1
|
Affiliation(s)
- Jens H Stupin
- Institut für Kinderernährung, Max Rubner-Institut (MRI), Haid-und-Neu-Str. 9, 76139, Karlsruhe, Deutschland
| |
Collapse
|
2
|
Schäfer-Graf UM, Adamczewski H, Grieshop M, Groten T, Hummel M, Hummel S, Kautzky-Willer A, Kühnert M, Laubner K, Schild R, Stupin JH, Schmidt M, Weschenfelder F, Abou-Dakn M. „A Pragmatic, Randomized Clinical Trial of Gestational Diabetes Screening“ – eine interdisziplinäre Stellungnahme. DIABETOL STOFFWECHS 2021. [DOI: 10.1055/a-1643-9734] [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: 10/20/2022]
Affiliation(s)
| | - Heinke Adamczewski
- Innere Medizin, Diabetologie, Diabetes Praxis Köln Ost, Köln, Deutschland
| | - Mellita Grieshop
- Hebammenwissenschaft, Evangelische Hochschule Berlin (EHB), Berlin, Deutschland
| | - Tanja Groten
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Jena, Jena, Deutschland
| | - Michael Hummel
- Diabetologischer Schwerpunkt, Internistische Gemeinschaftspraxis, Rosenheim, Deutschland
| | - Sandra Hummel
- Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), Institut für Diabetesforschung, München, Deutschland
| | - Alexandra Kautzky-Willer
- Endokrinologie und Stoffwechsel, Gender Medicine Unit, Medizinische Universität Wien, Wien, Österreich
| | - Maritta Kühnert
- Klinik für Frauenheilkunde und Geburtshilfe, UKGM Marburg, Marburg, Deutschland
| | - Katharina Laubner
- Klinik für Innere Medizin II, Abteilung Endokrinologie und Diabetologie, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - Ralf Schild
- Geburtshilfe und Perinatalmedizin, Diakovere Krankenhaus Henriettenstift und Friederikenstift mit dem Perinatalzentrum hannover, Hannover, Deutschland
| | - Jens H. Stupin
- Institut für Kinderernährung, Max-Rubner-Institut, Karlsruhe, Karlsruhe, Deutschland
| | - Markus Schmidt
- Klinik für Frauenheilkunde und Geburtshilfe, Sana Kliniken Duisburg GmbH, Duisburg, Deutschland
| | | | - Michael Abou-Dakn
- Klinik für Gynäkologie und Geburtshilfe, St. Joseph Krankenhaus Berlin-Tempelhof, Berlin, Deutschland
| |
Collapse
|
3
|
Stupin JH. [What the general practitioner needs to know about gestational diabetes]. MMW Fortschr Med 2021; 163:61-65. [PMID: 34533731 DOI: 10.1007/s15006-021-0220-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Jens H Stupin
- Klinik für Gynäkologie/Campus Virchow-Klinikum Charité, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| |
Collapse
|
4
|
Stupin JH, Henrich W, David M, Schlembach D, Razum O, Borde T, Breckenkamp J. Perinatales Outcome bei Frauen mit Gestationsdiabetes unter besonderer Berücksichtigung eines Migrationshintergrundes – Ergebnisse einer prospektiven Studie in Berlin. DIABETOL STOFFWECHS 2021. [DOI: 10.1055/a-1474-9761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Zusammenfassung
Hintergrund Etwa 25 % der Bevölkerung Deutschlands haben einen Migrationshintergrund (MH), der mit einem schlechteren perinatalen Outcome einhergehen kann. Der Gestationsdiabetes (GDM) gehört zu den häufigsten Schwangerschaftserkrankungen; von ihm sind Frauen mit MH in höherem Maße betroffen. Bisher liegen keine systematisch erhobenen Daten zur Betreuung von Migrantinnen mit GDM vor.
Fragestellung Ziel der Studie war es, Auswirkungen eines MH auf Schwangerschaften von Frauen mit GDM zu evaluieren: Haben Immigrantinnen und ihre Nachkommen ein schlechteres perinatales Outcome als Frauen ohne MH in den Parametern Geburtseinleitung, Sectio, Makrosomie, Apgar, Nabelschnur-pH-Wert, Verlegung auf eine neonatologische Intensivstation, Frühgeburt und prä-/postpartale Hb-Differenz? Beeinflusst ein MH außerdem den Zeitpunkt der ersten Schwangerenvorsorge sowie die Zahl der Vorsorgeuntersuchungen?
Methoden Datenerhebung an drei Berliner Geburtskliniken 2011/2012 unmittelbar in der Kreißsaalaufnahme über 12 Monate anhand standardisierter Interviews (Fragebogenset) in deutscher, türkischer und anderen Sprachen. Fragen zu soziodemografischen Aspekten, Schwangerenvorsorge sowie ggf. Migration und Akkulturation. Verknüpfung der Befragungsdaten mit Mutterpass- und klinischen Perinataldaten. Adjustierung für Alter, BMI, Parität und sozioökonomischen Status erfolgte in Regressionsmodellen.
