Zeitschrift fur Geburtshilfe und Neonatologie最新文献

{"title":"Neonatal Cardiac Rhabdomyoma: A Single-Center Experience.","authors":"Başak Kaya, Hasan Akduman, Dilek Dilli, İlker Ufuk Sayıcı, Seda Kunt, Merve Doğangönül, Gürses Şahin, Ömer Nuri Aksoy, Berna Uçan, Ayşegül Zenciroğlu","doi":"10.1055/a-2325-5490","DOIUrl":"10.1055/a-2325-5490","url":null,"abstract":"<p><strong>Aim: </strong>Cardiac rhabdomyoma, known as the most common benign cardiac tumor in childhood, is strongly associated with tuberous sclerosis complex. This study aims to present our single-center experience regarding clinical observations, diagnostic approaches, and treatment modalities for cardiac rhabdomyoma identified during the neonatal period.</p><p><strong>Patients and methods: </strong>In this clinical observational study, we retrospectively assessed the outcomes of 12 newborn patients diagnosed with cardiac rhabdomyoma who were followed up in our neonatal intensive care unit over the past 12 years.</p><p><strong>Results: </strong>The mean gestational age of the patients was 38.2±1.6 weeks, with an average birth weight of 3193±314 grams. The mean postnatal age at initial diagnosis was 12.42±15.75 days. Tuberous sclerosis complex was clinically identified in 50% of cases (six patients). Seven infants received everolimus treatment, while three infants underwent clinical monitoring without specific interventions. A significant reduction in cardiac mass size was observed in all surviving patients, leading to their subsequent discharge from the hospital.</p><p><strong>Conclusion: </strong>Cardiac rhabdomyomas often undergo spontaneous regression in early childhood. However, in cases with obstructive lesions or arrhythmias, they may present life-threatening consequences. Timely diagnosis, appropriate clinical management, and monitoring are crucial in optimizing outcomes for neonates with cardiac rhabdomyoma.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"520-527"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318458","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":"Maternal Cardiac Disease and Perinatal Outcomes in a Single Tertiary Care Center.","authors":"Huriye Ezveci, Şükran Doğru, Fatih Akkuş, Ülfet Sena Metin, Kazim Gezginc","doi":"10.1055/a-2311-4945","DOIUrl":"10.1055/a-2311-4945","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to compare the perinatal outcomes of pregnant women with heart disease and a healthy pregnant control group, as well as the maternal and newborn outcomes of pregnant women with congenital heart disease and acquired heart disease.</p><p><strong>Material method: </strong>Pregnant women with heart disease and healthy control pregnant women were included in this retrospective study. Sociodemographic data of all patients included in the study were obtained from electronic records. Perinatal outcomes of all patients were compared.</p><p><strong>Results: </strong>A total of 258 pregnant women were included in the study. While 129 pregnant women were diagnosed with heart disease, 129 patients were low-risk pregnant women. Preeclampsia (p=0.004) and cesarean section (p=0.01) rates were higher in pregnant women with heart disease compared to healthy pregnant women. Compared with healthy pregnant women, pregnant women with heart disease had a lower birth weight (p=0.003), a higher fetal growth restriction (FGR) rate (p=0.036), lower birth percentiles (p=0.002), a lower 5-minute APGAR (p=0.0001), a higher neonatal intensive care unit (NICU) admission rate (p=0.001), and a longer NICU stay rate (p=0.001). The mean gestational age at birth of pregnant women with congenital heart disease was higher than that of those with acquired heart disease (p=0.017).</p><p><strong>Conclusion: </strong>It was observed that all maternal heart diseases were associated with adverse perinatal outcomes compared to healthy pregnant women. In this series, perinatal adverse outcomes of pregnant women with congenital and acquired heart disease did not differ.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"507-513"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238376","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":"[Taboo subject of miscarriage? - Anchoring through mechanisms at the medical, social, and organisational level \"It broke my heart and that's just the way it is ...\"]","authors":"Sarah Christl-Sebinger, Barbara Schildberger","doi":"10.1055/a-2388-7717","DOIUrl":"10.1055/a-2388-7717","url":null,"abstract":"<p><strong>Introduction: </strong> Miscarriage is the most common complication of pregnancy. In this work, the experiences associated with miscarriage and their relevance for the women are analysed on different levels.</p><p><strong>Method: </strong> In May 2023, 14 guided interviews were conducted with women. The text material obtained will be brought to a higher level of abstraction using Mayring's content analysis approach and then interpreted.