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Steetskamp J, Zander M, Laufs V, Elger T, Hasenburg A, Skala C. Does vaginal bacterial colonization contribute to preterm birth in women with asymptomatic shortened cervix? Arch Gynecol Obstet 2024:10.1007/s00404-024-07397-2. [PMID: 38578544 DOI: 10.1007/s00404-024-07397-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 01/22/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE The aim of this study is to describe the typical microbial spectrum and the influence of distinct vaginal infections on preterm birth in pregnancies affected by cervical incompetence. METHODS 327 patients were admitted because of asymptomatic shortening of the cervix in the second and third trimester of pregnancy. Clinical data such as age, cervical length, gestational age at admission and at delivery and vaginal microbiologic findings were collected and analyzed. RESULTS The spectrum of germs in the vagina revealed seven different distinct species; the most common bacteria were Ureaplasma spp. and E. coli. In 327 included patients, 217 revealed a bacterial colonization, 110 did not. Most common bacteria in women with preterm birth before 34 weeks were Ureaplasma spp., while E. coli was most common in women undergoing preterm birth after 34 weeks. Nevertheless, the rates of occurrence of these bacterial taxa were not significantly different between who underwent preterm birth to those who did not. CONCLUSIONS This study gives an overview over the vaginal bacterial colonization in pregnant women with cervical incompetence. The clinical relevance of vaginal bacterial colonization remains unclear.
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Affiliation(s)
- J Steetskamp
- Department of Obstetrics and Gynecology, Mainz University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany
| | - M Zander
- . Josefs-Hospital Wiesbaden, Beethovenstraße 20, 65189, Wiesbaden, Germany
| | - V Laufs
- Department of Obstetrics and Gynecology, Mainz University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany
| | - T Elger
- Department of Obstetrics and Gynecology, Mainz University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany
| | - A Hasenburg
- Department of Obstetrics and Gynecology, Mainz University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany
| | - C Skala
- Department of Obstetrics and Gynecology, Mainz University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany.
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Almstedt K, Mendoza S, Battista MJ, Steetskamp J, Heimes AS, Krajnak S, Poplawski A, Hasenburg A, Schmidt M. EndoPredict® in early hormone receptor-positive, HER2-negative breast cancer: Impact on clinical decisions and clinico-pathological factors influencing its application. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
| | | | | | | | | | | | - A Poplawski
- Institut für Medizinische Biometrie, Epidemiologie and Informatik (IMBEI)
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Almstedt K, Mendoza S, Otto M, Battista MJ, Steetskamp J, Heimes AS, Krajnak S, Poplawski A, Gerhold-Ay A, Hasenburg A, Denkert C, Schmidt M. EndoPredict ® in early hormone receptor-positive, HER2-negative breast cancer. Breast Cancer Res Treat 2020; 182:137-146. [PMID: 32436145 PMCID: PMC7275019 DOI: 10.1007/s10549-020-05688-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 05/11/2020] [Indexed: 01/13/2023]
Abstract
Purpose Evaluating consecutive early breast cancer patients, we analyzed both the impact of EndoPredict® on clinical decisions as well as clinico-pathological factors influencing the decision to perform this gene expression test. Methods Hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative early breast cancer patients treated between 2011 and 2016 were included in this study to investigate the role of EndoPredict® (EPclin) in the treatment of early breast cancer. A main study aim was to analyze the changes in therapy recommendations with and without EPclin. In addition, the impact of clinico-pathological parameters for the decision to perform EPclin was examined by Pearson's chi-squared test (χ2-test) and Fisher's exact test as well as univariate