A common mutation in the factor V gene, the Leiden mutation, is the most frequent genetic cause o... more A common mutation in the factor V gene, the Leiden mutation, is the most frequent genetic cause of resistance to activated protein C (APC). Recent studies have shown that the prevalence of APC resistance is associated with severe pregnancy-induced hypertension (PIH). Our objective was to determine whether the factor V Leiden mutation is more prevalent in patients who developed severe PIH than in normotensive pregnant women. In 70 women with a history of severe PIH, of whom 15 had pre-eclampsia, we investigated common coagulation factors as well as APC resistance (factor V related). We found that seven of these 70 women showed low values for APC. Out of these, five were heterozygous and none was homozygous for factor V Leiden mutation. In a control group of normotensive pregnant women we found a 3.0% rate of APC resistance and a 3.0% rate of carriers of the Leiden mutation. These results indicate a significantly higher prevalence of both APC resistance and factor V Leiden mutation in...
An improvement in the mortality and morbidity of very low-birth-weight infants could be confirmed... more An improvement in the mortality and morbidity of very low-birth-weight infants could be confirmed by the regionalisation of high-risk pregnancies. The immaturity of premature newborn limits the therapeutic success. Our aim is therefore on the one hand, to make an early diagnosis of patients at risk of threatened premature delivery, and secondly, to provide intensive therapy for women already showing symptoms of premature delivery, to achieve the best possible prognosis. A reduction in the number of very low birth-weight infants and their mortality and morbidity rate appears to be possible if the pregnant women can be placed in a perinatal centre in good time; if the pregnancy can be prolonged and fetal lung maturation can be induced by betamethasone; if the delivery can be managed carefully, avoiding hypoxaemia, shock situations, and trauma; in certain cases this would mean performing a caesarean section by isthmo-cervical longitudinal incision; if primary neonatal care is performed...
Die Patientin ist nach 1 Jahr rezidivfrei und ohne Fernmetastasierung, bei relativem Wohlbefinden... more Die Patientin ist nach 1 Jahr rezidivfrei und ohne Fernmetastasierung, bei relativem Wohlbefinden. Sie erhält eine psychoonkologische Betreuung und nimmt an einem Sportprogramm teil. Die kombinierte antihormonelle Therapie und die 3-wöchentliche Trastuzumabapplikation werden für 1 Jahr fortgesetzt. Das Kind zeigt eine regelhafte Entwicklung.
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, Jan 31, 2015
To determine the effects of betamethasone on fetal growth and neonatal outcomes. A retrospective ... more To determine the effects of betamethasone on fetal growth and neonatal outcomes. A retrospective cohort study was performed of deliveries that occurred at Charité University Hospital Berlin, Germany, between January 1996 and December 2008. The betamethasone group included women with preterm labor and symptomatic contractions, cervical insufficiency, preterm premature rupture of membranes, or vaginal bleeding. Women in the control group were matched for gestational age at time of delivery and had not received betamethasone. Fetal growth changes and neonatal anthropometry were compared. Among 1799 newborns in the betamethasone group and 42 240 in the control group, betamethasone was associated with significantly lower birth weight (154g lower on average) after adjusting for confounders (e.g. hypertension, smoking, and maternal weight), sex, and gestational age at delivery (P<0.05). The higher the dose, the greater the difference in mean birth weight versus controls in births before...
Background: The long-term outcomes of antenatal glucocorticoids (GCs) vary between reports, and h... more Background: The long-term outcomes of antenatal glucocorticoids (GCs) vary between reports, and have generated controversy in terms of repeated and single-course events, causing irreversible effects on endocrine set points. Aim: This study aimed to assess the effects of alternative therapeutic agents other than synthetic glucocorticoid GC administration for fetal lung maturation. Methods: A review of literature from PubMed, EMBASE, Cochrane Library, and Google Scholar was conducted to assess the use of alternative therapies to synthetic GCs using recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). End points included the rates of respiratory distress syndrome (RDS), mRNA expression for pneumocyte type II, concentration of surfactant proteins in alveolar lavage, morphological differences, histological proof of lung maturation, and angiogenesis or quantification of the surfactant pool. Results: In all 41 studies examined, we fo...
