Zeitschrift fur Geburtshilfe und Neonatologie最新文献

{"title":"[The Duplicity of Incidents: Cervical Lymphatic Malformation in two Newborns].","authors":"Sarah Valerie Schnee, Maria Riedmeier, Theresa Hübner, Monika Rehn, Friedrich Georg Kapp, Christoph Härtel, Christine Silwedel","doi":"10.1055/a-2231-7148","DOIUrl":"10.1055/a-2231-7148","url":null,"abstract":"<p><p>We report on two neonates born the same day, both with an isolated cervical lymphatic malformation. Cervical masses were detected by ultrasound late in the third trimester. Following interdisciplinary case conferences, a caesarean section in the presence of a neonatal team was the chosen delivery mode in both cases. Delivery and transition of the newborns were uneventful. The suspected diagnosis was confirmed by postnatal MRIs, which demonstrated neither associated malformations nor compression of vital structures. Therefore, an expectant approach was chosen for the newborn with the smaller lesion. The other newborn featured a sizeable lymphatic malformation, and due to consecutive head tilt, sclerotherapy was initiated in its second week of life. Our case report outlines the challenges of a rare connatal malformation. Guidelines are often missing. Individual decisions regarding delivery mode, diagnostics and therapy have to be made on an interdisciplinary basis and patients as well as parents need counseling and support over a long period. All the more significant is good, interdisciplinary collaboration between the involved disciplines.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"303-308"},"PeriodicalIF":0.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724210","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 Uncommon Case: Kasabach-Merritt syndrome with VACTERL Association].","authors":"Melanie Le, Katharina Wenke, Jochen Herrmann, Dominique Singer, Mario Lange","doi":"10.1055/a-2262-8607","DOIUrl":"10.1055/a-2262-8607","url":null,"abstract":"<p><p>The Kasabach-Merrit syndrome is characterized as the association of a vascular tumor, typically a caposiform hemangioendothelioma and rarely a tufted hemangioma, and a severe consumptive coagulopathy with potentially life-threatening thrombocytopenia. The severe coagulopathy with increased bleeding tendency must be considered before invasive procedures and often requires repeated platelet concentrate substitutions. We present a case of a mature male neonate with Kasabach-Merritt- Syndrome as well as VACTERL association. The VACTERL association describes a group of malformations. Our patient presented with anal atresia combined with tethered cord, and left renal agenesis. The VACTERL association as well as Kasabach-Merritt syndrome were found to be independent pathologies within this patient. A common occurrence or an association with each other has not been described in the literature so far. The challenging coagulation setting due to severe thrombocytopenia complicated the surgical management so far. Finally, mTOR-inhibitor sirolimus was successful in terms of tumor reduction and especially reduction of platelet consumption.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"298-302"},"PeriodicalIF":0.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013426","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":"Investigation of Serum Amphiregulin Concentrations in Pregnant Women Diagnosed with Isolated Fetal Growth Restriction in the Third Trimester.","authors":"Fatma İsmail Ali Ramadan, İbrahim Kale, Berna Buse Kobal, Aysegul Ozel, Murat Muhcu","doi":"10.1055/a-2140-7110","DOIUrl":"10.1055/a-2140-7110","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate serum amphiregulin (AREG) concentrations in pregnant women with isolated fetal growth restriction (FGR) in the third trimester.</p><p><strong>Materials and methods: </strong>This cross-sectional study was conducted with 90 pregnant women who applied to the Umraniye Training and Research Hospital Gynecology and Obstetrics Clinic between January 2022 and May 2022. The FGR group consisted of 45 pregnant women diagnosed with FGR in the third trimester, and the control group consisted of 45 healthy pregnant women matched with the FGR group in terms of age and body mass index (BMI). Demographic characteristics, ultrasound findings, and neonatal outcomes were noted. As a primary outcome, the two groups were compared for maternal serum AREG concentrations.