Arife Akay, Yıldız Akdaş-Reis, Sait Erbey, Özde Beren Tatar, Elif Gülşah Diktaş, Ece Sevin Çukurova, Fahri Burçin Fıratlıgil, Funda Akpınar
{"title":"The role of placental elastography in postpartum blood loss in multiparous pregnancies.","authors":"Arife Akay, Yıldız Akdaş-Reis, Sait Erbey, Özde Beren Tatar, Elif Gülşah Diktaş, Ece Sevin Çukurova, Fahri Burçin Fıratlıgil, Funda Akpınar","doi":"10.1055/a-2680-4676","DOIUrl":"https://doi.org/10.1055/a-2680-4676","url":null,"abstract":"<p><p>The objective of this study was to assess the link between postpartum blood loss and placental elastography in multiparous pregnancies.In this prospective study, multiparous women who delivered at term between 2020 and 2024 were included. During the obstetric ultrasonography procedure, placental elastography was evaluated through the utilization of the shear wave elastography (SWE) technique. Elastographic measurements were performed at three distinct sites within the anteriorly positioned placentas via the abdominal route. The mean value of these three sites was subsequently calculated to derive the Z score. The difference (Δ) between prepartum and postpartum hemoglobin values was calculated, and cases with ΔHB below 2 g/dl were considered as the control group, and those with ΔHB above 2 g/dl were considered as the study group. Z scores were then compared between the two groups.A total of 109 cases was included in the study, 88 (80.7%) of which were assigned to the control group, and 21 (19.3%) to the study group. Maternal age (30.4±4.82 vs. 31.7±6.68) and BMI (28.7±3.96 vs. 28.1±4.77 kg/m2) were similar in both groups (p>0.05). A positive relationship was identified between ΔHB levels and Z score (r=0.521, p<0.001). The optimal cut-off value for the Z score was determined to be 5.64 kPa, exhibiting 76.2% sensitivity and 52.3% specificity (AUC: 0.709, p=0.003, 95% CI 0.586-0.833).The elastographic evaluation of the prepartum placenta has the potential to serve as a valuable tool in estimating postpartum hemoglobin decline.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024240","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":"Management of Amniotic Fluid Embolism (AFE) using anticoagulation-free ECMO.","authors":"Peijie Yan, Chuihua Sun, Xiaoyan Ma, Xin Sun, Liming Wang, Qinghai Zhang","doi":"10.1055/a-2685-9833","DOIUrl":"10.1055/a-2685-9833","url":null,"abstract":"<p><p>Amniotic fluid embolism (AFE) is a critical obstetric complication characterized by the entry of amniotic fluid and its components into maternal circulation during parturition, leading to acute cardiopulmonary failure, disseminated intravascular coagulation (DIC), and anaphylactic shock. Affected patients typically exhibit abrupt onset, rapid progression, and exceedingly high mortality. Early recognition and prompt intervention are pivotal in AFE management. We present a case of AFE-induced cardiac arrest in a 35-year-old primigravida who developed acute cardiopulmonary collapse during vaginal delivery, followed by cardiac arrest. After cardiopulmonary resuscitation, massive transfusion, and crash emergency cesarean section, anticoagulant-free venoarterial extracorporeal membrane oxygenation (VA-ECMO) was initiated. Subsequent multimodal therapies - including aggressive transfusion support, uterine artery embolization for hemostasis, exploratory laparotomy, and targeted DIC management - ensured safe ECMO maintenance without device-related complications. By hospital day 3, hemodynamic and respiratory stability were achieved, enabling successful ECMO weaning. This case highlights that ECMO remains a viable therapeutic option for salvaging critically ill AFE patients with refractory hemorrhagic shock, DIC, and cardiopulmonary failure.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006652","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}
Ivan Šklebar, Tanja Goranović, Jasna Čerkez Habek, Dubravko Habek
{"title":"Acute peripartum pontine ischemic stroke during epidural analgesia.","authors":"Ivan Šklebar, Tanja Goranović, Jasna Čerkez Habek, Dubravko Habek","doi":"10.1055/a-2683-6349","DOIUrl":"https://doi.org/10.1055/a-2683-6349","url":null,"abstract":"<p><p>We report a rare case of peripartum pontine stroke in a 34-year-old primipara initially attributed to an episode of severe transient hypotension caused by the subdural spread of local anesthetic during epidural analgesia for delivery. The rapid intrapartum intervention by the obstetric team because of spinal shock clinical pictures and fetal bradycardia using high vacuum extraction prevented the risk of fetal ischemic-hypoxic damage. A healthy child was born with an Apgar score of 8/10, 3790 grams /53 cm, with a normal neonatal course. On the third postpartum day, because of persistent neurologic symptoms (headache, urinary, and fecal incontinence), brain magnetic resonance imaging indicated a pontine ischemic lesion. The symptoms gradually regressed with acetylsalicylic acid and physical therapy, and on the 17th day, the patient was discharged home. After puerperium and recovery, thrombophilia were detected. The case indicates the importance of rapid intervention by the obstetric team in case of sudden peripartum maternal and fetal complications.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971386","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":"Correction: The value of prenatal indicators in predicting adverse fetal outcomes in patients with ICP.","authors":"Jiahong Jiang, Jun Zhou, Litao Zhang, Jie Li","doi":"10.1055/a-2678-8186","DOIUrl":"https://doi.org/10.1055/a-2678-8186","url":null,"abstract":"","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971362","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":"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":"274-279"},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","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}