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2010
To assess whether ultrasound experience or fetal head station affects the reliability of measurem... more To assess whether ultrasound experience or fetal head station affects the reliability of measurement of fetal head descent using the angle of progression on intrapartum ultrasound images obtained by a single experienced operator, and to determine reliability of measurements when images were acquired by different operators with variable ultrasound experience. One experienced obstetrician performed 44 transperineal ultrasound examinations of women at term and in prolonged second stage of labor with the fetus in the occipitoanterior position. Three midwives without ultrasound experience, three obstetricians with < 5 years' experience and three obstetricians with > 10 years' experience measured fetal head descent based on the angle of progression in the images obtained. The angle of progression was measured by two obstetricians in independent ultrasound examinations of 24 laboring women at term with the fetus in the cephalic position to allow assessment of the reliability ...
The aim of the present study was to evaluate the depth of endovascular trophoblast invasion and a... more The aim of the present study was to evaluate the depth of endovascular trophoblast invasion and associated remodelling of spiral arteries in a transgenic model of pre-eclampsia in the rat, a species showing a comparable deep invasion during normal pregnancy as the human. Pre-eclamptic (PE) transgenic rats (TGR) (hAngiotensinogen female x hRenin male) and non-PE reversely mated (RM) TGR rats were compared to normal Sprague-Dawley rats (C). Day 18 implantation sites were collected and the presence of endovascular trophoblast, fibrinoid, endothelial and smooth muscle cells were evaluated in spiral arteries in three parallel layers in the mesometrial triangle using an image analysis system (KS-400). In a separate group of animals peak-systolic and end-diastolic velocities were measured by Doppler in uterine and arcuate arteries, and the resistance indices (RI) were calculated. In PE and RM rats, the entire mesometrial triangle contained significantly more endovascular trophoblast and va...
A common mutation in the factor V gene, the Leiden mutation, is the most frequent genetic cause o... more A common mutation in the factor V gene, the Leiden mutation, is the most frequent genetic cause of resistance to activated protein C (APC). Recent studies have shown that the prevalence of APC resistance is associated with severe pregnancy-induced hypertension (PIH). Our objective was to determine whether the factor V Leiden mutation is more prevalent in patients who developed severe PIH than in normotensive pregnant women. In 70 women with a history of severe PIH, of whom 15 had pre-eclampsia, we investigated common coagulation factors as well as APC resistance (factor V related). We found that seven of these 70 women showed low values for APC. Out of these, five were heterozygous and none was homozygous for factor V Leiden mutation. In a control group of normotensive pregnant women we found a 3.0% rate of APC resistance and a 3.0% rate of carriers of the Leiden mutation. These results indicate a significantly higher prevalence of both APC resistance and factor V Leiden mutation in...
An improvement in the mortality and morbidity of very low-birth-weight infants could be confirmed... more An improvement in the mortality and morbidity of very low-birth-weight infants could be confirmed by the regionalisation of high-risk pregnancies. The immaturity of premature newborn limits the therapeutic success. Our aim is therefore on the one hand, to make an early diagnosis of patients at risk of threatened premature delivery, and secondly, to provide intensive therapy for women already showing symptoms of premature delivery, to achieve the best possible prognosis. A reduction in the number of very low birth-weight infants and their mortality and morbidity rate appears to be possible if the pregnant women can be placed in a perinatal centre in good time; if the pregnancy can be prolonged and fetal lung maturation can be induced by betamethasone; if the delivery can be managed carefully, avoiding hypoxaemia, shock situations, and trauma; in certain cases this would mean performing a caesarean section by isthmo-cervical longitudinal incision; if primary neonatal care is performed...