Ergebnisse Die Daten von n = 2878 Frauen mit MH (GDM: 4,7 %) und n = 2785 Frauen ohne MH (GDM: 4,8 %) konnten verglichen werden. Eine multiple Regressionsanalyse zeigte keine Unterschiede in den Chancen der beiden Gruppen mit GDM hinsichtlich Sectio, Makrosomie, Apgar, Nabelschnur-pH-Werten, Verlegungen auf eine neonatologische Intensivstation sowie Zeitpunkt der ersten Schwangerenvorsorge ≥ 12 SSW und Zahl der Vorsorgeuntersuchungen < 10. Sowohl für Frauen mit GDM und MH (OR 1,57; 95 %-KI 1,08–2,27) als auch für solche mit GDM ohne MH (OR 1,47; 95 %-KI 1,01–2,14) bestand eine signifikant höhere Chance der Geburtseinleitung.
Schlussfolgerung Frauen mit GDM und MH zeigen ein ähnlich gutes Schwangerschaftsergebnis wie solche mit GDM und ohne MH, was auf eine hohe Qualität der peripartalen Betreuung und Versorgung hinweist. Im Vergleich zu Frauen ohne GDM wird bedingt durch diesen und den höheren BMI unabhängig vom MH vermehrt eingeleitet. Die Ergebnisse für Frauen mit GDM lassen unabhängig vom MH auf einen ähnlichen Standard der Inanspruchnahme von Vorsorgeuntersuchungen in der Schwangerschaft schließen.
Collapse
Affiliation(s)
| | | | | | | | - Oliver Razum
- AG3 Epidemiology and International Public Health, Universität Bielefeld, Fakultät für Gesundheitswissenschaften, Bielefeld, Germany
| | - Theda Borde
- Public Health, Alice Salomon Hochschule Berlin, Germany
| | - Jürgen Breckenkamp
- AG3 Epidemiology and International Public Health, Universität Bielefeld, Fakultät für Gesundheitswissenschaften, Bielefeld, Germany
| |
Collapse
|
5
|
Stupin JH. COVID-19 in der Schwangerschaft erhöht Risiko für Mutter und Kind. Info Diabetol 2021. [PMCID: PMC8210957 DOI: 10.1007/s15034-021-3703-3] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jens H. Stupin
- Klinik f. Gynäkologie\/Campus Virchow-Klinikum Charité, Augustenburger Platz 1, 13353 Berlin, Germany
| |
Collapse
|
6
|
|
7
|
Ott R, Melchior K, Stupin JH, Ziska T, Schellong K, Henrich W, Rancourt RC, Plagemann A. Reduced Insulin Receptor Expression and Altered DNA Methylation in Fat Tissues and Blood of Women With GDM and Offspring. J Clin Endocrinol Metab 2019; 104:137-149. [PMID: 30260402 DOI: 10.1210/jc.2018-01659] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 09/20/2018] [Indexed: 02/04/2023]
Abstract
CONTEXT Altered expression of the insulin receptor (IR) in adipose tissue (AT) could contribute to gestational diabetes mellitus (GDM) etiopathogenesis. Transcriptional regulation via epigenetic mechanisms (e.g., DNA methylation) may play a critical role. However, the human IR promoter DNA methylation patterns and involvement in gene expression are unknown. OBJECTIVE We evaluated IR mRNA and protein expression accompanied by targeted DNA methylation analyses in AT and blood cells of women with GDM and their offspring. DESIGN Prospective observational study. SETTING Academic clinic and research unit. PARTICIPANTS GDM-affected (n = 25) and matched control (n = 30) mother-child dyads. MAIN OUTCOME MEASURES Maternal IR gene and protein expression in paired subcutaneous (SAT) and visceral adipose tissue samples (VAT). DNA methylation levels in IR promoter and intronic regions in maternal AT and blood cells of mother-offspring pairs. RESULTS In SAT and VAT, IR mRNA/protein expressions were significantly reduced in women with GDMs (P < 0.05). The decrease in VAT was more pronounced and independent of maternal body mass index. VAT IR protein levels were inversely associated with key maternal and neonatal anthropometric and metabolic parameters (P < 0.05). DNA methylation patterns were similar across tissues, with significant yet small size alterations between groups in mothers and offspring (P < 0.05). CONCLUSION Decreased IR levels in AT may be a relevant pathogenic factor in GDM, affecting materno-fetal metabolism. Further investigation of causal factors for IR dysregulation is necessary, especially in VAT. Potential functional and/or clinical roles of altered DNA methylation also should be evaluated.
