Zeitschrift fur Geburtshilfe und Neonatologie最新文献

{"title":"An Update on COVID-19-Associated Placental Pathologies.","authors":"Nora Schaumann, Jan-Theile Suhren","doi":"10.1055/a-2220-7469","DOIUrl":"10.1055/a-2220-7469","url":null,"abstract":"<p><p>COVID-19 pregnancies are associated with increased rates of premature delivery and stillbirths. It is still a matter of debate whether there is a COVID-19-associated pattern of placenta pathology. We updated our previously published results on a systematic literature review and meta-analysis of COVID-19 pregnancies. In total, 38 reports on 3677 placentas were evaluated regarding histopathological changes. Maternal vascular malperfusion (32%), fetal vascular malperfusion (19%), acute and chronic inflammation (20% and 22%) were frequent pathologies. In non-COVID-19 pregnancies, placentas show similar histologic patterns and mainly similar frequencies of manifestation. It has to be taken into account that there might be an observation bias, because some findings are diagnosed as a \"pathology\" that might have been classified as minor or unspecific findings in non-COVID-19 placentas. COVID-19 placentitis occurs in 1-2% of cases at the most. In conclusion, this updated meta-analysis indicates that COVID-19 infection during pregnancy does not result in an increased rate of a specific placenta pathology and COVID-19 placentitis is rare.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":"228 1","pages":"42-48"},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708017","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":"Zum 228. Jahrgang ein Themenschwerpunkt und neue Beiräte.","authors":"Sven Kehl","doi":"10.1055/a-2165-7400","DOIUrl":"10.1055/a-2165-7400","url":null,"abstract":"","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":"228 1","pages":"5-6"},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708023","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":"Covid-19 during Pregnancy - Histopathological Lesions of the Placenta.","authors":"Julia Kummer, Giada Ameli, Anja Jebens, Josefine Königbauer, Valentin Mihajlov, Anna Kaarina Nacke, My Hanh Pham, Christian Rickert, Luisa Simon, Tim Schellenberg, Lars Hellmeyer","doi":"10.1055/a-2180-7302","DOIUrl":"10.1055/a-2180-7302","url":null,"abstract":"<p><strong>Introduction: </strong>Pregnant women and their offspring represented a vulnerable patient collective during the Covid-19 pandemic. Beyond the direct effect of SARS-CoV-2 via vertical transmission, an indirect impact on the fetus can occur through placental lesions deteriorating placental villous function. We performed a histopathological analysis of placentas of parturients with SARS-CoV-2 compared to healthy controls.</p><p><strong>Methods and materials: </strong>Between February 2022 and July 2022 we conducted a prospective case-control study analyzing placental specimens of parturients with SARS-CoV-2 infection compared to specimens of placentas of healthy controls. Patient history, Covid-19-specific symptoms, and obstetric outcomes were recorded. Statistical analysis was performed.</p><p><strong>Results: </strong>During the observation period 71 patients were included with a gestational age 37 1/7-41 5/7 weeks. Thirty-six patients presented with SARS-CoV-2 infection. The control group consisted of 35 patients and showed no placental abnormalities. Among SARS-CoV-2-positive parturients, 66.7% of placentas of the case group showed histopathological abnormalities classified as vascular or inflammatory abnormalities. 22.2% of placentas showed acute ischemic infarction areas. 8.3% of placentas showed subchorionic layered thrombi. There was one case of severe acute subchorionitis. SARS-CoV-2 increased the risk of placental lesions significantly (OR 3.000, CI 1.890-4.762, p=0.0001). Placental lesions had no significant impact on perinatal acidosis (OR 0.455, CI 0.044-4.667, p=0.498) or number of cesarean sections (OR 2.314, CI 0.717-7.473, p=0.156).</p><p><strong>Conclusion: </strong>SARS-CoV-2 infection during labor and delivery increased the risk of adverse outcomes. Histopathological analysis indicated that the placenta as a maternal-fetal interface was affected by SARS-CoV-2, leading to systemic vasculopathy and inflammation.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"49-56"},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427437","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 Psychological Distress in Obstetric Patients during the Visit Ban in Hospitals in the SARS-CoV-2 Pandemic: A Prospective, Multicentre, Controlled Study].","authors":"Carmen Geißler, Julian Knoerlein, Michael K Bohlmann, Andreas Brandt, Durdana Guluzade, Monika Gerber, Dirk Watermann, Olga Weiz, Gudrun König, Filiz Markfeld, Maximilian Klar, Ingolf Juhasz-Böss, Mirjam Kunze","doi":"10.1055/a-2180-7507","DOIUrl":"10.1055/a-2180-7507","url":null,"abstract":"<p><strong>Introduction: </strong>Risk factors for postpartum depression include a lack of social support and perceived social isolation. We would like to determine whether the isolation of inpatients on the maternity wards during Covid-19 leads to increased psychological stress.