1
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Hochstätter R, Schütz AM, Taumberger N, Bornemann-Cimenti H, Oppelt P, Fazelnia C, Petricevic L, Tsibulak I, Batiduan LM, Tomasch G, Weiss EC, Tamussino K, Metnitz P, Fluhr H, Schöll W. Enhanced Recovery after Cesarean Section (ERAC): Where are We in Austria? Eur J Obstet Gynecol Reprod Biol 2023; 285:81-85. [PMID: 37087834 DOI: 10.1016/j.ejogrb.2023.03.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/29/2023] [Accepted: 03/31/2023] [Indexed: 04/09/2023]
Abstract
OBJECTIVE Enhanced recovery after surgery (ERAS) recommendations for cesarean section (ERAC), likely the most common reason for laparotomy in women, were issued in 2018-19. We examined how current perioperative management at cesarean section in Austrian hospitals aligns with ERAS recommendations. STUDY DESIGN We surveyed the 21 largest public obstetric units in Austria for alignment with 20 of the 31 strong ERAS recommendations regarding perioperative maternal care at cesarean section. We also looked at how the German-language clinical guideline for cesarean section (AWMF Guideline Sectio caesarea) aligns with ERAS recommendations. RESULTS The 21 obstetric units cared for about 51% of all births in Austria in 2019. Cesarean section rates ranged from 17.7% to 50.4%. All 21 units implemented the five strong recommendations regarding patient information and counselling, regional anesthesia, euvolemia and multimodal analgesia. The least implemented strong recommendation was the one for the use of pneumatic compression stockings to prevent thromboembolic disease (0/21 units). Overall, all 21 units implemented ≥11 and 13 (62%) implemented ≥15 (≥75%) of the 20 strong recommendations; no unit implemented all 20 strong recommendations. There were no differences in the implementation of strong recommendations according to hospital volume. CONCLUSIONS Even in the absence of formal adoption of ERAS program for cesarean section many perioperative ERAS recommendations are already implemented in Austria. The least implemented recommendations were the use of pneumatic compression stockings (0 of 21 units) and immediate catheter removal (4 of 21 units). Only 10 of the 20 ERAS recommendations we looked at are included in the current German-language clinical guideline for cesarean section.
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2
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Foßelteder J, Pabst G, Sconocchia T, Schlacher A, Auinger L, Kashofer K, Beham-Schmid C, Trajanoski S, Waskow C, Schöll W, Sill H, Zebisch A, Wölfler A, Thomas D, Reinisch A. Human gene-engineered calreticulin mutant stem cells recapitulate MPN hallmarks and identify targetable vulnerabilities. Leukemia 2023; 37:843-853. [PMID: 36813992 PMCID: PMC10079532 DOI: 10.1038/s41375-023-01848-6] [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] [Received: 07/19/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/24/2023]
Abstract
Calreticulin (CALR) mutations present the main oncogenic drivers in JAK2 wildtype (WT) myeloproliferative neoplasms (MPN), including essential thrombocythemia and myelofibrosis, where mutant (MUT) CALR is increasingly recognized as a suitable mutation-specific drug target. However, our current understanding of its mechanism-of-action is derived from mouse models or immortalized cell lines, where cross-species differences, ectopic over-expression and lack of disease penetrance are hampering translational research. Here, we describe the first human gene-engineered model of CALR MUT MPN using a CRISPR/Cas9 and adeno-associated viral vector-mediated knock-in strategy in primary human hematopoietic stem and progenitor cells (HSPCs) to establish a reproducible and trackable phenotype in vitro and in xenografted mice. Our humanized model recapitulates many disease hallmarks: thrombopoietin-independent megakaryopoiesis, myeloid-lineage skewing, splenomegaly, bone marrow fibrosis, and expansion of megakaryocyte-primed CD41+ progenitors. Strikingly, introduction of CALR mutations enforced early reprogramming of human HSPCs and the induction of an endoplasmic reticulum stress response. The observed compensatory upregulation of chaperones revealed novel mutation-specific vulnerabilities with preferential sensitivity of CALR mutant cells to inhibition of the BiP chaperone and the proteasome. Overall, our humanized model improves purely murine models and provides a readily usable basis for testing of novel therapeutic strategies in a human setting.