Collapse
Affiliation(s)
- Raffael Ott
- Division of 'Experimental Obstetrics,' Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Kerstin Melchior
- Division of 'Experimental Obstetrics,' Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Jens H Stupin
- Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Thomas Ziska
- Division of 'Experimental Obstetrics,' Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Karen Schellong
- Division of 'Experimental Obstetrics,' Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Wolfgang Henrich
- Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Rebecca C Rancourt
- Division of 'Experimental Obstetrics,' Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Andreas Plagemann
- Division of 'Experimental Obstetrics,' Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| |
Collapse
|
8
|
Ott R, Stupin JH, Melchior K, Schellong K, Ziska T, Dudenhausen JW, Henrich W, Rancourt RC, Plagemann A. Alterations of adiponectin gene expression and DNA methylation in adipose tissues and blood cells are associated with gestational diabetes and neonatal outcome. Clin Epigenetics 2018; 10:131. [PMID: 30355290 PMCID: PMC6201547 DOI: 10.1186/s13148-018-0567-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 10/14/2018] [Indexed: 12/12/2022] Open
Abstract
Background Adiponectin critically contributes to metabolic homeostasis, especially by insulin-sensitizing action. Gestational diabetes mellitus (GDM) is characterized by insulin resistance leading to materno-fetal hyperglycemia and detrimental birth outcomes. By investigating paired subcutaneous (SAT) and visceral adipose tissue (VAT) as well as blood (cell) samples of GDM-affected (n = 25) vs. matched control (n = 30) mother-child dyads of the prospective “EaCH” cohort study, we addressed whether alterations of adiponectin plasma, mRNA, and DNA methylation levels are associated with GDM and offspring characteristics. Results Hypoadiponectinemia was present in women with GDM, even after adjustment for body mass index (BMI). This was accompanied by significantly decreased mRNA levels in both SAT and VAT (P < 0.05), independent of BMI. Maternal plasma adiponectin showed inverse relations with glucose and homeostatic model assessment of insulin resistance (both P < 0.01). In parallel to reduced mRNA expression in GDM, significant (P < 0.05) yet small alterations in locus-specific DNA methylation were observed in maternal fat (~ 2%) and blood cells (~ 1%). While newborn adiponectin levels were similar between groups, DNA methylation in GDM offspring was variously altered (~ 1–4%; P < 0.05). Conclusions Reduced adiponectin seems to be a pathogenic co-factor in GDM, even independent of BMI, affecting materno-fetal metabolism. While altered maternal DNA methylation patterns appear rather marginally involved, functional, diagnostic, and/or predictive implications of cord blood DNA methylation should be further evaluated. Electronic supplementary material The online version of this article (10.1186/s13148-018-0567-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Raffael Ott
- Division of 'Experimental Obstetrics,' Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Jens H Stupin
- Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Kerstin Melchior
- Division of 'Experimental Obstetrics,' Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Karen Schellong
- Division of 'Experimental Obstetrics,' Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Thomas Ziska
- Division of 'Experimental Obstetrics,' Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Joachim W Dudenhausen
- Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Wolfgang Henrich
- Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Rebecca C Rancourt
- Division of 'Experimental Obstetrics,' Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Andreas Plagemann
- Division of 'Experimental Obstetrics,' Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| |
Collapse
|
9
|
Ott R, Stupin JH, Loui A, Eilers E, Melchior K, Rancourt RC, Schellong K, Ziska T, Dudenhausen JW, Henrich W, Plagemann A. Maternal overweight is not an independent risk factor for increased birth weight, leptin and insulin in newborns of gestational diabetic women: observations from the prospective 'EaCH' cohort study. BMC Pregnancy Childbirth 2018; 18:250. [PMID: 29925339 PMCID: PMC6011392 DOI: 10.1186/s12884-018-1889-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 06/10/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Both gestational diabetes mellitus (GDM) as well as overweight/obesity during pregnancy are risk factors for detrimental anthropometric and hormonal neonatal outcomes, identified to 'program' adverse health predispositions later on. While overweight/obesity are major determinants of GDM, independent effects on critical birth outcomes remain unclear. Thus, the aim of the present study was to evaluate, in women with GDM, the relative/independent impact of overweight/obesity vs. altered glucose metabolism on newborn parameters. METHODS The prospective observational 'Early CHARITÉ (EaCH)' cohort study primarily focuses on early developmental origins of unfavorable health outcomes through pre- and/or early postnatal exposure to a 'diabetogenic/adipogenic' environment. It includes 205 mother-child dyads, recruited between 2007 and 2010, from women with treated GDM and delivery at the Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, Germany. Recruitment, therapy, metabolite/hormone analyses, and data evaluation were performed according to standardized guidelines and protocols. This report specifically aimed to identify maternal anthropometric and metabolic determinants of anthropometric and critical hormonal birth outcomes in 'EaCH'. RESULTS Group comparisons, Spearman's correlations and unadjusted linear regression analyses initially confirmed that increased maternal prepregnancy body-mass-index (BMI) is a significant factor for elevated birth weight, cord-blood insulin and leptin (all P < 0.05). However, consideration of and adjustment for maternal glucose during late pregnancy showed that no maternal anthropometric parameter (weight, BMI, gestational weight gain) remained significant (all n.s.). In contrast, even after adjustment for maternal anthropometrics, third trimester glucose values (fasting and postprandial glucose at 32nd and 36th weeks' gestation, HbA1c in 3rd trimester and at delivery), were clearly positively associated with critical birth outcomes (all P < 0.05). CONCLUSIONS Neither overweight/obesity nor gestational weight gain appear to be independent determinants of increased birth weight, insulin and leptin. Rather, 3rd trimester glycemia seems to be crucial for respective neonatal outcomes. Thus, gestational care and future research studies should greatly consider late pregnancy glucose in overweight/obese women with or without GDM, for evaluation of critical causes and interventional strategies against 'perinatal programming of diabesity' in the offspring.
