Zeitschrift fur Geburtshilfe und Neonatologie最新文献

{"title":"[Operating models and organizational structures: opportunities and challenges for human milk banking in Germany].","authors":"Daniel Klotz,&nbsp;Monika Berns,&nbsp;Christoph Fusch,&nbsp;Rolf Lambert Schlößer,&nbsp;Markus Pöschinger,&nbsp;Sven Wellmann,&nbsp;Anja Erika Lange,&nbsp;Rudolf Georg Ascherl,&nbsp;Barbara Naust,&nbsp;Janaina Rauch,&nbsp;Judith Karger-Seider,&nbsp;Corinna Gebauer","doi":"10.1055/a-2125-1076","DOIUrl":"10.1055/a-2125-1076","url":null,"abstract":"<p><strong>Background: </strong>Donor human milk is the recommended alternative for feeding preterm infants if mother's own milk is unavailable. Human milk banks collect, screen, store and distribute donated human milk according to pre-specified standard operating procedures to premature infants without mothers own milk.</p><p><strong>Aim: </strong>  Herein we characterize current operating models and the structural organisation of German milk bank institutions. The analysis of current and future opportunities and challenges may support the development of a comprehensive donor milk service within Germany.</p><p><strong>Material and methods: </strong>Summary of the panel discussion entitled \"Operating models and organizational structures: opportunities and risks for donor human milk bank in Germany\" during the 3rd Scientific Symposium of the German Human Milk Bank Initiative (FMBI), November 25th to 26th 2022, in Nuremberg, Germany.</p><p><strong>Results and discussion: </strong>Differing operator models may facilitate the use of donor human milk by incorporating unique site-specific factors, pre-existing infrastructure, and individual needs. In addition to the establishment of milk banks serving single neonatal units, high-capacity milk banks should be enabled to provide donor human milk using several hub-and-spoke systems. This may create a nationwide network for a sustainable human milk supply for preterm infants that is based on qualified breastfeeding and lactation support.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/aa/b4/10-1055-a-2125-1076.PMC10575713.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9930920","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":"Gestationsdiabetes: Ist die Therapie vor 20 Schwangerschaftswochen sinnvoll?","authors":"","doi":"10.1055/a-2133-6945","DOIUrl":"https://doi.org/10.1055/a-2133-6945","url":null,"abstract":"Ein Gestationsdiabetes birgt sowohl für die Mutter als auch für das Kind erhebliche Risiken. Profitieren Schwangere mit erhöhtem Hyperglykämierisiko und auffälligem oralen Glukosetoleranztest (oGTT) innerhalb der ersten 20 Schwangerschaftswochen (SSW) im Hinblick auf den weiteren Schwangerschaftsverlauf sowie die neonatale Morbidität von einer frühzeitigen Diabetesbehandlung?","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135707712","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":"[Birth in the Midwife-Led Delivery Room of a Perinatal Center - Learning Curve, Outcomes and Benchmark].","authors":"Theresa Andraczek,&nbsp;Susann Magister,&nbsp;Sandy Bautzmann,&nbsp;Stephanie Poppke,&nbsp;Holger Stepan,&nbsp;Anne Tauscher","doi":"10.1055/a-2082-2176","DOIUrl":"10.1055/a-2082-2176","url":null,"abstract":"<p><strong>Introduction: </strong>Most births in Germany take place in a clinical setting. Midwife-led units have been offered in Germany since 2003 as an addition to the primarily physician-led obstetric care. The purpose of this study was to analyze differences regarding medical parameters between a midwife-led and a primarily physician-led unit in a level 1 perinatal center.</p><p><strong>Material and methods: </strong>Between 12/2020 and 12/2021, all births begun in the midwife-led unit were retrospectively analyzed and compared to a physician-led control cohort. Outcome measures were defined as obstetric interventions, delivery mode and duration, delivery position, and maternal and neonatal outcome.</p><p><strong>Results: </strong>The percentage of deliveries started in the midwife-led unit out of the total birth rate was 4.8% (n=132). Most transfers were made for more effective analgesia (52.6%). Among medically indicated transfers (n=30, 39.5%), transfers due to CTG abnormalities and failure to progress in labor after rupture of membranes predominated. 43.9% (n=58) of patients gave birth successfully in the midwife-led unit. The rate of episiotomy was significantly higher in the primarily physician-led unit compared to the successful midwife-led unit (p=0.019).