Zeitschrift fur Geburtshilfe und Neonatologie最新文献

{"title":"[Ethical Attitudes and Handling in Prenatal Conflict Situations - A Survey among Obstetricians and Prenatal Diagnosticians in Germany].","authors":"Katja Schneider, Johanna Müller, Tatjana Tissen-Diabaté, Ekkehard Schleußner","doi":"10.1055/a-2217-9635","DOIUrl":"https://doi.org/10.1055/a-2217-9635","url":null,"abstract":"<p><strong>Objective: </strong>Various studies have shown that belonging to a professional group has an influence on ethical attitudes. The aim of this study was to assess and compare the attitudes and approaches of obstetrical specialists and prenatal diagnosticians in prenatal conflict situations.</p><p><strong>Methods: </strong>Explorative cross-sectional online survey among tertiary perinatal care centers and prenatal diagnosticians with DEGUM Level II/III in Germany. The questionnaire included questions on ethical attitudes in the perinatal context and a case presentation of a fetal hypoplastic left heart syndrome.</p><p><strong>Results: </strong>The response rate was 57.1% (310/543). 55.5% of the respondents practiced both obstetrics and prenatal diagnostics, 24.5% exclusively prenatal diagnostics, and 14.2% purely obstetrics. 27% agreed with the statement \"An uncertain prognosis justifies pregnancy termination\". For complex fetal malformations joint interdisciplinary counseling was advocated by 98.3%. Addressing the option of postnatal palliative treatment in a case of a hypoplastic left heart syndrome was accepted by 84.3% across all professional groups, while mentioning fetocide was more frequently cited as an option by prenatal diagnosticians than by obstetricians (57.7% vs. 34.1%).</p><p><strong>Conclusion: </strong>Interdisciplinary prenatal parental counseling in complex fetal malformations is uniformly advocated by prenatal diagnosticians and obstetricians in Germany. However, different ethical attitudes appear among specialists groups with regard to the option of termination of pregnancy.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139520116","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":"[Acute Fatty Liver of Pregnancy - Case Series].","authors":"Martina Brügge, Ulrich Pecks, Antonella Iannaccone, Monika Palz-Fleige, Holger Stepan, Anne Tauscher","doi":"10.1055/a-2096-6230","DOIUrl":"10.1055/a-2096-6230","url":null,"abstract":"<p><p>With a prevalence of 0,01-0,03%, acute fatty liver in pregnancy (AFLP) is a rare and dangerous complication of pregnancy and is difficult to distinguish from other, sometimes more common, pregnancy diseases such as HELLP syndrome, aHUS and TTP because of its mostly non-specific symptoms. Due to its rarity, AFLP is often not obvious to the obstetrician as a possible differential diagnosis. Yet early diagnosis and the fastest possible delivery is the only causal therapy and is important for the mortality rate. In the present manuscript, the pathophysiology, diagnosis and therapy of acute fatty liver in pregnancy are highlighted for the clinical routine based on case descriptions from three university hospitals, and reference is made to possible findings that are helpful in establishing the diagnosis. The angiogenic preeclampsia marker sFlt-1 plays a role and provides new opportunities to consider pathophysiological approaches.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9870115","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":"[Update Perioperative Antibiotic Prophylaxis in Neonatology].","authors":"Arne Simon, Clemens Magnus Meier, Yeliz Baltaci, Rachel Müller, Solvej Agneta Heidtmann, Michael Zemlin, Hanna Renk","doi":"10.1055/a-2125-1233","DOIUrl":"10.1055/a-2125-1233","url":null,"abstract":"<p><p>This narrative review discusses basic principles of the perioperative antibiotic prophylaxis (PAP) in premature and at term newborns and refers to some particularities concerning the indication and dosing issues. Although this is a vulnerable patient population, the spectrum of activity should not be unnecessarily broad and the regular PAP must not be prolonged beyond 24 hours.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10000567","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 Effects of Maternal Smoking on Thyroid Function: Findings from Routine First-Trimester Sonographic Anomaly Screening.","authors":"Rabia Zehra Bakar, Caglar Cetin, Can Yilmaz Yozgat, Mehmet Serdar Kütük","doi":"10.1055/a-2165-8262","DOIUrl":"10.1055/a-2165-8262","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to assess the effect of tobacco exposure on maternal thyroid function and investigate its relationship to subclinical hypothyroidism in pregnant women during the first trimester.</p><p><strong>Subjects and method: </strong>A comparison of maternal thyroid function was made on 45 smokers, who composed the study group, and 72 non-smokers, pregnant women, who constituted the control group. After determining smokers by questionnaire, carbon monoxide (CO) levels in the expiratory air of the participants in both groups were measured and recorded, and the smokers' exposure was objectively confirmed.