</p><p><strong>Results: </strong>Both groups were similar in terms of demographic characteristics (p>0.05). While fetal BPD, AC, and FL measurements in the group diagnosed with FGR were significantly lower than in the control group, umbilical artery Doppler PI and S/D were higher (p=0.000, for all). Gestational age at birth, newborn birth weight, birth height, and 1-minute Apgar score were significantly lower and the NICU admission rate was higher in the FGR group (p=0.000, p=0.000, p=0.000, p=0.027, p=0.011 respectively). Gestational age at blood sampling for AREG was similar in both groups (p=0.869). While maternal serum AREG concentration was 969.39 ng/L in the FGR group, it was 795.20 ng/L in the control group (p=0.018). AUC analysis of AREG for estimation of FGR in ROC analysis was 0.57 (p<0.247, 95% CI=0.44-0.69). The optimal threshold value for FGR estimation of maternal serum AREG concentration was determined as 874.03 ng/L with 55% sensitivity and 55% specificity.</p><p><strong>Conclusion: </strong>High maternal serum AREG concentrations appear to be associated with isolated FGR in the third trimester. The pathways through which AREG modulates fetal growth remain to be investigated.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"161-165"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10427973","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":"Full trisomy 14 in one of bichorionic biamniotic twins.","authors":"Dubravko Habek, Anis Cerovac","doi":"10.1055/a-2215-6984","DOIUrl":"10.1055/a-2215-6984","url":null,"abstract":"<p><p>We describe the case of the lethal full trisomy (T) 14 in a fetus from bichorionic biamniotic (BCBA) twin pregnancy. This is a case of a 28-year-old primigravida, with an unremarkable personal and family history, who just like her 30-year-old husband, was without consanguinity between spouses. She conceived spontaneously, without a burdened gynecological-obstetric history. By the 12th week of pregnancy, she had hyperemesis gravidarum and one episode of bleeding due to which progesterone supplementation was prescribed. Due to asymptomatic bacteriuria, she took cefuroxime axetil in the 13th week of pregnancy and azithromycin in the 15th week due to cervicitis with ureaplasma urealyticum.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"196-197"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404614","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":"[Characteristics and Outcome of Neonates With Postnatally Diagnosed Congenital Diaphragmatic Hernia].","authors":"Bartolomeo B L Bo, Lotte Lemloh, Lennart Hale, Andreas Heydweiller, Brigitte Strizek, Charlotte Bendixen, Lukas Schroeder, Andreas Mueller, Florian Kipfmueller","doi":"10.1055/a-2198-8950","DOIUrl":"10.1055/a-2198-8950","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital diaphragmatic hernia (CDH) is one of the most severe neonatal malformations with a mortality of 20-35%. Currently, the rate of prenatally recognized CDHs is 60-80%. This study investigated the characteristics and outcome data of children with prenatally unrecognized CDH.</p><p><strong>Methods: </strong>Postnatally diagnosed CDH newborns treated at the University Hospital Bonn between 2012 and 2021 were included. Treatment and outcome data were compared according to type of maternity hospital, Apgar values, and between prenatally and postnatally diagnosed CDH.</p><p><strong>Results: </strong>Of 244 CDH newborns, 22 were included. Comparison for birth in a facility with vs. without pediatric care showed for mortality: 9% vs. 27%, p=0.478; ECMO rate: 9% vs. 36%, p=0.300; age at diagnosis: 84 vs. 129 min, p=0.049; time between intubation and diagnosis: 20 vs. 86 min, p=0.019. Newborns in the second group showed significantly worse values for pH and pCO2. Furthermore, there was a tendency for higher mortality and ECMO rates in children with an Apgar score<7 vs.≥7. Children diagnosed postnatally were significantly more likely to have moderate or severe PH and tended to have cardiac dysfunction more often than those diagnosed prenatally.</p><p><strong>Discussion: </strong>In our cohort, ca. one in 10 newborns received a postnatal CDH diagnosis. Birth in a facility without pediatric care is associated with later diagnosis, which may favor hypercapnia/acidosis and more severe pulm.</p><p><strong>Hypertension: </strong></p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"181-187"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138803911","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 the \"Neonatal Sequential Organ Failure Assessment\" to Predict Mortality in Late-Onset Sepsis in Very Preterm Infants.","authors":"Elvis Kraja, Ferhan Demirtas, Yasemin Ezgi Kostekci, Nazmiye Turker, Emel Okulu, Ömer Erdeve, Begum Atasay, Saadet Arsan","doi":"10.1055/a-2165-8307","DOIUrl":"10.1055/a-2165-8307","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to evaluate the use of \"Neonatal Sequential Organ Failure Assessment\" (nSOFA) scoring in predicting mortality, to compare the accuracy of nSOFA scores at different time points in very preterm infants with late-onset sepsis (LOS), and to investigate other possible parameters that would improve the prediction.