</p><p><strong>Results: </strong> The results of the study underpin the significance of a miscarriage as a dramatic experience and the assumption of a broad taboo experienced as stressful. The deliberately chosen exchange among like-minded people, the concealment of the pregnancy and subsequently the miscarriage for reasons of shame, self-protection from professional disadvantages, and the assumption of overburdening the partner do not weigh as heavily as those mechanisms that operate in the health sector: at this level, mistrust, trivialisation and organisational and spatial inadequacies contribute to tabooing. The stressful circumstance of miscarriage is cushioned by people who recognise the grief and offer support.</p><p><strong>Conclusions: </strong> Based on the results of the study, improvements can be derived primarily in the area of care: Recognition of miscarriage, needs-based support services, improvement of communicative elements and organisational and spatial framework conditions.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"534-543"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296740","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":"[\"Who cares about us?\" Results of a cross-sectional study on the psychosocial health of obstetricians and midwives after traumatic birth experiences].","authors":"Beate Hüner, Sven Kehl, Patrick Stelzl, Thomas W P Friedl, Wolfgang Janni, Frank Reister, Frederike Lunkenheimer","doi":"10.1055/a-2361-4211","DOIUrl":"10.1055/a-2361-4211","url":null,"abstract":"<p><strong>Background: </strong>Traumatic births not only cause emotional stress for expectant parents but can also affect the psychosocial health of midwives and obstetricians due to their professional demands.</p><p><strong>Aim: </strong>To evaluate the impact of traumatic birth experiences on the psychosocial health of obstetric healthcare professionals.</p><p><strong>Methods: </strong>A cross-sectional study using validated measurement tools (Impact of Event Scale Revised IES-R, Copenhagen Burnout Inventory CBI) and assessing post-traumatic growth (PGI-SF) through an online survey of midwives and obstetricians in German-speaking areas.</p><p><strong>Results: </strong>The study included 700 participants with peripartum and/or personal traumas. Of the 528 participants who completed the IES-R, 33 (6.3%) with post-traumatic stress disorder (PTSD) received less support from colleagues (p = 0.007) and were more likely to experience workplace consequences (p < 0.001) than participants without PTSD. A moderate to high level of burnout was found in 66.2% of the 542 participants who completed the CBI. Personal growth through experiencing trauma was reported by 75.9% of the 528 participants who completed the PGI-SF.</p><p><strong>Conclusion: </strong>The psychosocial health of midwives and obstetricians is at risk due to traumatic birth experiences. Screening tests and the provision of collegial and professional debriefings to strengthen resilience are essential preventive interventions.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"497-506"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914141","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 Fetal Breathing-Related Nasal Fluid Flow Doppler in the Third Trimester in Pregnant Women with Fetal Growth Restriction: Preliminary Observations.","authors":"Gunay Rzayeva, İbrahim Kale, Resul Arısoy, Murat Muhcu","doi":"10.1055/a-2271-1198","DOIUrl":"10.1055/a-2271-1198","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the fetal breathing-related nasal fluid flow Doppler waveforms as an indicator of fetal respiratory function in fetuses diagnosed with fetal growth restriction (FGR) in the third trimester.</p><p><strong>Materials and methods: </strong>This prospective, non-interventional case-control study was conducted on 96 pregnant women, including 23 pregnant women diagnosed with FGR in the third trimester as the FGR group and 73 healthy pregnant women with fetuses appropriate for gestational age (AGA) as the control group. Fetal breathing-related nasal fluid flow Doppler was examined in the fetuses of the participants. Inspiration and expiration duration, inspiration and expiration peak velocity, total breathing duration, and number of fetal breaths per minute were calculated.</p><p><strong>Results: </strong>Both groups were similar in terms of the duration of inspiration, duration of expiration, and total breathing duration (p=0.463, p=0.711, p=0.520, respectively). Peak inspiratory velocity and peak expiratory velocity were significantly lower in the FGR group than in the control group, and the number of fetal breaths per minute was similar in both groups (p=0.027, p=0.012, p=0.768, respectively). When participants were regrouped into those whose newborn was admitted to the neonatal intensive care unit (NICU) after birth and those who were not, all fetal nasal fluid flow Doppler parameters were similar in both groups.</p><p><strong>Conclusions: </strong>Although the number of participants was too small to draw a definitive conclusion, FGR appears to be associated with a decrease in peak inspiratory and expiratory velocity. The clinical significance of changes in fetal breathing-related nasal fluid flow Doppler parameters in FGR is as yet unclear, and their use in clinical follow-up and predicting unfavorable perinatal outcomes are the subjects of future research.