Zeitschrift fur Geburtshilfe und Neonatologie最新文献

{"title":"Fetal Gastroschisis: Maternal Epidemiologic Profile and Influence of Possible Risk Factors on Neonatal Outcomes.","authors":"Thalita Diógenes Muniz, Liliam Cristine Rolo, Edward Araujo Júnior","doi":"10.1055/a-2442-7557","DOIUrl":"10.1055/a-2442-7557","url":null,"abstract":"<p><strong>Objective: </strong>  The aim of this study was to evaluate the maternal epidemiological profile for gastroschisis as well as to assess whether the presence of meconium at birth was associated with adverse neonatal outcomes.</p><p><strong>Methods: </strong>  This was a retrospective observational cohort study that included 52 neonates with gastroschisis whose mothers had delivery at our service. The variables observed were the following: 1) socio-demographic data, 2) ultrasonographic data, 3) birth data, and 4) neonatal outcomes. Simple (univariate) and multiple (multivariate) logistic regression models were used to examine the influence of meconium on neonatal outcomes.</p><p><strong>Results: </strong>  Mean maternal age and body mass index (BMI) of the pregnant women were 21.9 years and 23.3 kg/m2, respectively. There was a similarity between mixed (50%) and white (48.1%) races, and 27.7% (13) reported to use an oral contraceptive (OC). Mean birth weight was 2,386.9 grams, and 24 of the neonates (46.2%) were premature (<37 weeks). The majority of neonates had neonatal sepsis (40.4%) and 39 were admitted to the neonatal intensive care unit with a median length of stay of 31 days. Forty neonates required mechanical ventilation, with a median duration of 5 days. Primary closure was achieved in 50% (26) of cases. Although not significant and with low precision, the point estimate suggested that the presence of meconium at birth, on average, reduced the chance of primary closure (OR=0.26, CI 95% [0.06; 1.16], p=0.077).</p><p><strong>Conclusion: </strong>  Pregnant women with gastroschisis fetuses were more likely to be young, primigravida, with a normal BMI, white or mixed, and with a history of OC use. There was no evidence of an association between the presence of meconium at birth and adverse perinatal outcomes.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"108-115"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627948","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":"[Primary and secondary cerclage in high-risk pregnant women: Influence on prolongation of pregnancy and preterm birth].","authors":"Filiz Markfeld-Erol, Julia Meschede, Maximilian Klar, Ingolf Juhasz-Böss, Mirjam Kunze","doi":"10.1055/a-2467-8698","DOIUrl":"10.1055/a-2467-8698","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to evaluate the effectiveness of cerclage in women with previous late miscarriages or premature births. The primary aim was to prolong pregnancy and achieve a term delivery. Secondarily, it was investigated whether an intervention after an early pathological 75-g-oGTT result influences these endpoints.</p><p><strong>Methods: </strong>A total of 133 cases were analyzed retrospectively. 80 women underwent primary cerclage between the 14th and 16th week of pregnancy; 53 women underwent secondary cerclage after cervical shortening of less than 25 mm. This group was further subdivided into therapeutic and emergency cerclage groups. Women with early pathologic 75-g-oGTT were treated diabetologically.</p><p><strong>Results: </strong>Primary cerclage prolonged pregnancy by 20.6 weeks and led to a term delivery in 51 women (63.8%). In the group with secondary cerclage, 25 women (47.2%) had a term delivery with a prolongation of 20.1 weeks. For amniotic sac prolapse, the prolongation was 7.9 weeks. Pathological 75-g-oGTT results were found in 63 women. Early intervention had no significant effect on prolongation and term delivery.</p><p><strong>Conclusion: </strong>Primary cerclage was more effective in achieving term delivery. Women with therapeutic cerclage without amniotic sac prolapse also benefited. With cervical shortening without prolapse, the prolongation was the same in both groups. The worst outcome was observed in emergency cerclage with amniotic sac prolapse. An early 75-g-oGTT is important in order to recognize and treat gestational diabetes in time.