harald Abele, Joachim Graf","doi":"10.1055/a-2566-0977","DOIUrl":"https://doi.org/10.1055/a-2566-0977","url":null,"abstract":"<p><p>In Germany, the midwifery profession has been fully academized since 2020. The practice-integrated bachelor's degree program prepares midwives comprehensively for the care of pregnant women, women in labor and newborns. This reform, recommended by the Science Council, strengthens the role of midwives in the modern healthcare system and adapts it to the growing challenges. In addition to the primary qualification, the introduction of midwife-specific Master's degree programs is gaining in importance. These programs prepare midwives for specialized tasks, such as the care of vulnerable population groups. Advanced Midwifery Practice (AMP) skills can be acquired as part of Master's degree courses. This enables graduates to effectively manage complex situations, provide continuous, evidence-based care, and reduce social inequalities in healthcare. This article outlines the potential for improving the quality of care for women and their families through the implementation of midwife-specific Master's degree programs. It also discusses the structural changes that should be initiated to achieve this goal.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: An Unexpected Herbaspirillum Huttiense Bacteremia in the Neonatal Intensive Care Unit.","authors":"Melda Tas, Canan Turkyilmaz, Gulendam Bozdayi, Hasan Tezer, Esin Koc","doi":"10.1055/a-2561-0748","DOIUrl":"https://doi.org/10.1055/a-2561-0748","url":null,"abstract":"<p><p>Herbaspirillum huttiense is a gram-negative bacterium that is rarely implicated in human infections. This case underscores the risk of opportunistic infections in immunocompromised neonates receiving high-dose corticosteroid therapy. It contributes to the scientific literature by expanding the current understanding of neonatal Herbaspirillum infections. A preterm infant was admitted to the neonatal intensive care unit due to thrombocytopenia secondary to maternal chronic idiopathic thrombocytopenic purpura. During high-dose methylprednisolone therapy, Herbaspirillum huttiense was isolated from the patient's blood culture. Following antimicrobial treatment, the infection was successfully eradicated, and the patient recovered. This case highlights the need for meticulous monitoring, early diagnosis, and timely intervention in managing severe infections in immunocompromised neonates. A comprehensive approach to infection surveillance is crucialto improving outcomes in this vulnerable population.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and Treatment of Fetal Anemia: Eight Years Experience of a Tertiary Center.","authors":"Ömer Gökhan Eyisoy, Ümit Taşdemir, Mucize Ozdemir, Murad Gezer, Oya Demirci","doi":"10.1055/a-2564-9371","DOIUrl":"https://doi.org/10.1055/a-2564-9371","url":null,"abstract":"<p><p>This study aimed to evaluate the efficacy of middle cerebral artery peak systolic velocity measurement in predicting moderate-to-severe fetal anemia and assess perinatal outcomes in patients who underwent intrauterine transfusion for fetal anemia.A retrospective cohort of 91 pregnant women at risk of fetal anemia, delivered between 2016 and 2024, was studied. The efficacy of middle cerebral artery peak systolic velocity in predicting moderate-severe fetal anemia was assessed. Additionally, the perinatal outcomes of fetuses undergoing intrauterine transfusion were analyzed. The middle cerebral artery peak systolic velocity threshold of 1.5 multiples of the median demonstrated a sensitivity of 92.3% and a specificity of 85.7% in predicting moderate-to-severe fetal anemia before the 35th gestational week. After the 35th gestational week, sensitivity and specificity were 73.3% and 79.1%, respectively. A total of 53 intrauterine transfusion procedures were conducted on 24 patients. The survival rate among fetuses appropriately treated with intrauterine transfusion (n=22) was 68.2%, and the complication rate per procedure was 11.3%. All intrauterine and neonatal deaths (n=9) occurred in hydropic fetuses. All neonates who had undergone intrauterine transfusion were admitted to the neonatal intensive care unit for advanced care.Middle cerebral artery Doppler is a valuable method for the screening and monitoring of fetal anemia, particularly before the 35th gestational week. Intrauterine transfusion should be considered the preferred treatment for moderate-to-severe fetal anemia. Given the potential risks and complications associated with intrauterine transfusion, hydropic fetuses appear to be at an elevated risk.