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"514-519"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190189","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":"Intrapericardial Teratoma and Associated 3q29 Deletion in a Fetus: Case Report.","authors":"Onur Guralp, Katharina Schoner, Aline Wolter, Johanna Schenk, Maleen Reitz, Ellydda Widriani, Katrin Froebius, Axel Weber, Roland Axt-Fliedner","doi":"10.1055/a-2365-8188","DOIUrl":"10.1055/a-2365-8188","url":null,"abstract":"<p><p>Depending on its location, size, and proximity to the cardiac structures, an intrapericardial teratoma may lead to severe circulatory disturbances and even fetal demise. A 34-year-old G2P1 presented at 20w5d with a solid cystic mass in the right thorax of the fetus, originating from the right atrium or lung, with signs of non-immune fetal hydrops, soon resulting in intrauterine fetal death. Detailed post-mortem autopsy revealed signs of hydrops fetalis universalis due to a spherical tumor mass originating from the aortic root. Histologic examination of the tumor showed the characteristic morphology of a teratoma. A 1.6-Mb microdeletion at 3q29 was identified by single nucleotide polymorphism array. This is the first report presenting the diagnosis of an intrapericardial teratoma in a fetus with a microdeletion of 3q29. Intrapericardial teratoma has a poor prognosis and the fetal outcome relies on the development of hydrops. A post-mortem examination is essential in order to make a definitive diagnosis, which underlines the status of the fetal pathologist and the need for interdisciplinary cooperation.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"528-533"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009547","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":"Forensic Obstetrics and Clinical Risk Factors.","authors":"Dubravko Habek, Vedrana Petrovečki, Anis Cerovac, Nika Orešković","doi":"10.1055/a-2412-3855","DOIUrl":"10.1055/a-2412-3855","url":null,"abstract":"<p><p>Forensic obstetrics attracts much attention from forensic experts and the public owing to the professional, legal, public health, and not inconsiderable social-emotional aspects and directly correlates with maternal, fetoneonatal, and iatrogenic risk factors. Modern obstetrics and fetomaternal medicine must not be quantified and qualified based only on perinatal disease but also according to current obstetric problems that burden forensic obstetrics. Therefore, high-risk obstetrics as a significant medico-legal problem should be viewed from the point of view of the entire perinatal period with possible long-term consequences, hence the monitoring of complete perinatal and infant morbidity is of immediate importance for quality control and risk control in the profession. The task of forensic obstetrics is to assess the impact of risk factors on the occurrence of an adverse event and to assess whether it is an obstetric complication or obstetric malpractice. Acknowledging the mentioned facts is the only way we will develop high obstetric awareness, and we and pregnant women, birth attendants, midwives and patients, fetuses, and newborns will have professional safety with imminent but controlled obstetric risk and controlled expected complications. On the other hand, the fact that the statistics of perinatal (obstetrical) malpractice globally is not abating requires a change in obstetrical philosophy, especially the unreasonable epidemic increase of cesarean sections with a significant percentage of cesarean sections without medical indication and complications. It is necessary to introduce and maintain solid professionalism and bioethical norms in obstetrics with constant training of skills, which is emphasized by numerous authors and with which we fully agree. Forensic obstetrics is based on the principles of good clinical practice, professional guidelines of modern obstetrics, and ethical and deontological principles. It clearly shows the perfection and imperfection of biological systems that we can and cannot influence. However, we must act according to the rules of the clinical profession, deontological rules, and health laws to reduce clinical risk to the smallest possible extent. Attention should certainly be focused on reducing the disproportion between iatrogenic and maternal-fetoneonatal risk factors, which is the most common reason for litigation today.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"490-496"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355284","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 new technique: Acar's atony suture for postpartum uterine hemorrhage.","authors":"Ali Acar, Cemre Alan, Şükran Doğru","doi":"10.1055/a-2441-6846","DOIUrl":"https://doi.org/10.1055/a-2441-6846","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to define a new compression suture technique that is easy to apply and effective in stopping PPH immediately.