and multivariate logistic regressions. Results In a cohort of 869 consecutive early HR-positive, HER-negative breast cancer patients, EPclin was utilized in 156 (18.0%) patients. EPclin led to changes in therapy recommendations in 33.3% (n = 52), with both therapy escalation in 19.2% (n = 30) and de-escalation in 14.1% (n = 22). The clinico-pathological factors influencing the use of EPclin were age (P < 0.001, odds ratio [OR] 0.498), tumor size (P = 0.011, OR 0.071), nodal status (P = 0.021, OR 1.674), histological grade (P = 0.043, OR 0.432), and Ki-67 (P < 0.001, OR 3.599). Conclusions EPclin led to a change in therapy recommendations in one third of the patients. Clinico-pathological parameters such as younger age, smaller tumor size, positive nodal status, intermediate histological grade and intermediate Ki-67 had a significant influence on the use of EndoPredict®. Electronic supplementary material The online version of this article (10.1007/s10549-020-05688-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- K Almstedt
- Department of Obstetrics and Gynecology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
| | - S Mendoza
- Department of Obstetrics and Gynecology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - M Otto
- Institute for Molecular Pathology, Trier, Germany
| | - M J Battista
- Department of Obstetrics and Gynecology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - J Steetskamp
- Department of Obstetrics and Gynecology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - A S Heimes
- Department of Obstetrics and Gynecology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - S Krajnak
- Department of Obstetrics and Gynecology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - A Poplawski
- Institute of Medical Biometry, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany
| | - A Gerhold-Ay
- Institute of Medical Biometry, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany
| | - A Hasenburg
- Department of Obstetrics and Gynecology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - C Denkert
- Institute of Pathology, Philipps-University Marburg and UKGM Marburg, Marburg, Germany
| | - M Schmidt
- Department of Obstetrics and Gynecology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
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Hedri A, Dionysopoulou A, Lindner C, Macchiella D, Steetskamp J, Hasenburg A. Pregnancy in a patient with primary sclerosing cholangitis. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- A Hedri
- Unifrauenklinik Mainz, Gynäkologie und Geburtshilfe, Mainz, Deutschland
| | - A Dionysopoulou
- Unifrauenklinik Mainz, Gynäkologie und Geburtshilfe, Mainz, Deutschland
| | - C Lindner
- Unifrauenklinik Mainz, Gynäkologie und Geburtshilfe, Mainz, Deutschland
| | - D Macchiella
- Unifrauenklinik Mainz, Gynäkologie und Geburtshilfe, Mainz, Deutschland
| | - J Steetskamp
- Unifrauenklinik Mainz, Gynäkologie und Geburtshilfe, Mainz, Deutschland
| | - A Hasenburg
- Unifrauenklinik Mainz, Gynäkologie und Geburtshilfe, Mainz, Deutschland
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Hedri A, Steetskamp J, Hasenburg A. Pregnancy-associated cancer: A 10-year experience at Mainz University Hospital, Germany. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- A Hedri
- Unifrauenklinik Mainz, Mainz, Deutschland
| | - J Steetskamp
- Unifrauenklinik Mainz, Gynäkologie und Geburtshilfe, Mainz, Deutschland
| | - A Hasenburg
- Unifrauenklinik Mainz, Gynäkologie und Geburtshilfe, Mainz, Deutschland
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Nezi S, Sicking I, Almstedt K, Battista M, Heimes AS, Krajnak S, Steetskamp J, Hasenburg A, Schmidt M. Risikofaktoren für Chemotherapie-assoziierte venöse Thrombosen bei gynäkoonkologischen Patientinnen. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- S Nezi
- Universitätsmedizin Mainz, Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Mainz, Deutschland
| | - I Sicking
- Universitätsmedizin Mainz, Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Mainz, Deutschland
| | - K Almstedt
- Universitätsmedizin Mainz, Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Mainz, Deutschland
| | - M Battista