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"99-107"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772779","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":"[Is the structure of perinatal care in Germany responsible for the less-than-optimal, merely average results in European comparison regarding rates for both infant and maternal mortality as well as rates of premature birth?]","authors":"Rainer Rossi","doi":"10.1055/a-2550-6215","DOIUrl":"https://doi.org/10.1055/a-2550-6215","url":null,"abstract":"<p><p>The outcomes of perinatal care in Germany in terms of infant mortality and prematurity rates remain only at the European average. Neither medical factors, such as maternal age, nor socioeconomic data sufficiently explain these differences. Perinatal care in Germany in characterized by a high number of obstetric units with relatively low annual deliveries; almost half of these units are not directly linked to a pediatric department. In contrast, Northern European countries have substantially larger obstectric units in terms of annual deliveries, and these are almost invariably integrated with pediatric departments. This structure of perinatal care is associated with significantly lower prematurity rates - particularly for gestational ages below 28 weeks - as well as reduced infant mortality rates, despite requiring longer travel distances. Consequently, these epidemiological differences should be considered in healthcare planning, and obstetric units should be exclusively organized in conjunction with pediatric departments to optimize outcomes.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700973","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":"Nomogram of the width, length, and area of the fetal optic chiasm according to gestational week.","authors":"Aytakin Mahammadaliyeva, Ayşegül Özel, İbrahim Kale","doi":"10.1055/a-2550-6724","DOIUrl":"10.1055/a-2550-6724","url":null,"abstract":"<p><p>Using transabdominal 2D ultrasonography, we aimed to establish nomograms for fetal optic chiasm (OC) width, length, and area between 16-37 weeks of gestation.OC measurements were performed by a resident and a perinatologist. An agreement was evaluated using intraclass correlation coefficients (ICCs) with 95% confidence intervals. Then, nomogram tables of OC width, length, and area measurements were derived using these measurements. A strong positive correlation was found between OC measurements and gestational week (GW) (r=0.873 for width, r=0.827 for length, r=0.863 for area; p<0.001). The regression equations obtained were: OC width=1.164+0.206×GW, OC length=0.072+0.180×GW, OC area =-25.226+2.228×GW. Interobserver agreement was high, with ICC values of 0.798 for width, 0.705 for length, and 0.758 for area, indicating consistent measurements between observers.This is the first study to establish normative data and nomograms for OC dimensions. Our findings confirm that OC width, length, and area increase linearly with advancing gestation. The high interobserver reliability suggests that these measurements can be reliably used in clinical practice and future research.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664586","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 Correlation of Vitamin D Concentrations in Healthy Pregnant Women and Their Infants with Outcome Parameters.","authors":"Marjana Jerković Raguž, Tatjana Barišić, Ivanka Mikulić, Vinka Mikulic, Ivona Šušak, Vajdana Tomic","doi":"10.1055/a-2542-2818","DOIUrl":"https://doi.org/10.1055/a-2542-2818","url":null,"abstract":"<p><p>The objective of this prospective study was to assess the concentration and impact of maternal 25(OH)D status on neonatal vitamin D concentrations and early neonatal outcomes in the newborns of mothers who did not take vitamin D supplements during pregnancy. The study is a cohort prospective study of the correlation of VD concentrations in mothers and their newborns. The study included 100 pairs. Only 16 mothers had a VD concentration in the reference interval (75-100 nmol/L), while 84 mothers had values less than 75 nmol/L (p<0.001). A significant difference in maternal VD concentration was determined in relation to tobacco consumption habits during pregnancy and placental condition (p<0.001). 95% of the neonates (95/100) of older, obese multigravida, who had hypovitaminosis D and inadequate exposure to sunshine, had normal VD concentrations (the mean=49.27 nmol/L) on the first day of life. The majority of the mothers gave birth to full-termnewborns with normal vitality scores and CRP and bilirubin levels in the reference interval. The conclusion of this prospective study is that 84% of the healthy pregnant women had hypovitaminosis D. However 95% of their newborns were born full term, with normal anthropometric measurements, normal vitality scores, and normal VD concentrations. This study also confirmed that there is still no cause-and-effect association between hypovitaminosis D in pregnant women and their offspring with outcome parameters for both.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606512","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":"[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":"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}