Zeitschrift fur Geburtshilfe und Neonatologie最新文献

{"title":"The Effect of Episiotomy Applied in Vaginal Delivery on Breastfeeding Self-Efficacy and Mother-Infant Attachment in the Postpartum Period.","authors":"Tuğba Yılmaz Esencan, Ayça Demir Yıldırım, Mehtap Yıldız","doi":"10.1055/a-2532-3897","DOIUrl":"https://doi.org/10.1055/a-2532-3897","url":null,"abstract":"<p><strong>Objective: </strong>  The aim of this study was to examine the effect of episiotomy applied in vaginal delivery on breastfeeding self-efficacy and mother-infant attachment in the postpartum period.</p><p><strong>Methods: </strong>  This descriptive study includes 110 puerperal women who were registered in 3 family health centers in a district in Istanbul between July and December 2022 and had a vaginal delivery. Data was collected using a descriptive information form, maternal bonding scale and postpartum breastfeeding self-efficacy scale.</p><p><strong>Results: </strong>  The mean age of the participants was 30.04±5.13 years. 61.9% of the puerperal women were multiparous, the mean gestational age at delivery was 39±1.21 weeks, and 72.7% had an episiotomy at delivery. There was a statistically significant correlation between the number of deliveries, having problems during labor, and episiotomy application (p=0.005, p=0.044). There was no statistically significant difference between the maternal bonding scale scores and postpartumbreastfeeding self-efficacy scale scores of women who underwent episiotomy at delivery and women who did not.</p><p><strong>Conclusion: </strong>  Episiotomy alone had no effect on maternal bonding and postpartum breastfeeding self-efficacy, and episiotomy-induced pain was found to be an effective factor in the postpartum period.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473112","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":"Mesenchymal dysplasia of the placenta: a rare entity and important differential diagnosis. Presentation of a case with placentomegaly.","authors":"Henning Feist, Afram Daliapo, Ann-Christin Sönnichsen","doi":"10.1055/a-2519-5898","DOIUrl":"https://doi.org/10.1055/a-2519-5898","url":null,"abstract":"<p><p>Placental mesenchymal dysplasia (PMD) is a rare disease with unclear etiology and peculiar placental findings (placentomegaly, abnormal chorionic vessels with thromboses, and grossly enlarged and often cystic-appearing stem villi). Songraphic findings are cystic changes, hypoechoic areas, placental enlargement, and dilated chorionic vessels.PMD can be associated with severe perinatal complications, e.g., intrauterine fetal demise, fetal growth restriction, and preterm delivery. Neonatal complications include Beckwith-Wiedemann Syndrome (BWS), hepatic tumors, and hematologic diseases, i.e., anemia and thrombocytopenia. However, in a minority of cases the mothers and children display no perinatal or postnatal findings. It is important to be aware of the entity because it can be mistaken for molar pregnancy (with a different clinical procedure) on routine ultrasound investigation. Maternal alpha-fetoprotein serum levels are often increased in the case of PMD.We report a case of PMD with typical entity-related findings on ultrasound investigation and striking pathological-anatomic findings such as massive placentomegaly and prominent thromboses of the tortuous chorionic vessels but without perinatal or postnatal complications.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450439","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":"Implementation of enhanced recovery in women undergoing cesarean delivery improves breastfeeding and maternal perioperative outcomes.","authors":"Duygu Yıldız Birden, Alper Başbuğ, Engin Yurtcu, İbrahim Kale","doi":"10.1055/a-2529-5424","DOIUrl":"https://doi.org/10.1055/a-2529-5424","url":null,"abstract":"<p><p>The study aimed to evaluate delivery outcomes after implementation of the Enhanced Recovery After Surgery (ERAS) protocol in patients delivered by cesarean section (CD).This randomized controlled prospective study was conducted on 78 pregnant women who underwent CD with the ERAS protocol and 78 pregnant women who under went standard perioperative care. We compared the time to first flatus, visual pain score (VAS), the success of breastfeeding, time to initiation of breastfeeding, time to return to daily activities, hemoglobin values, the incidence of postoperative nausea and vomiting, hospital readmission rates, postoperative wound infection rates, incidence of postpartum blues, and the need for blood transfusion between two groups.Time to first flatus, VAS score, time to initiation of breastfeeding, and time to return to activities of daily living were significantly lower in the ERAS group (p<0.001 for all). The rate of successful breastfeeding was significantly higher in the ERAS group (p<0.001). Both groups were similar in terms of other parameters.Implementation of ERAS after CD shortens the breastfeeding initiation time and increases rates of successful breastfeeding. ERAS protocols implemented in CD improve perioperative outcomes such as visual pain score and time to resume daily activities.