Zeitschrift fur Geburtshilfe und Neonatologie最新文献

Objective: We aimed to investigate the relationship between the hyperemesis gravidarum (HG) and maternal serum phoenixin-14 (PNX-14) concentrations.

Materials and methods: This cross-sectional study was conducted with 88 pregnant women who applied to the Umraniye Training and Research Hospital Gynecology and Obstetrics Clinic between February 2022 and October 2022. The HG group consisted of 44 pregnant women diagnosed with HG between the 7th and 14th gestational weeks, and the control group consisted of 44 healthy pregnant women matched with the HG group in terms of age, BMI, and gestational week. Demographic characteristics, ultrasound findings, and laboratory outcomes were noted. The two groups were compared in terms of maternal serum PNX-14 concentrations.

Results: Gestational age at blood sampling for PNX-14 was similar in both groups (p=1.000). While maternal serum PNX-14 concentration was 85.5 pg/ml in the HG group, it was 71.3 pg/ml in the control group (p=0.012). ROC analysis was performed to determine the value of maternal serum PNX-14 concentration in terms of predicting HG. AUC analysis of maternal serum PNX-14 for HG estimation was 0.656 (p=0.012, 95% CI=0.54-0.77). The optimal cutoff value for maternal serum PNX-14 concentration was determined as 79.81 pg/ml with 59% sensitivity and 59% specificity.

Conclusion: In this study, maternal serum PNX-14 concentration was found to be higher in pregnant women with HG, which indicates that high serum PNX-14 concentrations may have an anorexigenic effect on food intake in pregnancy. Concentrations of other PNX isoforms in HG and changes in PNX concentrations in pregnant women with HG who regained weight after treatment remain to be investigated.

Purpose: Evaluation of the effect of maternal nifedipine treatment on total uterine artery blood volume flow rate (TVFR).

Methods: In this prospective study, 43 women who were admitted to the Perinatology Department of the University of Health Sciences Etlik Zübeyde Hanım Gynecology Training and Research Hospital, with the diagnosis of the threat of preterm labor, and 40 healthy pregnant women, who were randomly selected as the control group, were evaluated between July 1, 2018, and September 1, 2018. A transabdominal ultrasound examination of uterine arteries was performed both before and 48 hours after administration of oral nifedipine for TVFR measurement. For the final analysis, the TVFR levels of the group diagnosed with the threat of preterm labor and the control group were compared.

Results: There was no significant difference in either uterine artery pulsatility index or resistance index values as well as the diameters of the uterine arteries after nifedipine treatment (p>0.05 for all). Total uterine artery blood volume flow rate (TVFR) was 424.66±236.74 mL/min before and 543.39±309.68 mL/min after treatment with nifedipine and was statistically significantly higher (p < 0.05).

Conclusions: Our study showed a statistically significant increase in total uterine artery blood volume flow rate 48 hours after oral nifedipine treatment.

Background: Donor human milk is the recommended alternative for feeding preterm infants if mother's own milk is unavailable. Human milk banks collect, screen, store and distribute donated human milk according to pre-specified standard operating procedures to premature infants without mothers own milk.

Aim:   Herein we characterize current operating models and the structural organisation of German milk bank institutions. The analysis of current and future opportunities and challenges may support the development of a comprehensive donor milk service within Germany.

Material and methods: Summary of the panel discussion entitled "Operating models and organizational structures: opportunities and risks for donor human milk bank in Germany" during the 3rd Scientific Symposium of the German Human Milk Bank Initiative (FMBI), November 25th to 26th 2022, in Nuremberg, Germany.

Results and discussion: Differing operator models may facilitate the use of donor human milk by incorporating unique site-specific factors, pre-existing infrastructure, and individual needs. In addition to the establishment of milk banks serving single neonatal units, high-capacity milk banks should be enabled to provide donor human milk using several hub-and-spoke systems. This may create a nationwide network for a sustainable human milk supply for preterm infants that is based on qualified breastfeeding and lactation support.

Introduction: Most births in Germany take place in a clinical setting. Midwife-led units have been offered in Germany since 2003 as an addition to the primarily physician-led obstetric care. The purpose of this study was to analyze differences regarding medical parameters between a midwife-led and a primarily physician-led unit in a level 1 perinatal center.

Material and methods: Between 12/2020 and 12/2021, all births begun in the midwife-led unit were retrospectively analyzed and compared to a physician-led control cohort. Outcome measures were defined as obstetric interventions, delivery mode and duration, delivery position, and maternal and neonatal outcome.

Results: The percentage of deliveries started in the midwife-led unit out of the total birth rate was 4.8% (n=132). Most transfers were made for more effective analgesia (52.6%). Among medically indicated transfers (n=30, 39.5%), transfers due to CTG abnormalities and failure to progress in labor after rupture of membranes predominated. 43.9% (n=58) of patients gave birth successfully in the midwife-led unit. The rate of episiotomy was significantly higher in the primarily physician-led unit compared to the successful midwife-led unit (p=0.019).

Conclusion: Birth in a midwife-led unit within a perinatal center can be considered an equivalent alternative to primarily physician-led birth for low-risk pregnant women.