Zeitschrift fur Geburtshilfe und Neonatologie最新文献

{"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":"[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":"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":"[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}

{"title":"[Survey on the State, Potential, and Obstacles of the Digital Transformation in Human Milk Banks].","authors":"Rudolf Georg Ascherl, Monika Berns, Christoph Fusch, Judith Karger-Seider, Daniel Klotz, Barbara Naust, Ulrike Sturm-Hentschel, Corinna Gebauer","doi":"10.1055/a-2405-0336","DOIUrl":"10.1055/a-2405-0336","url":null,"abstract":"<p><p>Digitalization of human milk banking was examined in a survey among participants of the largest German-speaking symposium for human milk banks. Of the 100 participants, 47% were nurses, 23% were physicians, and 3% were midwives. The overwhelming majority (96%) desired more digitalization in their milk bank. The best-digitized processes were clinical results from donors, milk labeling, and milk orders. At the same time, a discrepancy between the maximum conceivable potential and the current implementation of digital transformation became evident. The survey revealed most participants use in-house digital solutions. Potential main advantages of digitalization were cited as efficiency gains, while implementation efforts and security concerns, particularly power outages and cyberattacks, were seen as disadvantages. Financial restraints, personnel shortage, resistance from local IT departments, and legal concerns were perceived as the biggest barriers. Despite these challenges and a critical examination of the disadvantages, the participants expressed strong optimism and a desire for further digitalization in the human milk bank sector.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"38-43"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406962","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":"[Relationship between volume and structural characteristics and the quality of outcomes of perinatal centers for infants at the border of viability].","authors":"Teresa Thomas, Günther Heller, Udo Rolle, Ulrich Thome","doi":"10.1055/a-2405-1233","DOIUrl":"10.1055/a-2405-1233","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigates the relationship between volume, structural characteristics and quality of outcome, specifically for infants at the border of viability.</p><p><strong>Methods: </strong>Using administrative data of the largest provider of statutory healthcare insurance in Germany between 2010-2015, infants with an admission weight (AW) between 250-1249 g treated initially in perinatal centers were included. For infants at the border of viability (250-499 g AW), the endpoints mortality and mortality or morbidity were analyzed. For comparison, infants with 500-749 g and 750-1249 g AW were analyzed. The impact of categorized volume (in quartiles) and structural characteristics (university hospital and in-house pediatric surgery) were examined in separate regressions. Odds ratios (ORs) and potentially avoidable deaths or severe morbidity were calculated.</p><p><strong>Results: </strong>Infants with 250-499 g AW were significantly more likely to survive if initially treated in perinatal centers with an estimated volume of 62 cases (250-1249 g AW) per year (OR: 0.43; 95%-CI: 0.20-0.96) or in university perinatal centers with in-house pediatric surgery (OR: 0.48; 95%-CI: 0.24-0.93). There was also a positive impact of volume and structural characteristics for infants with 500-749 g and 750-1249 g AW.</p><p><strong>Conclusion: </strong>In addition to volume, structural characteristics also have a positive impact on the quality of outcomes. Additional requirements of structural characteristics for perinatal centers as well as a higher minimum volume may have a relevant positive impact on the outcome.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"29-37"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355283","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":"[Pneumonia due to Mycoplasma hominis in a Full-Term Newborn - A Case Report with Literature Review].","authors":"Inga Müller-Graff, Pia Paul, Johannes Forster, Johannes Wirbelauer","doi":"10.1055/a-2371-1802","DOIUrl":"10.1055/a-2371-1802","url":null,"abstract":"<p><p>Mycoplasma ssp can colonize various human tissues and can cause infections. Their lack of a cell wall makes them difficult to cultivate and to treat as they are resistant to beta-lactam antibiotics. Mycoplasma hominis and ureaplasma urealyticum can colonize the genital tract. While colonization in healthy adults is usually asymptomatic, they can cause neonatal infections during pregnancy through transmission to the fetus or during birth and lead to increased morbidity and mortality, especially in premature infants. However, in full-term neonates with high colonization rates, the pathogenic role and its treatment is controversial. In the following, we present a case of neonatal pneumonia caused by M. hominis in a full-term neonate, which was successfully treated with clindamycin. Mycoplasma spp. can cause symptomatic infections in neonates in individual cases and should be considered as potential pathogens, especially in the case of a protracted course.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"63-66"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983386","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}