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426399","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":"[TRAP (Twin Reversed Arterial Perfusion) Sequence in the Third Trimester].","authors":"Andreas Rizos, Froukje Snaaijer-Grotheer, Horst Meyberg, Nikolaus De Gregorio, Julia Jückstock","doi":"10.1055/a-2525-9498","DOIUrl":"https://doi.org/10.1055/a-2525-9498","url":null,"abstract":"<p><p>The twin reversed arterial perfusion (TRAP) sequence is a complex and rare malformation syndrome that can occur in monochorionic twin pregnancies. It is characterized by vascular anastomoses and partial or total malformation of the heart and extremities of one of the fetuses. This leads to a hemodynamic dependence of the \"parasitic\" fetus (acceptor) from the \"pump fetus\" (donor). The therapeutic goal is to maximize the survival chances of the pump fetus. Although the optimal time for the therapeutic intervention, using radiofrequency ablation or ultrasound laser coagulation, is not clear yet, it is internationally recommended to be performed before gestational week 16. We present the case of an undiagnosed und therefore unusual monochorionic monoamniotic pregnancy in gestational week 34, in our perinatal center and demonstrate the impressive maximal expression of an untreated TRAP sequence.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426395","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":""},"PeriodicalIF":0.7,"publicationDate":"2025-02-12","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":"Evaluation of Ophthalmic Artery Doppler Parameters in Preeclamptic and Normotensive Pregnant Women.","authors":"Aslı Kaplan, Ayşegül Özel, Cem Yalçınkaya, Safa Özyılmaz, İbrahim Kale, Murat Muhcu","doi":"10.1055/a-2371-1856","DOIUrl":"10.1055/a-2371-1856","url":null,"abstract":"<p><strong>Objective: </strong> Preeclampsia, whose pathophysiology is still not fully elucidated today, is a pregnancy-specific disease that affects most organ systems in pregnant women, including the central nervous system. In this context, we aimed to investigate the effects of preeclampsia on blood flow in the ophthalmic artery of the eye, which is considered a part of the central nervous system.</p><p><strong>Materials and methods: </strong> This prospective, non-interventional cohort study was conducted between February 2022 and June 2022 at Umraniye Training and Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey. Forty-six normotensive healthy pregnant women constituted the control group and 46 preeclamptic pregnant women constituted the preeclampsia group. Prenatal follow-up and delivery of the participants were carried out in our clinic. First, an obstetric ultrasound was performed on all participants with the same ultrasound device and the same clinician. Then, Doppler measurements of the ophthalmic artery of both eyes were made by the same clinician using the linear probe of the same ultrasound. Both groups were compared in terms of the first peak of systolic velocity (PSV), second PSV, pulsatility index (PI), PSV ratio, end-diastolic velocity (EDV), resistance index (RI), and systolic/diastolic ratio (S/D) measurements of the ophthalmic artery. RESULTS : The first PSV, second PSV, PSV ratio, and EDV were significantly higher in the preeclampsia group than in the control group (p=0.001, p<0.001, p=0.019, p<0.001, respectively). According to the receiver operating characteristic analysis, the second PSV with a cut-off value of 43.75 cm/s was the most powerful ophthalmic artery Doppler parameter in detecting preeclampsia with 63% sensitivity and 63% specificity. No significant difference was found between the early and late onset or mild and severe preeclampsia groups in terms of ophthalmic artery Doppler parameters.</p><p><strong>Conclusion: </strong> Although the number of participants was too small to draw a definitive conclusion, the second PSV seems to be the most powerful parameter for the detection of preeclampsia. Studies with larger series are needed to determine the usability of ophthalmic artery Doppler parameters in the routine clinical diagnosis of preeclampsia and follow-up of the disease.