</p><p><strong>Results: </strong>Smoking and non-smoking pregnant women were similar regarding body mass index (BMI). While the TSH and fT4 levels were respectively 1.48 mlU/L and 11.43 pmol/L in pregnant women who smoked, that ratio changed to 1.72 mlU/L and 11.17 pmol/L in the non-smokers' group. But the differences between the groups were not statistically significant (p=0.239, p=0.179). Even though the rate of subclinical hypothyroidism was 8.9% in the smoking group, it was approximately 19.4% in the non-smoker group; the difference was not statistically significant (p=0.187).</p><p><strong>Conclusion: </strong>This study proved that there is no statistically significant difference between maternal serum TSH and fT4 levels and the rate of subclinical hypothyroidism in smokers during pregnancy in the first trimester.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156833","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":"[Effects of High Birth Weight on the Development of Preschoolers].","authors":"Valerie Berge, Ute Thyen","doi":"10.1055/a-2160-0584","DOIUrl":"10.1055/a-2160-0584","url":null,"abstract":"<p><strong>Background: </strong>A high birth weight above 4,000 g may lead to risks in the development of affected children. The association is less studied than the effects of very low birth weight and is the subject of this study.</p><p><strong>Methods: </strong>The retrospective study design used data from school entry surveys in Schleswig-Holstein (Germany) collected in 2014-2017 and included 88,858 children aged 5-6 years. End points examined were language, motor skills, cognition, and behavior; use of support measures; and recommendation for special educational needs. Logistic regression models were used to estimate the association between birth weight and the outcome measures, adjusting for sociodemographic factors.</p><p><strong>Results: </strong>After accounting for sociodemographic factors, high birth weight is not associated with impaired child development, whereas low birth weight emerges as a significant predictor. Across all birth weights, sociodemographic factors explain most of the variance in multivariate models of the influence of birth weight on child development.</p><p><strong>Conclusions: </strong>Very high birth weight does not justify a general recommendation for support measures. Therefore, individual developmental trajectories should be monitored. Growing up in disadvantaged circumstances may represent a significant risk and should be a reason for early intervention.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41178585","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":"Impact of Increased Activated Protein-C Resistance, Decreased Antithrombin III Activity and Hypocomplementemia on the Gestational Outcomes of Pregnancies with MTHFR Polymorphisms.","authors":"Erdem Fadiloglu, Hanife Guler Donmez, Kemal Beksac, Mehmet Sinan Beksac","doi":"10.1055/a-2134-6452","DOIUrl":"10.1055/a-2134-6452","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of increased Activated Protein C (APC) resistance, decreased antithrombin III activity and hypocomplementemia on the pregnancy outcomes of the patients with methylentetrahydrofolate reductase (MTHFR) polymorphisms.</p><p><strong>Methods: </strong>This study was composed of 83 pregnancies with MTHFR polymorphisms. Increased APC resistance, decreased antithrombin III activity and hypocomplementemia were accepted as risk factors for poor gestational outcome.</p><p><strong>Results: </strong>Having at least one risk factor resulted in significantly higher rates of \"APGAR score of<7\" at the first ten minutes (p=0.009). Composite adverse outcome rate was also higher in patients with at least one of the defined risk factors despite lack of statistical significance (p=0.241). Rate of newborn with an \"APGAR score of<7\" at first ten minutes was significantly higher at patients with hypocomplementemia (p=0.03).</p><p><strong>Conclusion: </strong>Hypocomplementemia is a risk factor for poor gestational outcome in pregnancies with MTHFR polymorphisms.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10000565","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":"Ein medizinhistorisches Lehrstück aus vergangenen (?) Zeiten.","authors":"Dominique Singer","doi":"10.1055/a-2183-7738","DOIUrl":"10.1055/a-2183-7738","url":null,"abstract":"","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452604","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 maternal serum hepassocin concentrations in pregnant women with gestational diabetes mellitus: a prospective case-control study.","authors":"Aysegul Cakmak, İbrahim Kale, Murat Muhcu","doi":"10.1055/a-2096-6339","DOIUrl":"10.1055/a-2096-6339","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate the relationship between gestational diabetes mellitus (GDM) and maternal serum hepassocin concentrations.</p><p><strong>Materials and methods: </strong>This cross-sectional study was conducted with 88 pregnant women who applied to the Ümraniye Training and Research Hospital Gynecology and Obstetrics Clinic between April 2022 and November 2022. The GDM group consisted of 44 pregnant women who had a 75-g OGTT between the 24th and 28th week of pregnancy and were diagnosed with GDM. The control group consisted of 44 healthy pregnant women who were matched with the GDM group in terms of age and body mass index (BMI) and had a normal 75-g OGTT result. Demographic characteristics, laboratory findings, and perinatal outcomes were noted. Two groups were compared in terms of maternal serum hepassocin concentrations.