Zeitschrift fur Geburtshilfe und Neonatologie最新文献

{"title":"Diagnosis and Treatment of Fetal Anemia: Eight Years Experience of a Tertiary Center.","authors":"Ömer Gökhan Eyisoy, Ümit Taşdemir, Mucize Ozdemir, Murad Gezer, Oya Demirci","doi":"10.1055/a-2564-9371","DOIUrl":"10.1055/a-2564-9371","url":null,"abstract":"<p><p>This study aimed to evaluate the efficacy of middle cerebral artery peak systolic velocity measurement in predicting moderate-to-severe fetal anemia and assess perinatal outcomes in patients who underwent intrauterine transfusion for fetal anemia.A retrospective cohort of 91 pregnant women at risk of fetal anemia, delivered between 2016 and 2024, was studied. The efficacy of middle cerebral artery peak systolic velocity in predicting moderate-severe fetal anemia was assessed. Additionally, the perinatal outcomes of fetuses undergoing intrauterine transfusion were analyzed. The middle cerebral artery peak systolic velocity threshold of 1.5 multiples of the median demonstrated a sensitivity of 92.3% and a specificity of 85.7% in predicting moderate-to-severe fetal anemia before the 35th gestational week. After the 35th gestational week, sensitivity and specificity were 73.3% and 79.1%, respectively. A total of 53 intrauterine transfusion procedures were conducted on 24 patients. The survival rate among fetuses appropriately treated with intrauterine transfusion (n=22) was 68.2%, and the complication rate per procedure was 11.3%. All intrauterine and neonatal deaths (n=9) occurred in hydropic fetuses. All neonates who had undergone intrauterine transfusion were admitted to the neonatal intensive care unit for advanced care.Middle cerebral artery Doppler is a valuable method for the screening and monitoring of fetal anemia, particularly before the 35th gestational week. Intrauterine transfusion should be considered the preferred treatment for moderate-to-severe fetal anemia. Given the potential risks and complications associated with intrauterine transfusion, hydropic fetuses appear to be at an elevated risk.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"257-262"},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998625","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 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-2659-7707","DOIUrl":"10.1055/a-2659-7707","url":null,"abstract":"<p><p>Search for laboratory markers that can predict adverse fetal pregnancy outcomes in patients with cholestasis of pregnancy.This was an observational case-control study conducted from December 2016 to December 2019. Pregnancy outcome data and maternal antenatal laboratory markers were collected in the intrahepatic cholestasis of pregnancy (ICP) (N=117) and normal pregnancy controls (N=100), laboratory indictors including aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), γ-glutamyl transpeptidase (γ-GT), total bilirubin (TB), direct bilirubin (DB), total bile acids (TBA), cholyglycine (CG), prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen (FIB), etc. The ICP group was divided into an adverse outcome and normal outcome group according to fetal pregnancy outcomes. Descriptive statistics and regression analysis were performed on the prenatal indicators of the two groups to evaluate the association between prenatal laboratory indicators in ICP patients and adverse neonatal outcomes.ALT, TBA, CG, PT, APTT, hemoglobin, red blood cell distribution width, hematocrit, mean platelet volume, and platelet distribution width in ICP patients differed significantly from those in the normal control group, which led to premature birth, amniotic fluid pollution, low birth weight and other adverse outcomes. In terms of fetal outcomes, TBA [(39.16±35.70) μmol/L vs. (24.17±18.76) μmol/L], CG [(22.17±19.42) μg/mL vs. ( 13.91±13.18) μg/mL], DB [(22.17±19.42) μg/mL vs. (13.91±13.18) μg/mL] were higher than those in the normal outcome group, while fibrinogen was lower [(4.16±1.30) g/L vs. (4.78±0.91) g/L]; the difference was statistically significant. Multivariate logistic regression analysis showed that CG(OR=1.06, 95%CI:1.01~1.12, P=0.02, FIB(OR=0.54, 95%CI:0.31~0.92, P=0.02) was independently associated with the occurrence ofadverse fetal outcomes in ICP.Prenatal CG and FIB levels were independently associated with adverse fetal outcomes in patients with ICP.</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":"144765574","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":"Whole-exome sequencing identifies novel mutation in intrahepatic cholestasis of pregnancy: A case report and literature review.","authors":"Xixi Deng, Xueqi Li, Yongchi Zhan, Yuxin Ren, Tingting Xu, Xiaodong Wang","doi":"10.1055/a-2468-5250","DOIUrl":"10.1055/a-2468-5250","url":null,"abstract":"<p><p>Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disease characterized by pruritus and elevated total bile acid (TBA) levels. The most serious impact of ICP is sudden unexplained intrauterine fetal death, especially when an associated TBA ≥ 100 µmol/L is confirmed.We report a case of a 27-year-old female patient with early-onset severe refractory ICP. Whole-exome sequencing and mutation analyses were performed to obtain genetic data on the patient and her mother. Sanger sequencing was performed to screen the mutation site. Computer-based algorithms were applied to predict the pathogenesis of the identified mutation. Subsequently, we conducted a literature review to characterize the pathological features and perinatal management of severe refractory ICP, especially ICP with genetic susceptibility.A heterozygous mutation in the <i>ABCD3</i> gene: c.130C > T/p.Pro44Ser was detected in this patient. Through the analysis of pathogenicity prediction software, the mutations were disease-causing. This is the first report to identify the novel p.Pro44Ser mutations of <i>ABCD3</i> gene in ICP patients.Our report provides new insights into the genetic architecture of ICP involving <i>ABCD3</i> variants. Early-onset severe refractory ICP is rare and mutations in bile acid metabolism genes might accentuate the phenotype. Emphasized perinatal management and screening for potential pathogenicity sites of variants that drive specific recognition of ICP is necessary.