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Affiliation(s)
- Johannes Foßelteder
- Department of Internal Medicine, Division of Hematology, Medical University of Graz, Graz, Austria
| | - Gabriel Pabst
- Department of Internal Medicine, Division of Hematology, Medical University of Graz, Graz, Austria.,Research Institute of Molecular Pathology (IMP), Vienna BioCenter (VBC), Vienna, Austria.,Vienna BioCenter PhD Program, Doctoral School of the University of Vienna and Medical University of Vienna, Vienna BioCenter (VBC), Vienna, Austria
| | - Tommaso Sconocchia
- Department of Internal Medicine, Division of Hematology, Medical University of Graz, Graz, Austria
| | - Angelika Schlacher
- Department of Internal Medicine, Division of Hematology, Medical University of Graz, Graz, Austria
| | - Lisa Auinger
- Department of Internal Medicine, Division of Hematology, Medical University of Graz, Graz, Austria
| | - Karl Kashofer
- Diagnostic & Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | | | - Slave Trajanoski
- Core Facility Computational Bioanalytics, Medical University of Graz, Graz, Austria
| | - Claudia Waskow
- Leibniz Institute on Aging, Fritz Lipmann Institute, Jena, Germany.,Institute of Biochemistry and Biophysics, Faculty of Biological Sciences, Friedrich-Schiller-University, Jena, Germany
| | - Wolfgang Schöll
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Heinz Sill
- Department of Internal Medicine, Division of Hematology, Medical University of Graz, Graz, Austria
| | - Armin Zebisch
- Department of Internal Medicine, Division of Hematology, Medical University of Graz, Graz, Austria.,Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Division of Pharmacology, Medical University of Graz, Graz, Austria
| | - Albert Wölfler
- Department of Internal Medicine, Division of Hematology, Medical University of Graz, Graz, Austria
| | - Daniel Thomas
- Cancer Program, Precision Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.,Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Andreas Reinisch
- Department of Internal Medicine, Division of Hematology, Medical University of Graz, Graz, Austria. .,Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria.
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3
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Kirchhoff E, Schneider V, Pichler G, Reif P, Haas J, Joksch M, Mager C, Schmied C, Schöll W, Pichler-Stachl E, Gold D. Hexoprenaline Compared with Atosiban as Tocolytic Treatment for Preterm Labor. Geburtshilfe Frauenheilkd 2022; 82:852-858. [PMID: 35967742 PMCID: PMC9365465 DOI: 10.1055/a-1823-0176] [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] [Received: 10/07/2021] [Accepted: 04/10/2022] [Indexed: 11/08/2022] Open
Abstract
Introduction
Preterm birth is defined as a live birth before 37 weeks of gestation and is associated with increased neonatal morbidity and mortality. The aim of this study is to
compare the efficacy of hexoprenaline and atosiban for short- and long-term tocolysis and their effects on neonatal and maternal outcomes.
Methods
This retrospective cohort study included women with threatened preterm labor between 24 + 0 and 34 + 0 weeks of gestation without premature rupture of membranes. The
tocolytic efficacy of hexoprenaline and atosiban was compared in women receiving one of the two medications for short- and long-term tocolysis. Continuous variables were compared using
t-test or Mann–Whitney U test, as appropriate. Comparison of categorical variables between the two groups was done with χ
2
test after Pearsonʼs and Fisherʼs exact test.
Results
761 women were enrolled in this study; 387 women received atosiban and 374 women received hexoprenaline as their primary tocolytic agent. Atosiban showed a higher efficacy as
a primary tocolytic agent (p = 0.000) within 48 hours. As regards long-term tocolysis, there were no differences between the treatment groups (p = 0.466). Maternal side effects such as
tachycardia (p = 0.018) or palpitations (p = 0.000) occurred more frequently after the administration of hexoprenaline, while there were no differences between the two drugs administered
with regard to any other maternal or neonatal outcome parameter.
Conclusion
Our retrospective study shows a significantly higher efficacy of atosiban in the first 48 hours, especially when administered at an early gestational age. There were no
significant differences in terms of neonatal outcome but significantly more maternal adverse effects during the administration of hexoprenaline.