Collapse
Affiliation(s)
- Raffael Ott
- Clinic of Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
- Division of ‘Experimental Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Jens H. Stupin
- Clinic of Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Andrea Loui
- Department of Neonatology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Elisabeth Eilers
- Department of Neonatology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Kerstin Melchior
- Clinic of Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
- Division of ‘Experimental Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Rebecca C. Rancourt
- Clinic of Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
- Division of ‘Experimental Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Karen Schellong
- Clinic of Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
- Division of ‘Experimental Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Thomas Ziska
- Clinic of Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
- Division of ‘Experimental Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Joachim W. Dudenhausen
- Clinic of Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Wolfgang Henrich
- Clinic of Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Andreas Plagemann
- Clinic of Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
- Division of ‘Experimental Obstetrics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| |
Collapse
|
10
|
Görges J, Stupin JH, Arabin B. Beratungsqualität nach Kriterien des Institute of Medicine bei normalgewichtigen und adipösen Schwangeren. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593223] [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
|
11
|
Tillinger J, Stuckenschneider J, Klapp C, Stupin JH, Henrich W. Makrosomie bei Diabetes Mellitus (DM) Typ 1 mit normalem HbA1c-Wert – ein Fallbericht. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566627] [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: 10/22/2022]
|
12
|
Stupin JH. [A few months breastfeeding protects against maternal diabetes]. MMW Fortschr Med 2014; 156 Spec no 2:32. [PMID: 25552011 DOI: 10.1007/s15006-014-3685-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
13
|
David M, Adams L, Stupin JH. Natural Size Development of Myomata - Ultrasound Observational Study of 55 Premenopausal Patients. Geburtshilfe Frauenheilkd 2014; 74:75-80. [PMID: 24741122 DOI: 10.1055/s-0033-1351072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 04/21/2013] [Revised: 10/11/2013] [Accepted: 10/13/2013] [Indexed: 10/25/2022] Open
Abstract
Objective: The natural growth progression of uterine leiomyomata will be studied and used to identify potential predictive criteria of myoma size development. This should answer the question of whether myoma growth is dependent on patient age, or on the localisation or original size of the myoma, as well as how much of a size increase can be expected per unit of time, and the proportion of myomata which shrink. Patients and Methods: Patient files of a myoma surgery from 2010 to 2012 were retrospectively evaluated. The following inclusion criteria applied: diagnosis of at least one, but not more than three myomata, a minimum of two consultations within three years, the performance of a transvaginal ultrasound to determine size, no pregnancy, and no medical or surgical myoma reduction measures. Only premenopausal patients were included in the analysis. Myoma volume was approximated using a formula similar to that used to calculate the volume of an ellipsoid. Results: 55 out of 102 patients (median age: 38 years), in which a total of 72 myomata were diagnosed, could be included in the evaluation. The median diameter of the myomata at the start of the study was 3.8 cm, with an average growth rate of 30 % over 6 months (range: - 46 to + 459 %). 15 % of the myomata regressed. The linear regression analysis showed a correlation between myoma growth over 6 months, the original size of the myoma (p = 0.023) and patient age (p = 0.038), but no connection was found to the localisation of the myoma. Smaller myomata decreased significantly more in size than larger myomata (p = 0.011). Older patients presented with larger myomata. Conclusions: Myomata demonstrate a strikingly large variation in size development. Their growth is highly individual and not ultimately predictable. Patients should be advised of the possibility of spontaneous myoma regression.
Collapse
Affiliation(s)
- M David
- Clinic of Gynaecology, Charité-University Medicine Berlin, Berlin
| | - L Adams
- Clinic of Gynaecology, Charité-University Medicine Berlin, Berlin
| | - J H Stupin
- Clinic of Obstetrics, Charité-University Medicine Berlin, Berlin
| |
Collapse
|
14
|
Plagemann A, Harder T, Schellong K, Schulz S, Stupin JH. Early postnatal life as a critical time window for determination of long-term metabolic health. Best Pract Res Clin Endocrinol Metab 2012; 26:641-53. [PMID: 22980046 DOI: 10.1016/j.beem.2012.03.008] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Epidemiological studies demonstrated a clear phenomenological association between low birth weight and increased cardiometabolic risk later in life, very similar to that in high birth weight subjects. Pre- and/or neonatal overfeeding appears to be an etiological clue. In animal studies, irrespective of birth weight neonatal over-nutrition leads to later overweight, impaired glucose tolerance and cardiometabolic alterations. Probably, perinatally acquired alterations of DNA methylation patterns of gene promoters of central nervous regulators of body weight and metabolism play a key role in mediating these relationships. In humans, the long-term impact of neonatal nutrition is conclusively demonstrated by studies on the consequences of breastfeeding vs. formula-feeding. Taken together, the quantity and quality of nutrition during neonatal life plays a critical role, beyond prenatal development, in the long-term programming of health and disease. This opens a variety of opportunities and challenges to primarily prevent chronic diseases, e.g. the metabolic syndrome.