</p><p><strong>Methods: </strong>This single-center, retrospective study included preterm infants born atS<32 weeks' gestation with culture-proven LOS. The nSOFA scores of non-fatal and fatal episodes were compared at nine time points.</p><p><strong>Results: </strong>Of 120 culture-proven LOS episodes in 106 infants, 90 (75%) episodes were non-fatal and 30 (25%) episodes were fatal. The mean birth weight (BW) of the infants who died was lower than that of survivors (p=0.038). In the fatal LOS episodes, median nSOFA scores were higher at all time points measured before sepsis evaluation, at the time of evaluation, and at all time points measured after the evaluation (p<0.001). nSOFA scores before death and at 48 hours were higher in the fatal episodes (p<0.001). At the time of sepsis assessment, nSOFA score>4 was associated with a 7- to 16-fold increased risk of mortality. Adjustment for BW, lymphocyte and monocyte counts increased the risk to 9- to 18-fold.</p><p><strong>Conclusion: </strong>This study demonstrated that the use of nSOFA to predict mortality and morbidity in extremely preterm infants seems feasible. The scoring system could be improved by evaluating the other parameters.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"174-180"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138803934","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":"[Perinatal Networks: Ensuring Regional Care of Pregnant Woman and Newborns].","authors":"Mario Rüdiger, Jörg Reichert, Jochen Schmitt, Cahit Birdir","doi":"10.1055/a-2211-7018","DOIUrl":"10.1055/a-2211-7018","url":null,"abstract":"<p><p>Health care of pregnant women and their newborns is facing major challenges due to the decline in birth rate and shortage of specialists. In the current discussion about future concepts, the centralization associated with minimum quantities and the necessary safeguarding of care in the area are often construed as conflicting goals. Instead, concepts are needed to guarantee that pregnant women and their children will continue to receive care close to home. The example of the saxony center for feto/neonatal health is used to show how partners in a region can jointly ensure care during pregnancy, birth and the neonatal period on a supra-local and cross-hospital basis. The close cooperation of maximum care providers with regional partners enables comprehensive health care. At the same time, this cooperation enables hospitals to remain attractive employers in structurally weak regions and to provide comprehensive care for young families in need of medical services related to pregnancy and birth through good family and social integration close to home and work. The overriding goals of the saxony center for feto/neonatal health are optimal, guideline-based, interdisciplinary and intersectoral care of pregnant women and premature or sick newborns in the region.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"127-134"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11014747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747532","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":"Extraperitoneal Cesarean Section after two Medial Laparotomies, Anus Prater, and Surgical Treatment of the Rectovaginal Fistula in a Patient with Crohn's Disease: A Case Report.","authors":"Boris Bačić, Zlatko Hrgović, Anis Cerovac, Ognjen Barčot, Jelena Sabljić, Stipe Dumančić, Blagoja Markoski, Mateo Leskur","doi":"10.1055/a-2200-9504","DOIUrl":"10.1055/a-2200-9504","url":null,"abstract":"<p><p>The aim of this case report is to show the advantages of the extraperitoneal cesarean section (ECS) approach in a pregnant patient with multiple previous abdominal transperitoneal colon surgeries and Crohn's disease. A pregnant nulliparous woman with Crohn's disease was admitted for delivery. After delivery, a large rupture and lesion of the rectum was observed. Suturing of the vagina, rectum and sphincter was performed by an abdominal surgeon. Because of a very large and irregularly shaped rectum rupture, the patient underwent infraumbilical medial laparotomy and sigmoidostomy. After 18 months, the patient started to experience vaginal discharge and Y-shaped rectovaginal fistula was confirmed. Surgical reconstruction was performed. The patient's second pregnancy began one year later. At 38 weeks of pregnancy, elective extraperitoneal cesarean section was performed. A healthy newborn was delivered. Follow-up showed full and fast recovery after the ECS. In cases of pregnant women who have had multiple colon surgeries, gynecology surgeons can choose to perform an ECS to avoid transperitoneal entrance into the abdomen. ECS avoids lysis of postoperative adhesions after repetitive gastrointestinal surgeries, the formation of new adhesions by lysis of the old adhesions, and most importantly, the possibility of colon or small intestine lesions during lysis of dense or firm adhesions.