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Affiliation(s)
- Ebba Kirchhoff
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Verena Schneider
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Gerhard Pichler
- 2 Klinische Abteilung für Neonatologie der Med. Universität Graz, Graz, Austria
| | - Philipp Reif
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Josef Haas
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Maike Joksch
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Corinna Mager
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Christian Schmied
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Wolfgang Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Elisabeth Pichler-Stachl
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
| | - Daniela Gold
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz, Graz, Austria
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Pfniss I, Gold D, Holter M, Schöll W, Berger G, Greimel P, Lang U, Reif P. Birth during off-hours: Impact of time of birth, staff´s seniority, and unit volume on maternal adverse outcomes-a population-based cross-sectional study of 87 065 deliveries. Birth 2022; 50:449-460. [PMID: 35789033 DOI: 10.1111/birt.12663] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 06/13/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of this study was to investigate whether time of birth, unit volume, and staff seniority impact the incidence of maternal complications in deliveries ≥34 + 0 gestational weeks. METHODS We conducted a population-based cross-sectional study of 87 065 deliveries occurring between 2004 and 2015 in ten public hospitals in Styria, Austria. A composite adverse maternal outcome measure of uterine atony, postpartum hysterectomy, postpartum bleeding, impaired wound healing, postpartum infections requiring antibiotic treatment, sepsis, or maternal death was used to compare outcomes by time of birth, unit volume, and staff seniority. Based on delivery data, generalized estimating equations (GEEs) were used to calculate the risk of maternal adverse outcomes. RESULTS Maternal adverse events occurred in 1.33% of deliveries. Incidence of maternal adverse events was highest for units with >1000 deliveries (adjusted OR 1.40; CI 95%: 1.16-1.69) and higher for perinatal centers (adjusted OR 1.35; CI 95%: 1.15-1.57) compared with reference units (500-1000 deliveries/year). Delivery during the daytime compared with the afternoon and nighttime did not affect the incidence of maternal complications (P = 0.765 and P = 0.136, respectively). Compared with resident-guided deliveries, the odds ratio for an adverse event was the same when a consultant attended the delivery (adjusted OR 1.13; CI 95%: 0.98-1.30) but lower in deliveries managed by midwives only (adjusted OR 0.21; CI 95%: 0.07-0.64). CONCLUSION Procedures performed during the night shift were not associated with increased complication rates. Delivery volume and high-volume centers were associated with the highest risk of maternal complications, and units with 500-1000 deliveries per year were the lowest. With increasing odds of pregnancy risks, these results change, and delivering in a high-volume center becomes at least as safe as delivering in a smaller unit.
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Affiliation(s)
- Isabella Pfniss
- Department of Gynecology, Hospital of the Hospitaller Order of Saint John of God, Graz, Austria
| | - Daniela Gold
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Magdalena Holter
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Wolfgang Schöll
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Gerhard Berger
- Department of Obstetrics and Gynecology, Hospital Hartberg, Hartberg, Austria
| | - Patrick Greimel
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Uwe Lang
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Philipp Reif
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
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Schöll W, Schöll C, Wölfler M, Hochstätter R, Tomasch G, Fluhr H. Reproduktive Chirurgie: laparoskopische abdominelle Cerclage zur Therapie des habituellen Spätabortgeschehens und extremer Frühgeburtlichkeit. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750252] [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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Schöll C, Wölfler M, Hochstätter R, Fluhr H, Tomasch G, Schöll W. Reproduktive Chirurgie: Therapie der dehiszenten Sectionarbe – post operative Ergebnisse und Schwangerschafts-Outcome. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750251] [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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7
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Ritz N, Hochstätter R, Mikalauskas S, Talakić E, Seles M, Schöll W, Trutnovsky G, Laky R, Tamussino K, Fluhr H, Wölfler M. Interdisziplinäres Vorgehen bei tief infiltrierender Darmendometriose: OP-Techniken und deren Outcome. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750227] [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: 10/17/2022] Open
Affiliation(s)
- N Ritz
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz
| | - R Hochstätter
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz
| | - S Mikalauskas
- Universitätsklinik für Chirurgie, Medizinische Universität Graz
| | - E Talakić
- Universitätsklinik für Radiologie, Medizinische Universität Graz
| | - M Seles
- Universitätsklinik für Urologie; Medizinische Universität Graz
| | - W Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz
| | - G Trutnovsky
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz
| | - R Laky
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz
| | - K Tamussino
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz
| | - H Fluhr
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz
| | - M Wölfler
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz
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Hochstätter R, Schütz AM, Taumberger N, Bornemann-Cimenti H, Oppelt P, Fazelnia C, Petricevic L, Tsibulak I, Batiduan LM, Tomasch G, Weiss EC, Tamussino K, Metnitz P, Schöll W, Fluhr H. ERAS bei der Sectio: Wo stehen wir in Österreich? Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750244] [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: 10/17/2022] Open