Collapse
Affiliation(s)
- Andreas Plagemann
- Division of 'Experimental Obstetrics', Clinic of Obstetrics, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany.
| | | | | | | | | |
Collapse
|
15
|
Stupin JH, Rothmann K, Kentenich H, Utz-Billing I, David M. [Correlation between sonographic findings and level of knowledge/self-report of symptoms in women with uterine leiomyomata]. Ultraschall Med 2011; 32 Suppl 2:E86-E91. [PMID: 21877314 DOI: 10.1055/s-0031-1273470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE Is there any correlation between the pre-therapeutic level of knowledge concerning the number/size of leiomyomata or self-reported symptoms and confirmation by sonography? How does the assumption of the number/size of leiomyomata influence the self-perception of symptoms? MATERIALS AND METHODS In an anonymous questionnaire 498 patients were asked about the number, size and symptoms induced by leiomyomata using a visual chart from 0 - 10. The data were correlated with findings from transvaginal and abdominal ultrasound. RESULTS The self-reported number of leiomyomata corresponded with the sonographic findings in 80 % of patients with 1 leiomyoma and in 54 % of patients with 2 or 3 leiomyomata, while the self-reported size only corresponded with the sonographic findings in 20 % to 70 % of patients. There was no correlation between the number of leiomymata confirmed by sonography and self-reported symptoms. There are significant correlations between the sonography-defined size and self-reported level of dysmenorrhea (p = 0.003) and self-reported pressure in the abdomen (p = 0.02), as well as submucosal leiomyomata and hypermenorrhea (p = 0.01). Patients who assumed multiple or large leiomyomata ≥ 10 cm reported strong pressure on the bladder or pressure in the abdomen significantly more frequently than patients who assumed 1 leiomyoma (p = 0.03) or a leiomyoma less than 10 cm (p = 0.018). CONCLUSION There is a discrepancy between the relatively good knowledge about the number of leiomyomata and the lack of knowledge about their size. Subjective incorrect presumptions concerning the number or size of leiomymata can result in different disorders. Therefore, they should not be the exclusive indication for further operative interventions.
Collapse
Affiliation(s)
- J H Stupin
- Klinik für Gynäkologie, Charité - Universitätsmedizin Berlin.
| | | | | | | | | |
Collapse
|
16
|
Stupin JH, Raile V, Freitag H, Fuchs IB, Berns M, Henrich W. Langzeitentwicklung von Kindern mit pränatal diagnostizierter Agenesie des Corpus callosum (ACC). Z Geburtshilfe Neonatol 2011. [DOI: 10.1055/s-0031-1293292] [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: 10/15/2022]
|
17
|
Henrich W, Stupin JH. 3D volume contrast imaging (VCI) for the visualization of placenta previa increta and uterine wall thickness in a dichorionic twin pregnancy. Ultraschall Med 2011; 32:406-411. [PMID: 21080310 DOI: 10.1055/s-0029-1245796] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE Placenta increta is a rare event in pregnancy, but is associated with serious maternal morbidity and mortality due to life threatening hemorrhage. The incidence has increased due to high Cesarean rates. We describe a case of placenta previa increta in a dichorionic twin pregnancy, which was successfully treated conservatively, to discuss the role of ultrasound, especially 3D VCI and TUI, for diagnosis and conservative management in similar cases. MATERIALS AND METHODS A GE Voluson Expert 730 ultrasound system which provides both conventional 2D imaging and 3D volume acquisitions using VCI and TUI was used for diagnosis and management in a case of placenta increta in a dichorionic twin pregnancy in which the placenta previa increta of the first fetus was left in situ and the other placenta was removed. RESULTS The 3D VCI provided superior resolution of the anterior wall of the uterus, delineating the myometrial thickness in the area of the placental implantation site. With superior image quality, the 3D VCI technique facilitates the evaluation of the myometrial thickness and the depth of placental invasion due to significantly improved enhancement of the contrast and differentiation between various tissues compared to the 2D scan. CONCLUSION We describe for the first time the application of 3D VCI and TUI for the visualization of the depth of placental invasion in such a case. Preoperative ultrasound diagnosis allows appropriate preoperative preparations and the decision to leave the placenta untouched to avoid a probable fatal outcome for the patient.
Collapse
MESH Headings
- Adult
- Cesarean Section, Repeat
- Contrast Media
- Female
- Humans
- Imaging, Three-Dimensional/methods
- Infant, Newborn
- Male
- Myometrium/diagnostic imaging
- Obstetric Labor, Premature/diagnostic imaging
- Obstetric Labor, Premature/therapy
- Placenta Accreta/diagnostic imaging
- Placenta Accreta/therapy
- Placenta Previa/diagnostic imaging
- Placenta Previa/therapy
- Placenta, Retained/diagnostic imaging
- Placenta, Retained/therapy
- Postoperative Care/methods
- Pregnancy
- Pregnancy, Twin
- Prognosis
- Ultrasonography, Doppler, Color
- Ultrasonography, Prenatal/methods
- Uterus/diagnostic imaging
Collapse
Affiliation(s)
- W Henrich
- Department of Obstetrics, Charité Medical University Berlin, Berlin, Germany
| | | |
Collapse
|
18
|
Stupin JH, Fuchs IB, Eckholdt F, Gellermann J, Dudenhausen JW, Henrich W. Langzeitentwicklung von Kindern mit pränatal diagnostizierten urogenitalen Fehlbildungen. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1222810] [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]
|
19
|
Stupin JH, Utz-Billing I, Kentenich H, David M. Korrelation der Selbsteinschätzung von Symptomen mit Untersuchungsergebnissen von Frauen mit Uterus myomatosus. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1088999] [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: 10/19/2022] Open
|
20
|
Henrich W, Blasi I, Stupin JH, Dudenhausen JW. Ectopic pregnancy complicated by an arteriovenous malformation of the fallopian tube: preoperative sonographic findings and intraoperative correlation. J Ultrasound Med 2008; 27:1257-1261. [PMID: 18645087 DOI: 10.7863/jum.2008.27.8.1257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Wolfgang Henrich
- Department of Obstetrics, Charité, Virchow Clinic, Berlin, Germany.