Fernanda Lopes, Mary Uchiyama Nakamura, Edward Araujo Júnior, Roseli Mieko Yamamoto Nomura
{"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":"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":"268-273"},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","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}
Duygu Adiyaman, Andrea Korzoum, Stefan Lukac, Beate Hüner, Christiane Lato, Leonie Burkert, Annika Schmid, Wolfgang Janni, Krisztian Lato
{"title":"[Effects of Pregnancy on Sexuality, Physical Activity, and Well-Being of Women During Pregnancy].","authors":"Duygu Adiyaman, Andrea Korzoum, Stefan Lukac, Beate Hüner, Christiane Lato, Leonie Burkert, Annika Schmid, Wolfgang Janni, Krisztian Lato","doi":"10.1055/a-2607-7766","DOIUrl":"10.1055/a-2607-7766","url":null,"abstract":"<p><p>Pregnancy induces significant physical and emotional changes affecting sexual behavior and maternal well-being. This study examined these changes and the possible influence of fetal sex.A total of 320 women with singleton pregnancies in early gestation participated. For analysis, 296 complete questionnaires were included; miscarriages and fetal anomalies were excluded.After pregnancy onset, 27% reported ceasing intercourse; overall frequency declined significantly (p<0.001). Women over 30 showed a stronger decline (p=0.035). Physical activity decreased especially in women under 30 (p=0.038). No significant difference was found between primigravida and multigravida (p=0.173). Common symptoms included low energy (78%), poor sleep (59%), nausea (55%), constipation (49%), increased appetite (46%), and mood swings (45%). Fetal sex had no significant influence on most symptoms (p>0.05). However, concentration problems were more frequent with female fetuses (p=0.024), hair loss with male fetuses (p=0.038). Changes in vaginal discharge occurred more often when fetal sex differed from previous pregnancies (p=0.025).Pregnancy leads to marked changes in sexual behavior, physical activity, and well-being. Understanding these can support more personalized and compassionate prenatal care.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"239-248"},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217105","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}
Sara Gabriela Hangen Rodriguez, Tomáš Kupec, Nele Kristin Freerksen-Kirschner, Julia Wittenborn, Laila Najjari, Elmar Stickeler, Philipp Meyer-Wilmes
{"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":"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":"294-298"},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","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}
Mesut Yıldırım, İbrahim Kale, Osman Eren Çetinkaya, Ayşegül Özel
{"title":"Evaluation of fetal breathing-related nasal fluid flow Doppler parameters in pregnant women with gestational diabetes mellitus.","authors":"Mesut Yıldırım, İbrahim Kale, Osman Eren Çetinkaya, Ayşegül Özel","doi":"10.1055/a-2650-9169","DOIUrl":"https://doi.org/10.1055/a-2650-9169","url":null,"abstract":"<p><p>To investigate the fetal breathing-related nasal fluid flow Doppler parameters in pregnant women with gestational diabetes mellitus (GDM).This prospective, case-control study was conducted on a total of 90 pregnant women, including 44 with GDM and 46 with normal glucose tolerance. The control group was matched with the GDM group in terms of maternal age and gestational week. Fetal nasal fluid flow Doppler examination was performed between 32 and 34 weeks of gestation.Both groups were similar in terms of inspiration and expiration duration (p=0.809, p=0.710, respectively). Inspiration and expiration peak velocity were similar in both groups (p=0.444 and p=0.357, respectively). Inspiration duration/expiration duration and inspiration peak velocity/expiration peak velocity were similar in both groups (p=0.460, p=0.781, respectively). Both groups were similar in terms of total breathing duration and number of fetal breaths per minute (p=0.669, p=0.629, respectively). Postnatal respiratory distress syndrome (RDS) in newborns and neonatal intensive care unit (NICU) admissions were also similar in both groups (p=0.236, p=0.091, respectively).Although the sample size is limited, fetal breathing-related nasal fluid flow Doppler parameters appear to be unaffected in pregnancies with well-controlled GDM. Similar rates of neonatal RDS and NICU admissions between GDM and non-GDM groups support this finding. However, these findings are not yet applicable to clinical practice, as the study was limited to pregnant women with well-controlled GDM, and the impact of poorly controlled hyperglycemia on these parameters remains unknown. Further research is warranted to address this limitation.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765573","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}
Melda Tas, Canan Turkyilmaz, Gulendam Bozdayi, Hasan Tezer, Esin Koc
{"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":"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":"299-301"},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","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}