</p><p><strong>Methods: </strong>This is a multicentre, controlled study of obstetric patients who gave birth during an inpatient stay. Patients were included during the visitation ban (study group) and after the visitation ban (control group). Psychological stress was evaluated with the Edinburgh Postnatal Depression Scale (EPDS) during the inpatient stay and six to eight weeks postpartum.</p><p><strong>Results: </strong>A total of 194 women were included, 107 in the study group and 87 in the control group. The overall result of the first EPDS shows a higher score in the study group compared to the control group (7.0 vs. 4.9 points). Primipara show a higher score in the first EPDS compared to multipara (7.28 vs. 4.82). Caesarean section, regardless of isolation, shows a higher score in the first EPDS than vaginal birth (8.42 vs. 5.11). Comparison of vaginal birth shows a higher score only in the study group (5.97 vs. 4.07).</p><p><strong>Conclusion: </strong>In the context of Covid-19, women giving birth and new mothers, especially primipara, are exposed to increased psychological stress in the clinics. Caesarean section leads to increased psychological stress.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"80-87"},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71486674","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":"Breastfeeding Rates During the COVID-19 Pandemic in Germany: Data from the CRONOS Registry.","authors":"Ann Carolin Longardt, Janine Zöllkau, Nadine Mand, Feline Wowretzko, Johanna Büchel, Kristin Andresen, Bimba Franziska Hoyer, Katrina Kraft, Ulrich Pecks","doi":"10.1055/a-2222-6491","DOIUrl":"10.1055/a-2222-6491","url":null,"abstract":"<p><p>SARS-CoV-2 infection and COVID-19 disease are thought to have an impact on breastfeeding rate - besides other known peripartal issues. Data of the national CRONOS registry regarding breastfeeding behavior in 6,746 women was analyzed regarding the time window between maternal SARS-CoV-2 infection and time of delivery. In addition, other influencing factors like the predominant viral variant, maternal disease severity, and gestational age at delivery were taken into account. Our data suggest that within the variables analyzed, in the case of acute maternal infection (<14 days before birth), breastfeeding behavior improved with increasing gestational age at birth (p<0.0001), with less severe maternal illness (p<0.0001) and as the pandemic progressed with less virulent viral variants (p=0.01). When adjusting for COVID-19-associated and non-associated factors, rooming-in remains the most important factor positively influencing breastfeeding behavior. With regards to the benefits for mother and infants from breastfeeding, a separation of mother and child even in case of infectious settings should be avoided.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":"228 1","pages":"88-96"},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708018","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":"[Acute Fatty Liver of Pregnancy - Case Series].","authors":"Martina Brügge, Ulrich Pecks, Antonella Iannaccone, Monika Palz-Fleige, Holger Stepan, Anne Tauscher","doi":"10.1055/a-2096-6230","DOIUrl":"10.1055/a-2096-6230","url":null,"abstract":"<p><p>With a prevalence of 0,01-0,03%, acute fatty liver in pregnancy (AFLP) is a rare and dangerous complication of pregnancy and is difficult to distinguish from other, sometimes more common, pregnancy diseases such as HELLP syndrome, aHUS and TTP because of its mostly non-specific symptoms. Due to its rarity, AFLP is often not obvious to the obstetrician as a possible differential diagnosis. Yet early diagnosis and the fastest possible delivery is the only causal therapy and is important for the mortality rate. In the present manuscript, the pathophysiology, diagnosis and therapy of acute fatty liver in pregnancy are highlighted for the clinical routine based on case descriptions from three university hospitals, and reference is made to possible findings that are helpful in establishing the diagnosis. The angiogenic preeclampsia marker sFlt-1 plays a role and provides new opportunities to consider pathophysiological approaches.