</p><p><strong>Results: </strong>Both groups were similar in terms of age, BMI, weight gain, gravida, parity, polycystic ovary syndrome history, history of diabetes mellitus in the family, and the gestational week at blood sampling for hepassocin (p>0.05 for each). The median maternal serum hepassocin concentration was found to be 18.21 ng/ml in the GDM group, while it was determined as 13.05 ng/ml in the non-GDM group (p=0.012). The GDM group was divided into two groups: the group that only dieted until birth and the group that used insulin until birth for blood glucose regulation. The median hepassocin concentration was found to be 17.99 ng/ml in the diet-only GDM group and 32.15 ng/ml in the insulin-using GDM group. ROC analysis was performed to determine the value of maternal serum hepassocin concentration in predicting GDM. AUC analysis of maternal serum hepassocin for estimation of GDM was 0.656 (p=0.012, 95% CI=0.53-0.77). The optimal threshold value for maternal serum hepassocin concentration was determined as 14.13 ng/ml with 61.4% sensitivity and 61.4% specificity.</p><p><strong>Conclusion: </strong>Serum hepassocin concentration evaluated between 24 and 28 weeks of gestation was found to be higher in pregnant women with GDM than in the non-GDM group. The highest serum hepassocin concentration was found in the GDM group using insulin for blood glucose regulation. Hepassocin seems to be a promising molecule that can be used in GDM screening in pregnant women who do not want to have an OGTT in the future.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9683798","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":"[Five Legal Pitfalls in Informing Patients About the Treatment Alternative \"Ceasarean Sectio\"].","authors":"Johannes Brocks","doi":"10.1055/a-2071-9884","DOIUrl":"10.1055/a-2071-9884","url":null,"abstract":"<p><p>As is well known, claims for damages in birth injury law can arise not only from treatment errors, but also from incorrect information provided to the pregnant woman. The accusation that the possibility of a C-section was not explained, not explained sufficiently, or not explained in time plays an important role here. The accusation is practically significant because it is very often raised in birth injury disputes and is not infrequently successful. In practice, the same information errors that can lead to liability occur time and again.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9365678","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 Cardiac Output and Modified Myocardial Performance Index in Pregnant Women with Idiopathic Polyhydramnios: A Case Control Study from a Tertiary Hospital.","authors":"Bedri Sakcak,&nbsp;Ramazan Denizli,&nbsp;Nihat Farisoğulları,&nbsp;Murat Haksever,&nbsp;Ezgi Turgut,&nbsp;Ozgur Kara,&nbsp;Atakan Tanacan,&nbsp;Dilek Sahin","doi":"10.1055/a-2109-5237","DOIUrl":"10.1055/a-2109-5237","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate fetal cardiac output and myocardial performance index in pregnant women with idiopathic polyhydramnios and compare them to healthy pregnant women.</p><p><strong>Methods: </strong>Thirty patients admitted to Ankara City Hospital at 24-39 weeks of gestation with idiopathic polyhydramnios were included as the study group. Clinical characteristics, fetal cardiac output, and fetal modified myocardial performance index (Mod-MPI) were compared between the groups.</p><p><strong>Results: </strong>The combined cardiac output (CCO), left cardiac output (LCO), right cardiac output (RCO), pulmonary artery velocity time integral (PA-VTI), and aortic VTI were statistically significantly higher in the study group (p=0.003, p=0.028, p=0.002, p=0.000, and p=0.017, respectively).The idiopathic polyhydramnios group had a significantly higher Mod-MPI and isovolumetric contraction time (ICT) and a significantly lower ejection time (ET) compared to the controls (p=000, p=0.003, and p=0.023, respectively). In the idiopathic polyhydramnios group, the aortic max (p=0.009) and aortic VTI (p=0.047) values were significantly lower and the left ventricular outflow tract isovolumetric relaxation time (LVOT-IRT) (p=0.021) was significantly higher in cases where the NICU was required. According to the ROC analysis performed in the idiopathic polyhydramnios group, the optimal cut-off values of aortic max, aortic VTI, and LVOT-IRT in the prediction of the NICU requirement were (57.5, 0.089 and 41.5, respective cut-off value) (p=0.010, p=0.048, p=0.021, respectively).</p><p><strong>Conclusions: </strong>Both fetal cardiac output and Mod-MPI values were altered in fetuses with idiopathic polyhydramnios.</p>","PeriodicalId":23854,"journal":{"name":"Zeitschrift fur Geburtshilfe und Neonatologie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10154977","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}