</p><p><strong>Study design: </strong>This is a retrospective study of 22 women who received Acar's uterine compressive atony sutures at a single tertiary hospital between January 2021 and November 2023. Demographic and obstetric data were collected. Outcomes included units of blood transfused, intraoperative and postoperative adverse events, duration of hospital admission, and hysterectomy rate.</p><p><strong>Results: </strong>The new suture technique was successful in all cases. Acar's atony suture effectively stopped PPH due to uterine atony. None of the patients needed a hysterectomy. Ten (45.5%) patients received blood product transfusions. Only two of the patients (9%), both of whom had given birth in an external center and in whom the suture was applied afterwards, needed a a stay in the postoperative intensive care unit. The mean hospital stay was 4±1 days.</p><p><strong>Conclusions: </strong>Acar's atony suture is a practical, feasible, and uterine-sparing technique for PPH due to uterine atony.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627943","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":"[Ready to Care for Pregnant Women with Breech Presentation? - Results from an Online Survey for Midwives and Midwifery Students in Germany, Austria, and Switzerland].","authors":"Berit K Friedrichsohn, Sebastian A Bauch, Teresa Starrach, Mira Pflanz, Ulrich Pecks, Johanna Buechel","doi":"10.1055/a-2309-4103","DOIUrl":"10.1055/a-2309-4103","url":null,"abstract":"<p><p>The vaginal birth of breech presentation is an option for pregnant women supported by current German and international guidelines when favorable conditions and appropriately trained personnel are available. According to midwifery laws in the D-A-CH region, midwives should be able to provide care for a vaginal breech birth in emergencies. Therefore, imparting skills for breech delivery is enshrined in the curriculum for midwifery students. This study evaluated the knowledge and training needs of midwives and midwifery students in the German-speaking region. In May 2022, experiences, specific knowledge, and further training needs regarding vaginal breech birth were assessed through an online survey. Analysis of 467 questionnaires showed that only 30% of respondents currently attend vaginal breech births in their professional environment, but 50% would like to offer this service. 94% of respondents indicated that they would feel more confident if regular training opportunities, particularly simulations and virtual offerings, were provided for vaginal breech birth. However, currently only 10% of respondents receive regular training opportunities for vaginal breech births. The results suggest an increased provision of training opportunities for vaginal breech births to enhance midwives' safety in managing such births.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"461-467"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238371","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":"Significance of Physical Exercise in Pregnancy: Comparison of Short and Long Exercise Programs.","authors":"Esra Uzelpasacı, Levent Ozcakar, Serap Özgül, Özgür Özyüncü, Mehmet Sinan Beksac, Türkan Akbayrak","doi":"10.1055/a-2231-7074","DOIUrl":"10.1055/a-2231-7074","url":null,"abstract":"<p><strong>Background: </strong>Several musculoskeletal changes occur in pregnancy, particularly in the abdominal region. The aim of this study was to search and compare the effects of long (LEP) and short exercise programs (SEP) in terms of the satisfaction of the needs of pregnant women.</p><p><strong>Methods: </strong>This study consisted of 2 groups: LEP (n=16) and SEP (n=16). Muscle thickness measurements determined by ultrasound, the 6 minute walk test, Pregnancy Physical Activity Questionnaire, Visual Analogue Scale, Oswestry Disability Index, and Short Form-36 Quality of Life Questionnaire were the study variables. Evaluations were done at the 16th (baseline), 24th, and 32nd gestational weeks. The LEP consisted of 20 and the SEP consisted of 9 exercises, which were applied for 16 weeks until the 32nd gestational week.</p><p><strong>Results: </strong>Emotional role limitation and pain scores of quality of life, 6 minute walk test, and occupational physical activity were found to be better in the LEP group at the 24th gestational week (p=0.043, p=0.049, p=0.049, p=0.026). At the 32nd gestational week, the 6 minute walk test and occupational physical activity were found to be higher in the LEP group (p=0.006, p=0.017). Additionally, rectus abdominis and bilateral diaphragm muscle thicknesses, \"moderate intensity and sports physical activity\" and \"vitality and emotional well-being\" were increased over time with the LEP (p+<+0.05 for all). On the other hand, unilateral diaphragm muscle thickness, sports physical activity level, and vitality were improved with the SEP (p+<+0.05 for all).</p><p><strong>Conclusions: </strong>The SEP and LEP both have beneficial effects in pregnant women. However, the LEP increases physical activity level, functional capacity, and quality of life more than the SEP during the later stages of pregnancy.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"427-438"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576244","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}