</p><p><strong>Conclusion: </strong>Birth in a midwife-led unit within a perinatal center can be considered an equivalent alternative to primarily physician-led birth for low-risk pregnant women.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9956650","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":"Pläne für die Krankenhausreform: gut gedacht, aber ausreichend?","authors":"","doi":"10.1055/a-2161-2616","DOIUrl":"https://doi.org/10.1055/a-2161-2616","url":null,"abstract":"Liebe Kolleginnen und Kollegen, wenn Sie diese Zeilen lesen, sind Sommer und Urlaubszeit vorbei und wir alle wieder voll im Alltag eingespannt. Ich hoffe, Sie hatten eine gute Zeit der Erholung und haben genug Energie für den Rest des Jahres getankt.","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135707526","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":"[Hyperreactio Luteinalis and an Incidentally Detected FIGO IIIB Borderline Tumor of the Ovary in Pregnancy - Diagnostic, Therapy and Review of Literature].","authors":"Franziska Mergel,&nbsp;Fabienne Schochter,&nbsp;Nikolaus DeGregorio,&nbsp;Wolfgang Janni,&nbsp;Frank Reister,&nbsp;Ulrike Friebe-Hofmann,&nbsp;Beate Hüner","doi":"10.1055/a-2065-0231","DOIUrl":"10.1055/a-2065-0231","url":null,"abstract":"<p><p>Adnexal masses affect 2-10% of all pregnancies. The highest incidence of 1-6% can be seen in the first trimester, with a high rate of spontaneous remission. Two percent of these masses are malignant neoplasms or borderline tumors. A rare benign mass of the adnexa in pregnancy is hyperreactio luteinalis characterised by bilateral, multicystic ovaries with a frequent occurrence in the 3^rd trimester. Clinical signs include maternal hyperandrogenaemia with virilisation, hyperemesis, nonspecific abdominal pain or laboratory findings of hyperthyroidism and elevated ß-HCG. Hyperreactio luteinalis does not require therapy due to complete spontaneous remission postpartum, but is often treated surgically in graviditate. In our case we report a first-time gravida in the 31^st week of pregnancy with a symptomatic 25-cm multicystic, partly solid mass. After antenatal corticosteroid therapy, an exploratory laparotomy with right adnexectomy was performed on suspicion of malignancy. Histology revealed a hyperreactio luteinalis with an incidental finding of a serous borderline tumor of the ovary (FIGO IIIB). At 33 weeks of gestation, a pathological CTG was observed, and an urgent secondary caesarean section by re-longitudinal laparotomy was performed. Postpartum completion surgery revealed no further neoplastic cells.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9456318","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":"Frühgeborene: Krabbeltraining auf dem Mini-Skateboard","authors":"","doi":"10.1055/a-2133-6889","DOIUrl":"https://doi.org/10.1055/a-2133-6889","url":null,"abstract":"Sehr unreife Frühgeborene haben ein hohes Risiko für motorische Defizite. Da die Forschung einen starken Zusammenhang zwischen dem Erreichen des Meilensteins „Krabbeln“ und der weiteren motorischen und psychischen Entwicklung der Kinder sieht, stellte sich eine französische Arbeitsgruppe die Frage, ob die Frühgeborenen von einer frühzeitigen Förderung dieses Bewegungsmusters auf einem speziell entwickelten Rollbrett profitieren.","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135707728","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":"Begünstigen hypertensive Schwangerschaftserkrankungen kognitive Defizite?","authors":"","doi":"10.1055/a-2133-6903","DOIUrl":"https://doi.org/10.1055/a-2133-6903","url":null,"abstract":"Ein erheblicher Teil aller Frauen leidet mindestens einmal im Leben während einer Schwangerschaft an einer hypertensiven Erkrankung – einem Gestationshypertonus, einer chronischen Hypertonie, einer (Prä)Eklampsie oder einer Propf-(Prä)Eklampsie. Welche Auswirkungen haben diese hypertensiven Erkrankungen auf die langfristige geistige Gesundheit der Betroffenen? Und welche kognitiven Fähigkeiten leiden möglicherweise am stärksten?","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135707708","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":"Incarceration of the Gravid Uterus - a Rare Condition not to be Missed.","authors":"Nadja Grosse,&nbsp;Sandy Liem,&nbsp;Elvira Miller,&nbsp;Gunnar Möller,&nbsp;Jürgen Weidemann,&nbsp;Christine A Morfeld,&nbsp;Ralf Schild,&nbsp;Katrin Oehler-Rahman","doi":"10.1055/a-2042-9930","DOIUrl":"https://doi.org/10.1055/a-2042-9930","url":null,"abstract":"<p><strong>Background: </strong>Incarceration of a gravid uterus (IGU) is a rare manifestation in obstetrics that may be associated with serious complications.