Die Patientin ist nach 1 Jahr rezidivfrei und ohne Fernmetastasierung, bei relativem Wohlbefinden... more Die Patientin ist nach 1 Jahr rezidivfrei und ohne Fernmetastasierung, bei relativem Wohlbefinden. Sie erhält eine psychoonkologische Betreuung und nimmt an einem Sportprogramm teil. Die kombinierte antihormonelle Therapie und die 3-wöchentliche Trastuzumabapplikation werden für 1 Jahr fortgesetzt. Das Kind zeigt eine regelhafte Entwicklung.
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, Jan 31, 2015
To determine the effects of betamethasone on fetal growth and neonatal outcomes. A retrospective ... more To determine the effects of betamethasone on fetal growth and neonatal outcomes. A retrospective cohort study was performed of deliveries that occurred at Charité University Hospital Berlin, Germany, between January 1996 and December 2008. The betamethasone group included women with preterm labor and symptomatic contractions, cervical insufficiency, preterm premature rupture of membranes, or vaginal bleeding. Women in the control group were matched for gestational age at time of delivery and had not received betamethasone. Fetal growth changes and neonatal anthropometry were compared. Among 1799 newborns in the betamethasone group and 42 240 in the control group, betamethasone was associated with significantly lower birth weight (154g lower on average) after adjusting for confounders (e.g. hypertension, smoking, and maternal weight), sex, and gestational age at delivery (P<0.05). The higher the dose, the greater the difference in mean birth weight versus controls in births before...
Background: The long-term outcomes of antenatal glucocorticoids (GCs) vary between reports, and h... more Background: The long-term outcomes of antenatal glucocorticoids (GCs) vary between reports, and have generated controversy in terms of repeated and single-course events, causing irreversible effects on endocrine set points. Aim: This study aimed to assess the effects of alternative therapeutic agents other than synthetic glucocorticoid GC administration for fetal lung maturation. Methods: A review of literature from PubMed, EMBASE, Cochrane Library, and Google Scholar was conducted to assess the use of alternative therapies to synthetic GCs using recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). End points included the rates of respiratory distress syndrome (RDS), mRNA expression for pneumocyte type II, concentration of surfactant proteins in alveolar lavage, morphological differences, histological proof of lung maturation, and angiogenesis or quantification of the surfactant pool. Results: In all 41 studies examined, we fo...
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2010
To assess whether ultrasound experience or fetal head station affects the reliability of measurem... more To assess whether ultrasound experience or fetal head station affects the reliability of measurement of fetal head descent using the angle of progression on intrapartum ultrasound images obtained by a single experienced operator, and to determine reliability of measurements when images were acquired by different operators with variable ultrasound experience. One experienced obstetrician performed 44 transperineal ultrasound examinations of women at term and in prolonged second stage of labor with the fetus in the occipitoanterior position. Three midwives without ultrasound experience, three obstetricians with < 5 years' experience and three obstetricians with > 10 years' experience measured fetal head descent based on the angle of progression in the images obtained. The angle of progression was measured by two obstetricians in independent ultrasound examinations of 24 laboring women at term with the fetus in the cephalic position to allow assessment of the reliability ...
The aim of the present study was to evaluate the depth of endovascular trophoblast invasion and a... more The aim of the present study was to evaluate the depth of endovascular trophoblast invasion and associated remodelling of spiral arteries in a transgenic model of pre-eclampsia in the rat, a species showing a comparable deep invasion during normal pregnancy as the human. Pre-eclamptic (PE) transgenic rats (TGR) (hAngiotensinogen female x hRenin male) and non-PE reversely mated (RM) TGR rats were compared to normal Sprague-Dawley rats (C). Day 18 implantation sites were collected and the presence of endovascular trophoblast, fibrinoid, endothelial and smooth muscle cells were evaluated in spiral arteries in three parallel layers in the mesometrial triangle using an image analysis system (KS-400). In a separate group of animals peak-systolic and end-diastolic velocities were measured by Doppler in uterine and arcuate arteries, and the resistance indices (RI) were calculated. In PE and RM rats, the entire mesometrial triangle contained significantly more endovascular trophoblast and va...
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