- Universitätsmedizin Mainz, Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Mainz, Deutschland
| | - AS Heimes
- Universitätsmedizin Mainz, Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Mainz, Deutschland
| | - S Krajnak
- Universitätsmedizin Mainz, Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Mainz, Deutschland
| | - J Steetskamp
- Universitätsmedizin Mainz, Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Mainz, Deutschland
| | - A Hasenburg
- Universitätsmedizin Mainz, Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Mainz, Deutschland
| | - M Schmidt
- Universitätsmedizin Mainz, Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Mainz, Deutschland
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Henkel A, Heun X, Steetskamp J, Albrich S, Naumann G, Skala C. TVT versus Mini-Arc Ein Vergleich des intra- und postoperativen Verlaufs. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Albrich SB, Welker K, Wolpert B, Steetskamp J, Porta S, Hasenburg A, Skala C. How common is ballooning? Hiatal area on 3D transperineal ultrasound in urogynecological patients and its association with lower urinary tract symptoms. Arch Gynecol Obstet 2016; 295:103-109. [DOI: 10.1007/s00404-016-4200-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 09/06/2016] [Indexed: 12/01/2022]
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Albrich S, Steetskamp J, Rommens K, Porta S, Battista M, Hoffmann G, Skala C. Detection of Subpubic Tumor Causing Bladder Outlet Obstruction by 3D Perineal Ultrasound. Geburtshilfe Frauenheilkd 2015; 75:719-722. [PMID: 26257409 DOI: 10.1055/s-0035-1546219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 06/03/2015] [Accepted: 06/12/2015] [Indexed: 10/23/2022] Open
Abstract
This case report shows that 3D perineal ultrasound can be superior to clinical examination and routine 2D perineal ultrasound in the detection of an unusual subpubic tumor. A 73-year-old female patient was referred to our urogynecological outpatient unit complaining of over-active bladder symptoms and voiding dysfunction for 3 years. Gynecological examination found no signs of pelvic organ prolapse or abnormality in the vaginal cavity. Routine 2D perineal ultrasound showed substantial residual urine (ca. 300 ml on catheter) and limited bladder neck mobility, but no signs of pelvic organ prolapse. Use of standardized 3D perineal ultrasound revealed a 24 × 26 × 32 mm spherical, hypoechoic tumor below the pubic symphysis between the distal urethra and the pubic bones. This structure was mistaken for the pubic symphysis in the midline on 2D ultrasound performed earlier. At surgery, the tumor was completely excised through a vaginal incision between the urethra and the pubic symphysis. After an uneventful postoperative recovery the patient developed de-novo stress urinary incontinence, which was corrected successfully by the insertion of a retropubic tension-free suburethral sling after an interval of 8 weeks. After a further follow-up of 8 weeks the patient reported well-being, urinary continence and no voiding dysfunction; no abnormalities were found on examination. In conclusion, 3D perineal ultrasound is a useful additional tool for the diagnostic workup of bladder outlet obstruction.
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Affiliation(s)
- S Albrich
- Department of Obstetrics and Gynecology, Johannes-Gutenberg-University Mainz, Mainz
| | - J Steetskamp
- Department of Obstetrics and Gynecology, Johannes-Gutenberg-University Mainz, Mainz
| | - K Rommens
- Department of Obstetrics and Gynecology, Johannes-Gutenberg-University Mainz, Mainz
| | - S Porta
- Department of Obstetrics and Gynecology, Johannes-Gutenberg-University Mainz, Mainz
| | - M Battista
- Department of Obstetrics and Gynecology, Johannes-Gutenberg-University Mainz, Mainz
| | - G Hoffmann
- Department of Obstetrics and Gynecology, Johannes-Gutenberg-University Mainz, Mainz
| | - C Skala
- Department of Obstetrics and Gynecology, Johannes-Gutenberg-University Mainz, Mainz