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"288-293"},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011736","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":"[Two cases of skeletal ciliopathies in one family].","authors":"Georgi Stefanov Kirov, Frauke Schmidt, Senem Elena Alsat-Krenz, Flutura Dede","doi":"10.1055/a-2663-7946","DOIUrl":"https://doi.org/10.1055/a-2663-7946","url":null,"abstract":"<p><p>Cilia are thin extensions on the cells of eukaryotic organisms. They are formed by a special protein transport mechanism - the intraflagellar transporter (IFT). The IFT consists of two proteins: complex A and complex B. Mutations in the genes of the IFT-A complex (IFT43, IFT121, IFT122, IFT139, IFT140, and IFT144) lead to the development of skeletal ciliopathies. These include Sensenbrenner, Jeune, and short-rib polydactyly syndrome [1,2]. We report two cases of different ciliopathies in a non-related family; both parents are heterozygous carriers of a pathogenic mutation in the IFT122 gene.</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":"144765572","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":"A Simple Combined Method for Vaginal Breech Presentation Delivery: A Retrospective Single Tertiary Center Comparison of Outcomes Across Two Generational Approaches (2007-2022).","authors":"Christina Kouskouti, Alex Horky, Simon Hajda, Sergej Haide, Franz Kainer","doi":"10.1055/a-2607-7667","DOIUrl":"10.1055/a-2607-7667","url":null,"abstract":"<p><p>The management of breech presentation at term has been a subject of controversy in recent decades. The Term Breech Trial (TBT) in 2000 demonstrated a significant reduction in perinatal morbidity and mortality through planned cesarean delivery, leading to increased rates of cesarean breech deliveries. Subsequent publications questioned the TBT results, yet without a significant increase in vaginal breech deliveries. This decline in vaginal breech deliveries has raised concerns about the training of the new generation. Here we introduce an individualized approach with careful selection of appropriate candidates and the application of a simple 3-step method (Hold - Lever - Rotate) for vaginal breech delivery.We conducted a retrospective analysis of two distinct periods: 2007-2012 and 2013-2022 to compare approaches to vaginal breech deliveries. The vaginal breech delivery rate was 8% (n=65) from 2007 to 2012 and 10% (n=146) from 2013 to 2022. The success rate for planned vaginal breech deliveries decreased from 62% to 53%.Risk stratification and informed patient selection are pivotal in managing vaginal breech deliveries. The proposed 3-step algorithm (Hold - Lever - Rotate) provides a simple and efficient method for obstetricians and midwives to manage breech deliveries safely, even with limited training opportunities.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"263-267"},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235385","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":"[Academization of the midwifery profession: expanded fields of work and new roles].","authors":"Claudia F Plappert, Stephan Zipfel, Harald Abele, Joachim Graf","doi":"10.1055/a-2566-0977","DOIUrl":"10.1055/a-2566-0977","url":null,"abstract":"<p><p>In Germany, the midwifery profession has been fully academized since 2020. The practice-integrated bachelor's degree program prepares midwives comprehensively for the care of pregnant women, women in labor and newborns. This reform, recommended by the Science Council, strengthens the role of midwives in the modern healthcare system and adapts it to the growing challenges. In addition to the primary qualification, the introduction of midwife-specific Master's degree programs is gaining in importance. These programs prepare midwives for specialized tasks, such as the care of vulnerable population groups. Advanced Midwifery Practice (AMP) skills can be acquired as part of Master's degree courses. This enables graduates to effectively manage complex situations, provide continuous, evidence-based care, and reduce social inequalities in healthcare. This article outlines the potential for improving the quality of care for women and their families through the implementation of midwife-specific Master's degree programs. It also discusses the structural changes that should be initiated to achieve this goal.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"280-287"},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049539","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":"249-256"},"PeriodicalIF":0.6,"publicationDate":"2025-08-01","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 predictive role of maternal serum and cervicovaginal fluid vitamin D-binding protein for preterm birth and latency period.","authors":"Ayten Nesibe Ozen, Gulten Ozgen, Burcu Dincgez, Levent Ozgen","doi":"10.1055/a-2650-9284","DOIUrl":"https://doi.org/10.1055/a-2650-9284","url":null,"abstract":"<p><p>Adverse perinatal outcomes have been linked to alterations in vitamin D-binding protein (VDBP) levels. We assessed the predictive value of serum and cervicovaginal fluid VDBP for preterm birth, as well as to measure VDBP in threatened preterm labor (TPL) and preterm premature rupture