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"22-28"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005418","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":"[AI-supported decision-making in obstetrics - a feasibility study on the medical accuracy and reliability of ChatGPT].","authors":"Simon Bader, Michael O Schneider, Iason Psilopatis, Daniel Anetsberger, Julius Emons, Sven Kehl","doi":"10.1055/a-2411-9516","DOIUrl":"10.1055/a-2411-9516","url":null,"abstract":"<p><p>The aim of this study is to investigate the feasibility of artificial intelligence in the interpretation and application of medical guidelines to support clinical decision-making in obstetrics. ChatGPT was provided with guidelines on specific obstetric issues. Using several clinical scenarios as examples, the AI was then evaluated for its ability to make accurate diagnoses and appropriate clinical decisions. The results varied, with ChatGPT providing predominantly correct answers in some fictional scenarios but performing inadequately in others. Despite ChatGPT's ability to grasp complex medical information, the study revealed limitations in the precision and reliability of its interpretations and recommendations. These discrepancies highlight the need for careful review by healthcare professionals and underscore the importance of clear, unambiguous guideline recommendations. Furthermore, continuous technical development is required to harness artificial intelligence as a supportive tool in clinical practice. Overall, while the use of AI in medicine shows promise, its current suitability primarily lies in controlled scientific settings due to potential error susceptibility and interpretation weaknesses, aiming to safeguard the safety and accuracy of patient care.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"15-21"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476150","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":"[Structural Challenges to the Reimbursement of Corrective Surgery of Complex Malformations Through the German G-DRG System].","authors":"Miriam Wilms, Horst Schuster, Franz Krause, Johannes Wolff, Michael Boettcher, Wolfram Trudo Knoefel, Ekkehart Jenetzky","doi":"10.1055/a-2437-0367","DOIUrl":"10.1055/a-2437-0367","url":null,"abstract":"","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"44-52"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628028","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 rare reason for massive lactic aciduria and mitochondrial disorders: combined oxidative phosphorylation deficiency type 23 (COXPD23).","authors":"Halil Tuna Akar, Hasan Akduman, Abdülkerim Kolkıran, Elifcan Taşadelen, Nur Aycan","doi":"10.1055/a-2465-3661","DOIUrl":"10.1055/a-2465-3661","url":null,"abstract":"<p><p>Mitochondrial respiratory chain dysfunction and impaired oxidative phosphorylation are rare but significant causes of mitochondrial diseases in children, presenting with diverse clinical features. Combined oxidative phosphorylation deficiency type 23 (COXPD23), an autosomal recessive disorder due to GTPBP3 gene mutations, typically manifests as lactic acidosis, hypertrophic cardiomyopathy, and encephalopathy. This case report describes a male infant born at 35 weeks gestation, who exhibited severe lactic aciduria and hypotonia but no cardiomyopathy, which is atypical for COXPD23. Genetic analysis revealed a novel homozygous missense variant in the GTPBP3 gene. Despite intensive metabolic and supportive treatments, the patient's condition worsened, leading to death on the 23rd day. This case emphasizes the need to consider mitochondrial cytopathies in neonates with persistent metabolic acidosis and hyperlactatemia and highlights the importance of early genetic screening for accurate diagnosis and management.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"60-62"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693148","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":"Rare Diseases and Syndromes Observed in Newborn Babies with Idiopathic Hypertrophic Pyloric Stenosis.","authors":"Başak Kaya, Hasan Akduman, Dilek Dilli, Cem Geyik, Ayşe Karaman, Berna Uçan, Özkan Kaya, Seda Aydoğan, Ayşegül Zenciroğlu","doi":"10.1055/a-2410-5830","DOIUrl":"10.1055/a-2410-5830","url":null,"abstract":"<p><strong>Aim: </strong>  Although infantile hypertrophic pyloric stenosis is a multifactorial disease caused by genetic and environmental factors, the role of genetic factors has become more important recently. With this study, we aimed to present rare diseases accompanying infantile hypertrophic pyloric stenosis caused by genetic factors.</p><p><strong>Patients and methods: </strong>  This is a retrospective study. Babies who were operated on with the diagnosis of infantile hypertrophic pyloric stenosis in the neonatal intensive care unit between 2000 and 2022 and had additional diseases were included in the study.</p><p><strong>Results: </strong>  9.8% of patients diagnosed with infantile hypertrophic pyloric stenosis had an accompanying rare disease.</p><p><strong>Conclusion: </strong>  Early diagnosis and treatment of rare diseases associated with infantile hypertrophic pyloric stenosis are of great importance in reducing morbidity/mortality due to these diseases.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"53-59"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393805","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}