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Albrich S, Rommens K, Steetskamp J, Weyer V, Hoffmann G, Skala C, Zahn E. Prevalence of Levator Ani Defects in Urogynecological Patients. Geburtshilfe Frauenheilkd 2015; 75:51-55. [PMID: 27635090 PMCID: PMC5019347 DOI: 10.1055/s-0034-1396180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 11/02/2014] [Accepted: 11/02/2014] [Indexed: 10/24/2022] Open
Abstract
Introduction: Defects of the levator ani muscle complex could represent a pathophysiological link between vaginal birth trauma and urogynecological symptoms many years later. The aim of our study was to determine the prevalence of levator ani muscle defects using 3D or 4D ultrasound and palpation in urogynecological patients. Material and Methods: Urogynecological patients were retrospectively investigated using 3D or 4D ultrasound. Clinical examination consisted of palpation and 3D or 4D imaging of the levator ani muscle. Results: A total of 319 women were included in the analysis. Mean age was 64.9 years, average parity was 2.1. Stress incontinence was present in 50.8 %, overactive bladder symptoms in 69.3 % and pelvic organ prolapse in 42.3 % of patients. A levator ani defect was found on ultrasound in 76 patients (23.8 %) and on palpation in 64 women (20.0 %). In the group of patients with pelvic organ prolapse, levator ani defects were found in 32.6 % of patients using ultrasound and in 26.7 % of patients using palpation. The odds ratio (OR) for levator ani defects in women with pelvic organ prolapse was 2.3 (95 % CI [CI: confidence interval]: 1.36-3.88], p = 0.002). Conclusion: In a cohort of urogynecological patients seen at a tertiary urogynecological unit, the prevalence of levator ani defects was significantly higher in women with pelvic organ prolapse compared to women with stress incontinence or urge symptoms.
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Affiliation(s)
- S. Albrich
- Johannes-Gutenberg-University Mainz, Department of Obstetrics and
Gynecology, Mainz
| | - K. Rommens
- Johannes-Gutenberg-University Mainz, Department of Obstetrics and
Gynecology, Mainz
| | - J. Steetskamp
- Johannes-Gutenberg-University Mainz, Department of Obstetrics and
Gynecology, Mainz
| | - V. Weyer
- Johannes-Gutenberg-University Mainz, Institute of Medical Biostatistics,
Epidemiology and Informatics (IMBEI), Mainz
| | - G. Hoffmann
- Johannes-Gutenberg-University Mainz, Department of Obstetrics and
Gynecology, Mainz
| | - C. Skala
- Johannes-Gutenberg-University Mainz, Department of Obstetrics and
Gynecology, Mainz
| | - E. Zahn
- Klinikum Kempten, Obstetrics and Gynecology, Kempten
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Steetskamp J, Skala CE, Knöchel SL, Hoffmann G, Albrich S. Beurteilung der Kontraktilität der Beckenbodenmuskulatur mittels 2D- und 3D-Perinealsonografie. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Albrich SB, Knöchel SL, Porta S, Rommens K, Steetskamp J, Skala C. Klinische Beurteilung von „Hiatus-Ballooning“ mittels POPQ-Score. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Albrich SB, Krajnak S, Brochhausen C, Rommens K, Steetskamp J, Porta S, Skala C. Histologische Beurteilung nach Teilexzision suburethraler Inkontinenz-Bänder. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Dionysopoulou A, Rommens K, Henriques A, Porta S, Steetskamp J, Skala C, Albrich SB. Pilotstudie zur Etablierung einer neuen Referenz-Linie in der 2D-Perineal-Sonografie. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Hornung R, Albrich S, Skala C, Steetskamp J, Stoll L, Porta S, Rommens K. Einfluss der Tageszeit auf die Hiatusfläche der Frau in der 3D-Sonografie. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Naumann G, Steetskamp J, Meyer M, Albrich S. Sexualfunktion und Lebensqualität nach TVT-Bandplastik und Single-Incision-Schlingen (SIS-Band) bei der Belastungsinkontinenz der Frau: Ergebnisse einer prospektiven Studie. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Albrich SB, Henriques A, Dionysopoulou A, Rommens K, Porta S, Steetskamp J, Skala C. Effect of patient positioning in ultrasound evaluation of bladder neck mobility and genital hiatus area – pilot study. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Klöckner ME, Steetskamp J, Brockerhoff P, Puhl AG. Prostaglandine zur Geburtseinleitung: Vergleich der Effektivität von Misoprostol und Dinoproston Vaginalgel an einem deutschen Perinatalzentrum. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Steetskamp J, Klöckner ME, Felberbaum R, Puhl AG. Die „schwierige Einleitung“: Minprostin und Cytotec im Vergleich bei Geburtseinleitung vor Termin und bei ungünstigem Bishop-Score. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Fuchs AJ, Geißler-Tertilt C, Steetskamp J, Hofmann C, Brockerhoff P, Mildenberger E. Vaginale Geburt oder Kaiserschnitt bei Frühgeborenen eines Geburtsgewichtes unter 1500 g – Retrospektive Analyse des Outcomes. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Steetskamp J, Puhl AG, Zelazny J, Skala C, Kölbl H, Bahlmann F. [Clinical and economic challenges of moderate preterm babies born between 32+0 and 36+6 weeks of gestation]. Z Geburtshilfe Neonatol 2011; 215:158-62. [PMID: 21874633 DOI: 10.1055/s-0031-1275740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Preterm births show a worldwide increasing incidence. The majority of preterm births occur between 32+0 and 36+6 weeks of gestation and are associated with an increased rate of maternal and neonatal morbidity. The focus of our research is the clinical and economical analysis of all preterm births between 32+0 and 36+6 weeks of gestation in a German level 1 perinatal centre over a period of 3 years. MATERIALS AND METHODS A retrospective analysis of all preterm births between 32+0 and 36+6 weeks of gestation in the University Hospital Mainz from 2007 to 2009 was undertaken. Data were collected using our electronic documentation system. Gestational age at delivery, mode of birth, indication for delivery, duration of the peripartum treatment, treatment of the newborn in the children's hospital, birth weight and therapy costs were evaluated. RESULTS We recorded 407 moderate preterm births in total; this amounts to a rate of of 10% of all births. Major causes of prematurity were PPROM, preterm labour and preeclampsia/HELLP. Maternal and fetal systemic diseases were more uncommon. Rates of Caesarean sections (62%) and of neonatal inpatient treatment needs (58.5%) were high. Maternal treatment costs were 332 Euro/day. The mean duration of maternal inpatient treatment was 13.15 days. DISCUSSION Moderate preterm birth is associated with maternal morbidity frequently due to a high rate of Caesarean sections. Neonatal morbidity is also increased. In comparison with previous research, we saw an increased rate of pregnancy complications. This could be typical for a level 1 perinatal centre. Moderate preterm birth is seen as the cause of considerable treatment costs.
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Affiliation(s)
- J Steetskamp
- Universitätsmedizin Mainz, Klinik und Poliklinik für Geburtshilfe und Frauenheilkunde, Germany.
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Battista MJ, Steetskamp J, Mantai N, Gebhard S, Cotarelo C, Victor A, Petry I, Schmidt M, Kölbl H. Immunoreactive score of Ep-CAM might predict survival in early ovarian cancer patients. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1286464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Tchirikov M, Kharkevich O, Steetskamp J, Beluga M, Strohner M. Treatment of Growth-Restricted Human Fetuses with Amino Acids and Glucose Supplementation through a Chronic Fetal Intravascular Perinatal Port System. Eur Surg Res 2010; 45:45-9. [DOI: 10.1159/000318859] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Accepted: 07/06/2010] [Indexed: 11/19/2022]
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Oddo S, Thiel A, Klinger D, Würzburg J, Grabmair C, Steetskamp J, Thiel J, Louwen F, Stirn A. Wochenbettdepression: Interdisziplinär und multimodal betrachtet. Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-0029-1208296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Stirn A, Thiel A, Steetskamp J, Grabmair C, Würzburg J, Klinger D, Louwen F, Oddo S. Gibt es einen Zusammenhang zwischen eigener Bindungserfahrung, Mutter-Kind-Bindung und postpartaler Depression? Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-0029-1208314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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