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"192-195"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499570","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":"First-trimester neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic immune-response index (SIRI) as predictors of composite adverse outcomes in pregnant women with Familial Mediterranean fever.","authors":"Refaettin Sahin, Atakan Tanacan, Hakki Serbetci, Busra Karagoz, Zahid Agaoglu, Ozgur Kara, Dilek Sahin","doi":"10.1055/a-2125-0973","DOIUrl":"10.1055/a-2125-0973","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the utility of the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic immune-response index (SIRI) in the prediction of adverse pregnancy outcomes in pregnant women with Familial Mediterranean fever (FMF) MATERIAL AND METHODS: This retrospective case-control study was conducted between 2019-2023. First-trimester NLR, SII (NLR X platelet count), and SIRI (NLR X monocyte count) values were compared between pregnant women with FMF (n=85) and without FMF (n=105). Thereafter, pregnant women with FMF were divided into two groups: 1) FMF with perinatal complications (n=30), and 2) FMF without perinatal complications (n=55). NLR, SII, and SIRI values were compared between the two subgroups. Finally, an ROC analysis was performed to determine optimal cut-off values for NLR, SII, and SIRI in the prediction of composite adverse pregnancy outcomes.</p><p><strong>Results: </strong>The FMF group had significantly higher first-trimester NLR, SII, and SIRI values compared to the controls. The FMF with perinatal complications group had significantly higher NLR, SII, and SIRI values than the FMF group without perinatal complications (p<0.05). Optimal cut-off values were 4.89 (80% sensitivity, 78.2% specificity), 1180.6 (76.7% sensitivity, 72.7% specificity), and 1.9 (83.3% sensitivity,72.7% specificity) for NLR, SII, and SIRI, respectively.</p><p><strong>Conclusion: </strong>SII, SIRI, and NLR may be used to predict adverse pregnancy outcomes in pregnant women with FMF.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"156-160"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10021519","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":"[Legal Compliance of Medical Information in the Case of a Relatively Indicated Secondary Caesarean Section in Obstetric Clinics in Germany - Part I: Status Quo-Survey].","authors":"Alexandra Marina Jaster, Peter Wolfgang Gaidzik, Sven Schiermeier","doi":"10.1055/a-2183-8841","DOIUrl":"10.1055/a-2183-8841","url":null,"abstract":"<p><strong>Introduction: </strong>In order to guarantee the patient's right to self-determination, in the case of a relative indication for a secondary caesarean section the Supreme Court expects early information about this real treatment alternative and the patient's option to choose the delivery method. The aim of this study throughout Germany was to survey the status quo of legal compliance of the practice of providing information at all German obstetric clinics and a further comparison based on the clinic format.</p><p><strong>Methods: </strong>All obstetric clinics in Germany were emailed within the context of an anonymous online study using a questionnaire developed on the basis of the BGH judgment of August 28, 2018 (AZ: VI ZR 509/17). Three questions had to be answered cumulatively with \"yes\" to affirm legal compliance. The responding clinics were divided into six groups based on their format (status as university hospital / other hospitals stratified by number of births per year).</p><p><strong>Results: </strong>93 questionnaires were analyzed. 14 clinics (15.05%) met the requirements. Clinics with an annual number of births of 1,000-1,499 perform best in comparison.</p><p><strong>Conclusion: </strong>There is an urgent need for a secure, legally compliant information concept for everyday birth practice in German clinics.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":" ","pages":"151-155"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49682946","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}