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Confirmatory Factor Analysis of the Mackey Childbirth Satisfaction Rating Scale in Brazil.","authors":"Fernanda Lopes, Mary Uchiyama Nakamura, Edward Araujo Júnior, Roseli Mieko Yamamoto Nomura","doi":"10.1055/a-2561-0810","DOIUrl":"https://doi.org/10.1055/a-2561-0810","url":null,"abstract":"<p><p>To examine the psychometric properties of the Mackey Childbirth Satisfaction Rating Scale (MCSRS), previously translated and adapted to Brazilian Portuguese. A methodological and cross-sectional study with data collected at a low-risk maternity hospital, period of 2017 and 2018. The inclusion criteria were early postpartum, maternal age between 18 and 34 years, birth of a live infant, and birth over 36 weeks' gestation. The Brazilian Portuguese version of the MCSRS with 34 items in six subscales (self, partner, baby, nurse, physicians, and overall childbirth satisfaction) was administered in a face-to-face interview. Psychometric analyses assessed internal consistency using Cronbach's alpha and McDonald's omega, and confirmatory factor analysis (CFA) examined dimensionality. The population included 411 participants. Confirmatory factor analysis (CFA) indicated a good fitness for the model, comparative fit index (CFI) and goodness-of-fit index (GFI)=0.99; root mean square error of approximation (RMSEA) (0.07; 95% CI 0.07-0.08); incremental fit index (IFI) and Tucker-Lewis index (TLI)=0.99, which confirmed the six subscales identified in the original scale. The factorial loads of the items were all above 0.70. For the questionnaire's overall reliability, Cronbach's alpha was 0.96 and McDonald's omega was 0.97. The MCSRS is a valid instrument, being that all subscales had good reliability indexes. CFA inclusion criteria also encompassed women who underwent an unplanned cesarean section, thus extending the use of the MCSRS.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-TPO-Negative Subclinical Hypothyroidism in the First Trimester and Its Influences on Obstetric and Neonatal Outcomes.","authors":"Nurdan Dinlen Fettah, Seda Kunt, Meryem Sağır, Çağnay Soysal","doi":"10.1055/a-2564-0905","DOIUrl":"https://doi.org/10.1055/a-2564-0905","url":null,"abstract":"<p><p>The aim of this study was to assess the relationship between maternal anti-thyroid peroxidase (anti-TPO)-negative subclinical hypothyroidism (SCH) in the first trimester with complications of pregnancy and neonatal outcomes. The study was done at a maternity and children's research training hospital. First-trimester thyroid function tests (TFTs) (free thyroxine (FT4), thyroid stimulating hormone (TSH), anti-TPO) were checked for mothers who gave birth at the center, and their newborns were accepted for the study. Based on the results of the TFTs, two groups were formed, the normal thyroid function (euthyroid) and SCH groups. The neonatal and maternal outcomes were noted. This study included 150 mothers, of whom 110 (73.3%) had normal thyroid function and 40 (26.7%) had anti-TPO-negative subclinical hypothyroidism (SCH). Based on thyroid function tests (TSH: 0.1-4.0 mIU/L, FT4: 0.7-1.8 ng/dL), significant differences in pregnancy complications wereobserved, with higher rates of placental abruption, preeclampsia, and postpartum hemorrhage in the SCH group (p<0.001). Neonatal outcomes in the SCH group showed significantly higher rates of small for gestational age (SGA) (52.5%), NICU admission (77.5%), low Apgar score (52.5%), and transient tachypnea of the newborn (TTN) (67.5%) (all p<0.001). Logistic regression analysis identified SCH as a significant risk factor for TTN (OR=7.24; 95% CI: 3-17; p<0.001), while no significant associations were found with gestational age (p=0.194) or maternal age (p=0.600). Anti-TPO-negative SCH in pregnancy has undesirable effects, not only during pregnancy but also in siblings, and surprisingly, it may be a risk factor for TTN.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital gastric duplication cyst: A case report of a 36 day-old girl.","authors":"Simon Nwakor, Konrad Reinshagen, Joachim Suß, Julian Jürgens, Katharina Wenke, Christian Tomuschat","doi":"10.1055/a-2563-1133","DOIUrl":"https://doi.org/10.1055/a-2563-1133","url":null,"abstract":"<p><p>Duplications of the gastrointestinal tract exist in various forms and present differently depending on their location. They are extremely rare congenital malformations, and especially duplication cysts of the pyloric channel are among the rarest. They appear with a variety of symptoms, above all with severe vomiting. To date a surgical resection seems to be the only effective treatment. In order to share our experience with a congenital gastric duplication cyst, we present the case of a 36-day-old girl.