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"466-473"},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9870115","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":"[Update Perioperative Antibiotic Prophylaxis in Neonatology].","authors":"Arne Simon, Clemens Magnus Meier, Yeliz Baltaci, Rachel Müller, Solvej Agneta Heidtmann, Michael Zemlin, Hanna Renk","doi":"10.1055/a-2125-1233","DOIUrl":"10.1055/a-2125-1233","url":null,"abstract":"<p><p>This narrative review discusses basic principles of the perioperative antibiotic prophylaxis (PAP) in premature and at term newborns and refers to some particularities concerning the indication and dosing issues. Although this is a vulnerable patient population, the spectrum of activity should not be unnecessarily broad and the regular PAP must not be prolonged beyond 24 hours.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"421-428"},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10000567","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 Effects of Maternal Smoking on Thyroid Function: Findings from Routine First-Trimester Sonographic Anomaly Screening.","authors":"Rabia Zehra Bakar, Caglar Cetin, Can Yilmaz Yozgat, Mehmet Serdar Kütük","doi":"10.1055/a-2165-8262","DOIUrl":"10.1055/a-2165-8262","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to assess the effect of tobacco exposure on maternal thyroid function and investigate its relationship to subclinical hypothyroidism in pregnant women during the first trimester.</p><p><strong>Subjects and method: </strong>A comparison of maternal thyroid function was made on 45 smokers, who composed the study group, and 72 non-smokers, pregnant women, who constituted the control group. After determining smokers by questionnaire, carbon monoxide (CO) levels in the expiratory air of the participants in both groups were measured and recorded, and the smokers' exposure was objectively confirmed.</p><p><strong>Results: </strong>Smoking and non-smoking pregnant women were similar regarding body mass index (BMI). While the TSH and fT4 levels were respectively 1.48 mlU/L and 11.43 pmol/L in pregnant women who smoked, that ratio changed to 1.72 mlU/L and 11.17 pmol/L in the non-smokers' group. But the differences between the groups were not statistically significant (p=0.239, p=0.179). Even though the rate of subclinical hypothyroidism was 8.9% in the smoking group, it was approximately 19.4% in the non-smoker group; the difference was not statistically significant (p=0.187).</p><p><strong>Conclusion: </strong>This study proved that there is no statistically significant difference between maternal serum TSH and fT4 levels and the rate of subclinical hypothyroidism in smokers during pregnancy in the first trimester.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"429-433"},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156833","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":"[Effects of High Birth Weight on the Development of Preschoolers].","authors":"Valerie Berge, Ute Thyen","doi":"10.1055/a-2160-0584","DOIUrl":"10.1055/a-2160-0584","url":null,"abstract":"<p><strong>Background: </strong>A high birth weight above 4,000 g may lead to risks in the development of affected children. The association is less studied than the effects of very low birth weight and is the subject of this study.</p><p><strong>Methods: </strong>The retrospective study design used data from school entry surveys in Schleswig-Holstein (Germany) collected in 2014-2017 and included 88,858 children aged 5-6 years. End points examined were language, motor skills, cognition, and behavior; use of support measures; and recommendation for special educational needs. Logistic regression models were used to estimate the association between birth weight and the outcome measures, adjusting for sociodemographic factors.</p><p><strong>Results: </strong>After accounting for sociodemographic factors, high birth weight is not associated with impaired child development, whereas low birth weight emerges as a significant predictor. Across all birth weights, sociodemographic factors explain most of the variance in multivariate models of the influence of birth weight on child development.</p><p><strong>Conclusions: </strong>Very high birth weight does not justify a general recommendation for support measures. Therefore, individual developmental trajectories should be monitored. Growing up in disadvantaged circumstances may represent a significant risk and should be a reason for early intervention.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"448-465"},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41178585","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":"Ein medizinhistorisches Lehrstück aus vergangenen (?) Zeiten.","authors":"Dominique Singer","doi":"10.1055/a-2183-7738","DOIUrl":"10.1055/a-2183-7738","url":null,"abstract":"","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":"227 6","pages":"409"},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452604","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}