</p><p><strong>Case: </strong>We report on a 29-year-old patient at 34+2 weeks' gestation who presented with HELLP syndrome. IGU had been initially diagnosed in our department at 23+6 weeks' gestation. Urgent cesarean section was performed taking into account the specific characteristics of IGU. A healthy premature child was born. With the prior knowledge of IGU no complications during delivery occurred and mother and child had favorable outcomes.</p><p><strong>Conclusion: </strong>IGU is a rare condition in pregnancy that should not be overlooked. Early diagnosis and treatment of IGU can prevent serious complications to the mother and child during pregnancy and delivery. In this report, we discuss the specific peculiarities of an incarcerated uterus that need to be considered in this regard.</p><p><strong>Hintergrund: </strong>Ein Uterus incarceratus ist eine seltene Manifestation in der Geburtshilfe, welche mit schwerwiegenden Komplikationen einhergehen kann. FALL: Wir berichten über eine 29-jährige Patientin, die sich mit 34+2 Schwangerschaftswochen (SSW) mit einem HELLP-Syndrom in unserer Klinik vorgestellt hat. Die Erstdiagnose des inkarzerierten Uterus wurde in unserer Klinik mit 23+6 SSW gestellt. Aufgrund unserer Vorkenntnis über diese Diagnose konnte nun die dringend indizierte Sectio caesarea unter Berücksichtigung der spezifischen Merkmale in modifizierter Technik durchgeführt werden. Es wurde ein gesundes Frühgeborenes geboren. Es traten während der Geburt keine Komplikationen auf und Mutter und Kind hatten einen günstigen Verlauf.</p><p><strong>Schlussfolgerung: </strong>Ein Uterus incarceratus ist eine seltene Manifestation in der Schwangerschaft, welche nicht übersehen werden sollte. Eine frühzeitige Diagnose und Behandlung kann schwerwiegende Komplikationen für Mutter und Kind während der Schwangerschaft und unter der Geburt verhindern. Wir diskutieren die spezifischen Besonderheiten eines Uterus incarceratus, die hierbei zu berücksichtigen sind.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10073648","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":"Intrauterine Oxygenierung in den letzten\u0000 Schwangerschaftswochen","authors":"","doi":"10.1055/a-2103-8179","DOIUrl":"https://doi.org/10.1055/a-2103-8179","url":null,"abstract":"\u0000 Im Verlauf des 2. Trimenons der Schwangerschaft steigt infolge der\u0000 Plazentaentwicklung das Sauerstoffangebot im fetalen Kreislauf langsam an.\u0000 Welchen dynamischen Veränderungen unterliegt die Oxygenierung in den\u0000 letzten Wochen vor der Geburt?\u0000","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45116434","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":"[Fathers' Experiences of Pregnancy, Birth and Postpartum During the Covid 19 Pandemic].","authors":"Marylin Sarah Sebinger,&nbsp;Barbara Schildberger","doi":"10.1055/a-2043-0006","DOIUrl":"https://doi.org/10.1055/a-2043-0006","url":null,"abstract":"<p><strong>Introduction: </strong>In order to reduce the possible risk of infection by SARS-CoV-2, access restrictions have been introduced in all areas of public life. In extra- and intramural health care facilities, these measures also affect pregnant women, women giving birth, and women who have recently given birth as well as their partners. The aim of this study is to collect and reflect on the experiences of expectant fathers against the background of pandemic-related restrictions.</p><p><strong>Method: </strong>Following a qualitative study design, 11 guided interviews with fathers who experienced a birth during the Covid 19 pandemic were conducted in June 2022. Based on a content analysis according to Mayring, categories were derived, and the results from the interviews were transferred to a higher level of abstraction and interpreted.</p><p><strong>Results: </strong>The fathers felt excluded, stressed and insecure due to the pandemic-related restrictions during pregnancy, birth, and the women's inpatient stay. Although there was understanding for the measures, there was a prevailing fear of not being able to support the partner sufficiently and of not having enough opportunities for bonding with the newborn.</p><p><strong>Conclusion: </strong>The results of the study make it clear that during the covid pandemic, the need for structured frameworks for the involvement of accompanying persons in the obstetric setting should receive increased attention. The active participation of partners in antenatal and birth care should be encouraged.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10015015","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}