| | | | | | | |
Collapse
|
21
|
Stupin JH, David M, Siedentopf JP, Dudenhausen JW. Emergency cerclage versus bed rest for amniotic sac prolapse before 27 gestational weeks. Eur J Obstet Gynecol Reprod Biol 2008; 139:32-7. [DOI: 10.1016/j.ejogrb.2007.11.009] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2007] [Revised: 11/19/2007] [Accepted: 11/20/2007] [Indexed: 10/22/2022]
|
22
|
Norén H, Luttkus AK, Stupin JH, Blad S, Arulkumaran S, Erkkola R, Luzietti R, Visser GHA, Yli B, Rosén KG. Fetal scalp pH and ST analysis of the fetal ECG as an adjunct to cardiotocography to predict fetal acidosis in labor--a multi-center, case controlled study. J Perinat Med 2007; 35:408-14. [PMID: 17685855 DOI: 10.1515/jpm.2007.097] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the relationship between scalp pH (FBS) and ST analysis in situations of acidosis with special emphasis on the timing of cardiotocography (CTG), FBS and ST changes during labor. STUDY DESIGN From a European Union multicenter study on clinical implementation of the STAN methodology, 911 cases were identified where a scalp-pH had been obtained. In 53 cases, marked cord artery acidosis was found (cord artery pH<7.06) and 44 cases showed moderate acidemia at birth (pH 7.06-7.09). Comparisons were made with 97 control cases (pH>or=7.20). RESULTS Of those cases with FHR+ST events recorded within 16 min of delivery, 61% (17/28) had a cord artery pH>or=7.20. The corresponding figure for cases where STAN indications occurred for more than 16 min was 19% (13/69) (OR 6.66, 2.53-17.55, P<0.001). Out of the 121 cases with an abnormal CTG, 84 (69%) showed a cord artery pH of <7.10. STAN indicated abnormality in 83% (70 out of 84). The corresponding figure for scalp pH<7.20 was 43% (36/84). In the case of CTG changes at the start of an adequate recording STAN guidelines provided information on developing acidosis in all cases but one (16 out of 17) in the marked acidosis group. STAN guidelines indicated abnormality prior to an abnormal FBS in 14 out of 17 cases. The median duration between STAN indications to intervention and an abnormal FBS was 29 (95% CI 11-74) min. CONCLUSIONS ST analysis, as an adjunct to CTG, identifies adverse fetal conditions during labor similar to that of FBS but on a more consistent basis. The timing of CTG+ST changes relates to the level of acidosis at birth.
Collapse
Affiliation(s)
- Håkan Norén
- Department of Obstetrics and Gynecology, Perinatal Center, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Weichert A, Stupin JH, Dudenhausen JW, Henrich W. Schwangerschaft bei maternalem Caroli-Syndrom – Ein seltener Fall. Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-1002993] [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]
|
24
|
Stupin JH, Harder T, Harder T, Plagemann A, Plagemann A, Michael T, Dudenhausen JW, Henrich W. Mütterliches Übergewicht/Adipositas beeinflusst die Langzeitergebnisse von Kindern mit Spina bifida ungünstig. Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-1002979] [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]
|
25
|
Stupin JH, Kleine-Tebbe A, Kristiansen G, Schneider A, Dudenhausen JW. Mammakarzinom in der Schwangerschaft. Ein Fallbericht. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952672] [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
|
26
|
Sehouli J, Stupin JH, Schlieper U, Kuemmel S, Henrich W, Denkert C, Dietel M, Lichtenegger W. Actinomycotic inflammatory disease and misdiagnosis of ovarian cancer. A case report. Anticancer Res 2006; 26:1727-31. [PMID: 16617568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Actinomycosis in the pelvic region is an uncommon diagnosis. This infection is caused by Actinomyces israelii, a gram-positive anerobic saprophyte bacterium that is a normal inhabitant of the upper intestinal tract in humans. Pelvic actinomycosis is difficult to diagnose pre-operatively and is diagnosed, in most cases, accidentally. Actinomycosis can mimic pelvic and abdominal malignancies. A case report of a 35-year-old female patient with a fixed pelvic mass is presented and the diagnosis and treatment of pelvic actinomycotic inflammatory disease in relation to ovarian cancer are discussed. Clinicians should be aware of this rare infection to spare women potential morbidity from excessive surgical procedures.