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Systematic review of individual biopsychosocial aspects of interventions during a physiological birth in primiparous women].","authors":"Tina Berg, Stefanie Flunkert, Erich Brenner","doi":"10.1055/a-2506-9511","DOIUrl":"10.1055/a-2506-9511","url":null,"abstract":"<p><p>The birth process involves biopsychosocial aspects, the identification of which has been little researched. This systematic review aims to identify biopsychosocial aspects of interventions during physiological birth in first-time mothers and to assess the effectiveness of these interventions on birth outcomes.A systematic guideline search resulted in the definition of a physiological birth of first-time mothers with a singleton from the cephalic position at 37+0 to 42+0 weeks' gestation. A systematic literature search assessed intervention studies for evidence quality using the GRADE methodology. Structured content analysis according to Mayring was used to identify biopsychosocial aspects.18 bio-organic, psychological and sociological aspects were identified from 20 studies. The quality of evidence was mostly low to very low due to inadequate reporting of fetal and maternal outcomes and characteristics. Moderate confidence was shown for midwifery care and aromatherapy in increasing spontaneous labor, and transcutaneous electrical nerve stimulation in improving satisfaction, subjective pain perception and APGAR score. Identified biopsychosocial aspects enable a multidimensional assessment of physiological birth and could lead to a biopsychosocial care model. Insufficient quality of evidence does not allow the derivation of specific interventions. Studies in obstetrics should use defined endpoints and characteristics to improve the quality of evidence.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"131-146"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Perineal Fistula With Scrotal Pearls.","authors":"Christelle Destinval, Jean-Louis Lemelle","doi":"10.1055/a-2481-5390","DOIUrl":"https://doi.org/10.1055/a-2481-5390","url":null,"abstract":"","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":"229 2","pages":"147"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Immunohistochemical and Bioinformatics Analysis of the Placental Expressions of Vascular Cell Adhesion Protein 1 (VCAM-1) and High Mobility Group Box 1 (HMGB1) Proteins in Gestational Diabetic Mothers.","authors":"Süleyman Cemil Oğlak, Fırat Aşır, Emine Zeynep Yılmaz, Gökhan Bolluk, Tuğcan Korak, Elif Ağaçayak","doi":"10.1055/a-2451-2223","DOIUrl":"10.1055/a-2451-2223","url":null,"abstract":"<p><strong>Objective: </strong>  We aimed to examine both the expression levels of high mobility group box 1 (HMGB1) and vascular cell adhesion molecule-1 (VCAM-1) proteins in the placentas of pregnant women with gestational diabetes mellitus (GDM) and control groups by immunohistochemical (IHC) method.</p><p><strong>Material and methods: </strong>  An experimental case-control study was conducted, including 40 pregnant women complicated with GDM and 40 healthy pregnant women. Placental tissues obtained following cesarean delivery were subjected to routine tissue monitoring. The placental sections were stained with VCAM-1 and HMGB1 immunostains and subjected to IHC examination under a light microscope. H-score (HS) was used to evaluate the results of IHC staining by semi-quantitative analysis. Pathway analysis in Cytoscape software identified GDM-associated proteins within HMGB1 and VCAM-1 interaction networks, followed by GO analysis to explore associated biological processes.</p><p><strong>Results: </strong>  Placental HGMB1 expression was significantly increased in the GDM group compared to the control group (p<0.001). However, placental VCAM-1 expression was found to be statistically similar in GDM and control groups (p=0.584). The shared 19 proteins were identified between HMGB1 and GDM, and 13 between VCAM-1 and GDM, with notable GO biological process terms such as immune system activation for HMGB1 and interleukin-6 regulation for VCAM-1 associated with GDM.</p><p><strong>Conclusion: </strong>  We consider that GDM-related inflammation and oxidative stress may contribute to tissue damage and inflammation by increasing placental HMGB1 expression. The blockade of HMGB1 and its receptors might represent a promising therapeutic approach to control inflammation in GDM. Understanding the distinct roles of HMGB1 and VCAM-1 may provide valuable insights for the development of targeted therapies aimed at mitigating the inflammatory processes associated with GDM and improving maternal and fetal outcomes.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"90-98"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}