of membranes (PPROM).A total of 138 pregnant women were divided into three groups in this prospective case-control study: TPL(n=59), PPROM (n=43) and control (n=36). Also, all patients were divided into two groups according to whether the latency period was shorter (n=48) or longer than 48 hours (n=90). The VDBP levels were measured using an enzyme-linked immunosorbent assay kit and compared between groups.Cervicovaginal fluid and serum VDBP levels were lower in the TPL and PPROM groups than controls. Cervicovaginal fluid VDBP<0.63ng/ml predicted preterm birth with 81.58% sensitivity and 53.23% specificity (AUC=0.713, p<0.001). Serum VDBP≤ 0.26ng/ml predicted preterm birth with 61.84% sensitivity and 64.52% specificity (AUC=0.629, p=0.008). No significant difference was detected between serum and cervicovaginal fluid VDBP levels for predicting preterm birth (p=0.018). Moreover, cervicovaginal fluid VDBP>0.44ng/ml predicted latency period≤48 hours with 43.75% sensitivity and 94.44% specificity (AUC=0.694, p<0.001), while serum VDBP did not predict a latency period shorter than 48 hours (AUC=0.515, p=0.771).Both serum and cervicovaginal VDBP may be valuable markers for predicting preterm birth. Although no difference was found between serum and cervicovaginal VDBP in terms of predictive role, cervicovaginal fluid VDBP may be one step ahead of serum VDBP with the ability to predict a short latency period.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691702","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":"Postpartum Balance and Kinesiophobia in Cesarean Delivery: Impact of Abdominal Fascial Scars.","authors":"Yağmur Mengü, Emine Atici","doi":"10.1055/a-2629-6700","DOIUrl":"https://doi.org/10.1055/a-2629-6700","url":null,"abstract":"<p><p>Considering that the incisions made during cesarean delivery may damage subcutaneous tissue and fascia, and pelvic floor muscle contractions are effective in femoral head movements, it is hypothesized that the mode of delivery may have an impact on balance and kinesiophobia. This study aimed to investigate the effect of cesarean delivery on balance, kinesiophobia, and body awareness.A total of 70 women participated in the study. Demographic and obstetric data of the participants were recorded. Thoracolumbar fascia was assessed using a goniometric platform, trunk flexibility with the Modified Schober test, static balance with the Flamingo Balance test, and dynamic balance with the Y Balance Test. The Tampa Scale of Kinesiophobia was used to evaluate movement fear, and the Body Awareness Questionnaire was used to assess body awareness.No significant differences were found between cesarean and vaginal deliveries in terms of thoracolumbar fascia assessment, static balance, or dynamic balance measurements (p>0.05). In women who delivered vaginally, dynamic balance was observed to decrease with advancing age (p<0.05). Moreover, in vaginal deliveries, a shorter time since last birth was associated with improved anterior dynamic balance, while an increased number of deliveries was linked to impaired anterior dynamic balance (p<0.05). Regardless of the mode of delivery, all women experienced a decline in static balance and reduced anterior reach with increasing age. Additionally, an increased number of deliveries was associated with impaired static balance, and shorter postpartum duration was linked to decreased dynamic balance (p<0.05). No significant difference was found between vaginal and cesarean deliveries in terms of kinesiophobia (p>0.05). However, in women who delivered vaginally, body awareness decreased with age (p<0.05). In conclusion, the study found that cesarean scars had no adverse effects on balance, kinesiophobia, or body awareness. Nevertheless, further research focusing on balance is recommended.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327002","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":"Methylene Blue for Refractory Shock in A Neonate.","authors":"Ferhan Demirtaş, Yasemin Ezgi Köstekci, Aziz Kılıç, Engin Köse, Ömer Erdeve, Tanıl Kendirli, Begum Atasay","doi":"10.1055/a-2625-2706","DOIUrl":"https://doi.org/10.1055/a-2625-2706","url":null,"abstract":"<p><p>Neonatal shock has a high mortality rate in neonates. New treatment approaches are being researched. Methylene blue (MB) may have the ability to enhance blood pressure but is rarely used on newborns. MB usage in a newborn with catecholamine-resistant shock who needed renal replacement therapy (RRT) due to hyperammonemia from an underlying urea cycle defect is presented here. A 3050-g female neonate, born at 38 weeks' gestation, was admitted to our neonatal intensive care unit on the fourth postnatal day due to hyperammonemia and encephalopathy. She was in shock but did not have sepsis, and her cardiological evaluation was normal. Upon detection of severe hyperammonemia, protein intake was ceased and ammonia-reducing medications were initiated. She required RRT due to persistent severe hyperammonemia, but despite receiving fluid resuscitation, vasopressors, and hydrocortisone, her blood pressure remained low until starting MB. Afterwards, RRT waseffectively performed. After continuous RRT, the patient's ammonia level decreased. Unfortunately, the patient died on the tenth day following delivery due to multiple organ failure. Catecholamine-resistant shock is a significant factor in neonatal mortality. In neonates with decompensated catecholamine-resistant shock and normal cardiac function, MB might be a novel therapeutic alternative. However, more studies are required to examine the efficacy, dose, and use.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310509","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}