Collapse
Affiliation(s)
- Jalid Sehouli
- University Departments of Gynecology and Obstetrics, Charité University of Medicine, Virchow-Klinikum Campus, Berlin, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Stupin JH, Henrich W, Korell M, Michael T, Stöver B, Dudenhausen JW. Langzeitentwicklung von Kindern mit pränatal diagnostizierten Fehlbildungen des Zentralnervensystems (ZNS). Geburtshilfe Frauenheilkd 2005. [DOI: 10.1055/s-2005-920840] [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: 10/19/2022] Open
|
28
|
Luttkus AK, Norén H, Stupin JH, Blad S, Arulkumaran S, Erkkola R, Hagberg H, Lenstrup C, Visser GHA, Tamazian O, Yli B, Rosén KG, Dudenhausen JW. Fetal scalp pH and ST analysis of the fetal ECG as an adjunct to CTG. A multi-center, observational study. J Perinat Med 2005; 32:486-94. [PMID: 15576269 DOI: 10.1515/jpm.2004.121] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the relationships between scalp-pH and CTG plus ST waveform analysis of the fetal ECG (STAN) clinical guidelines as indicators of intrapartum hypoxia in term fetuses born with cord artery acidemia. STUDY DESIGN Data from 6999 term deliveries monitored by the STAN (R) S 21 as part of an EU multi-center study on clinical implementation of the STAN methodology for intrapartum fetal surveillance were analyzed. We identified 911 cases where a scalp-pH was obtained, including 53 cases with cord artery acidemia (pH < 7.06). Lag times between ST events and scalp-pH and time to delivery were related to cord artery metabolic and respiratory acidosis and neonatal outcome. RESULTS 43 fetuses were identified by CTG plus ST as being in need of intervention 31 (25-46) minutes before delivery (median, 95% Cl). In five, no indications were given and in another five there were inadequate data. Fifteen cases with metabolic acidosis required special neonatal care, all 14 cases adequately monitored on STAN had indications to intervene for 19 minutes or more. In 30 adequately recorded cases, fetal blood sampling (FBS) was obtained within the last hour of labor. In 22 cases, FBS was obtained 13 (7-24) minutes after STAN guidelines had indicated abnormality and in eight no ST changes had occurred at time of FBS. The corresponding FBS data were pH 7.10 (7.01-7.15) and pH 7.21 (7.08-7.31), respectively, P = 0.01. In cases of metabolic acidosis, scalp-pH fell 0.01 units per minute after a baseline T/QRS rise was recorded during the second stage of labor. Apart from one newborn that died at 2 h from E. Coli septicemia, none of the neonates were affected neurologically. CONCLUSION Cardiotocography plus ST analysis provides accurate information about intrapartum hypoxia similar to that obtained by scalp-pH.
Collapse
Affiliation(s)
- Andreas K Luttkus
- Department of Obstetrics, Charité-University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Stupin JH, Callsen TA, Luttkus AK, Dudenhausen JW. Fetalblutanalyse (FBA) und ST-Analyse des fetalen EKG als Ergänzung zum CTG. Eine prospektive Beobachtungsstudie. Z Geburtshilfe Neonatol 2005. [DOI: 10.1055/s-2005-923188] [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: 10/18/2022]
|
30
|
Stupin JH, Callsen TA, Luttkus AK, Dudenhausen JW. Einfluss der Pulsoxymetrie auf die Frequenz der Fetalblutanalysen. Eine prospektiv randomisierte Interventionsstudie. Z Geburtshilfe Neonatol 2004. [DOI: 10.1055/s-2003-818088] [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]
|
31
|
Luttkus A, Stupin JH, Dudenhausen JW. Bedeutung der Überwachung des Feten durch das EKG (STAN S21)beim Verdacht auf Sauerstoffmangel sub partu. Z Geburtshilfe Neonatol 2004. [DOI: 10.1055/s-2003-818087] [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]
|
32
|
Stupin JH, Herschel A, Jakubek G, Loui A, Luttkus AK, Dudenhausen JW. Kontinuierliche Pulsoxymetrie am Neugeborenen im Kreißsaal zur Detektion einer beginnenden neonatalen Infektion. Z Geburtshilfe Neonatol 2004. [DOI: 10.1055/s-2003-818238] [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]
|
33
|
Luttkus AK, Callsen TA, Stupin JH, Dudenhausen JW. Pulse oximetry during labour--does it give rise to hope? Value of saturation monitoring in comparison to fetal blood gas status. Eur J Obstet Gynecol Reprod Biol 2003; 110 Suppl 1:S132-8. [PMID: 12965102 DOI: 10.1016/s0301-2115(03)00184-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Purpose of this presentation is to show the diagnostic power of fetal pulse oximetry in comparison to the other blood gas parameters from fetal blood samplings (FBS). The distribution of saturation readings in acidotic fetuses and normally oxygenated fetuses should be established. STUDY DESIGN A fetal pulse oximetry system (N400, FS14) was evaluated in a strictly observational study design based on blinded saturation display and on continuous data storing. The investigation was performed on 170 fetuses with non-reassuring fetal heart rate (FHR)-tracings. Since pulse oximetry readings were not available for decision finding, the clinical management was based on electronic fetal monitoring and fetal blood samplings. The oxygen saturation from FBS or umbilical cord blood was measured by blood gas analysers with an integrated hemoximeter (Bayer 865; ABL 625, Radiometer) and biosensors measuring lactate as metabolic component. Out of the 170 cases 17 cases were defined as group of acidemia (pH(umb.art.) < 7.16 + BD<-9.4). The distribution of saturation readings and the duration of desaturation periods (in minutes and percentage of total monitoring time SPO2 below 30%) were determined. ROC curve analysis from FBS preceding delivery compared the diagnostic power of other blood gas parameters with oxygen saturation. The Wilcoxon test for uneven pairs was used. RESULTS The distribution of oxygen saturation in the normal group of fetuses differs significantly from the acidemic group. The correlation coefficient between both methods to determine oxygen saturation was r=0.66. A specific evaluation of the distribution of SPO2 shows an overestimation of pulse oximetry in the low range and an underestimation in the high range of saturation. ROC-curve analysis showed a good diagnostic power of lactate in comparison to the oxygen saturation measured by pulse oximetry or by hemoximetry. CONCLUSIONS The advantage of continuous fetal pulse oximetry surveilling the fetus under suspicion of hypoxia appears limited by the poor diagnostic power of the respiratory parameter saturation itself and by the impairment of the precision of the technology.
Collapse
Affiliation(s)
- Andreas K Luttkus
- Clinic of Obstetrics, Charité Campus Virchow-Klinikum, Humboldt-University, Augustenburger Platz 1, D-13353 Berlin, Germany.
| | | | | | | |
Collapse
|
34
|
Luttkus AK, Stupin JH, Callsen TA, Dudenhausen JW. Feasibility of simultaneous application of fetal electrocardiography and fetal pulse oximetry. Acta Obstet Gynecol Scand 2003; 82:443-8. [PMID: 12752075 DOI: 10.1034/j.1600-0412.2003.00134.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Fetal pulse oximetry measures arterial oxygen saturation during delivery. The fetal electrocardiogram STAN S21 analyzes the repolarisation segment of ECG (ST) waveform, which is altered by the intramyocardial potassium release resulting from metabolic acidemia. This study aimed to evaluate the feasibility of a simultaneous application of pulse oximetry and fetal electrocardiography and to estimate any agreement between both methods indicating fetal compromise. METHODS In an observational trial 35 fetuses were simultaneously monitored by pulse oximetry (OBS-500) and electrocardiography. The evaluation focused on signal output and on the coincidence of desaturation in fetal pulse oximetry and on ST events. Desaturation was defined as a drop of at least 20% of oxygen saturation from base line level occurring within 1 min (steep desaturation) or duration of time (s) with oxygen saturation below the threshold of 30%. Statistical analysis was performed with the Mann-Whitney U-test for continuous variables. RESULTS Signal output of the simultaneous application of both sensors was not significantly reduced in the electrocardiogram and in pulse oximetry (8% vs. 12% reduction). In 15 of the 35 fetuses, ST events indicating fetal hypoxia occurred. In these cases, pulse oximetry showed significantly more episodes of desaturation in comparison with fetuses without ST events. Median saturation during the ST events was significantly lower than in the recordings without ST events (60% vs. 74%, p < 0.05). In the umbilical artery these neonates showed significantly lower pH (7.19 vs. 7.33, p < 0.001), significantly higher lactate (5.1 vs. 3.4 mmol/l, p < 0.05) and significantly lower base deficit (-9.4mmol/l vs. -4.0 mmol/l, p < 0.001) levels. CONCLUSIONS The combination of fetal pulse oximetry and fetal electrocardiography appears feasible and indicates signs of intermittent hypoxia. These findings may encourage the development of technology that combines these different methods of monitoring.
Collapse
Affiliation(s)
- Andreas K Luttkus
- Clinic of Obstetrics, Charité, Campus Virchow-Klinikum, Humboldt-University, Berlin, Germany.
| | | | | | | |
Collapse
|
35
|
Stupin JH, Henrich W, Bührer C, Dudenhausen JW. [Prenatal findings, perinatal management and postoperative course in a child suffering from a cavernous tumour of the thalamus]. Zentralbl Gynakol 2002; 124:336-7. [PMID: 12384820 DOI: 10.1055/s-2002-34747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- J H Stupin
- Klinik für Geburtsmedizin, Gerlin, Germany
| | | | | | | |
Collapse
|
36
|
Henrich W, Stupin JH, Bühling KJ, Bührer C, Bassir C, Dudenhausen JW. Prenatal sonographic findings of thalamic cavernous angioma. Ultrasound Obstet Gynecol 2002; 19:518-522. [PMID: 11982990 DOI: 10.1046/j.1469-0705.2002.00700.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A cavernous angioma of the thalamus is a rare congenital brain tumor. We report the perinatal management and follow-up to 2 years in a case diagnosed in utero at 37 weeks of gestation, and review the literature.
Collapse
Affiliation(s)
- W Henrich
- University Department of Obstetrics, Charité, Campus Virchow-Klinikum, Humboldt University Berlin, Germany.
| | | | | | | | | | | |
Collapse
|
37
|
Luttkus AK, Stupin JH, Foertsch I, Porath M, Dudenhausen JW. 179 Agreement between fetal pulse oximetry and fetal ECG in episodes of suspected hypoxia. Am J Obstet Gynecol 2001. [DOI: 10.1016/s0002-9378(01)80214-3] [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]
|