Affiliation(s)
- R Hochstätter
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - A-M Schütz
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - N Taumberger
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - H Bornemann-Cimenti
- Klinische Abteilung für Allgemeine Anästhesiologie, Notfall- und Intensivmedizin, Medizinische Universität Graz
| | - P Oppelt
- Gynäkologie, Geburtshilfe und Gyn. Endokrinologie, Kepler Universitätsklinikum Linz
| | - C Fazelnia
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, PMU Salzburg
| | - L Petricevic
- Univ. Klinik für Frauenheilkunde, AKH – Medizinische Universität Wien
| | - I Tsibulak
- Univ.-Klinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - L-M Batiduan
- Abteilung für Gynäkologie und Geburtshilfe, St. Josef Krankenhaus Wien
| | - G Tomasch
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - E-C Weiss
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - K Tamussino
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - P Metnitz
- Klinische Abteilung für Allgemeine Anästhesiologie, Notfall- und Intensivmedizin, Medizinische Universität Graz
| | - W Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - Herbert Fluhr
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
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Feigl S, Schöll W, Hochstätter R, Neumayer M, Ritz N, Trutnovsky G, Laky R, Tamussino K, Fluhr H, Wölfler M. Stellenwert der Sonographie und der #ENZIAN-Klassifikation für die präoperative Beratung und Therapieplanung bei Endometriose und Adenomyosis uteri – ein Fallbericht. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750222] [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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10
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Mautner E, Stern C, Avian A, Deutsch M, Schöll W, Greimel E. Neonates in the Intensive Care Unit: Maternal Health-Related Quality of Life and Depression After Term and Preterm Births. Front Pediatr 2022; 9:684576. [PMID: 35071122 PMCID: PMC8770971 DOI: 10.3389/fped.2021.684576] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background/Objective: To examine maternal physical and mental health-related quality of life (HRQoL) and depression after early and late preterm and term births in the early postpartum period. Method: In a prospective pilot study, three groups of women whose newborns had to be treated in the neonatal ward during the immediate postpartum period were established and compared with each other: 20 women with extremely to very preterm birth, 20 with moderate to late preterm birth and 20 women with term birth. All participants completed the Short Form-12 Health Survey (SF-12) to measure HRQoL, and the Edinburgh Postnatal Depression Scale (EPDS) to detect depressive symptoms combined with independently developed questions to evaluate anxiety and psychological distress. Results: Maternal psychological HRQoL was significantly worse in the very preterm birth group compared to moderate to late preterm birth (p < 0.001) and full-term birth groups (p = 0.004). There were no differences between the birth groups in depressive symptoms (p = 0.083), anxiety (p = 0.238), perceived stress (p = 0.340) and the general psychological distress values (p = 0.755). In the EPDS, the depression screening instrument 30 to 65% were beyond the cut-off-value to detect major depression. Conclusions: During the early postpartum period, an extensive medical care focussing on acute stress, HRQoL parameters and depression may be a good step to improving maternal well-being.
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Affiliation(s)
- Eva Mautner
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Christina Stern
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Alexander Avian
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Maria Deutsch
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Wolfgang Schöll
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Elfriede Greimel
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
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Foßelteder J, Rosenberger A, Pabst G, Amtmann B, Schöll W, Wölfler A, Reinisch A. 3013 – TARGETED INTRODUCTION OF HETEROZYGOUS CALR MUTATIONS INTO HUMAN HEMATOPOIETIC STEM AND PROGENITOR CELLS MIMICS MPN PATHOGENESIS IN VITRO AND IN VIVO. Exp Hematol 2021. [DOI: 10.1016/j.exphem.2021.12.235] [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]
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12
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Bracic T, Pfniß I, Taumberger N, Kutllovci-Hasani K, Ulrich D, Schöll W, Reif P. A 10 year comparative study of caesarean deliveries using the Robson 10 group classification system in a university hospital in Austria. PLoS One 2020; 15:e0240475. [PMID: 33064735 PMCID: PMC7567372 DOI: 10.1371/journal.pone.0240475] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/27/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The Robson ten group classification system is used as a global standard for assessing, monitoring and comparing caesarean delivery (CD) rates within and between maternity services. Our objective was to compare the changes of CD rates at our institution between the years 2008-2010 and 2017-2019 using the Robson ten group classification system. STUDY DESIGN Data was collected retrospectively and all women were classified using the obstetric concepts and parameters described in the Robson ten group classification system. RESULTS During 2008-2010 7,832 deliveries were performed, increasing to 9,490 in 2017-2019. The CD rate also increased from 29.1% to 32.2% (p<.05) during this 10 year period. In both observed periods group 5 (single cephalic multiparous women at term with a previous CD) was the largest contributor to the overall CD rate accounting for 20.2% of all CD during 2008-2010 and increasing to 26.9% in 2017-2019 (p<.001). The overall size of group 5 also increased from 8.3% to 11.6% (p<.001). Furthermore, an increase in CD rate in group 7 (multiparous women with a single breech pregnancy, including women with a uterine scar) from 92.9% to 98.2% (p = .752) could be observed. In group 8 (women with multiple pregnancies, including women with a uterine scar) a slight shift towards vaginal delivery (VD) can be reported with CD rates decreasing from 82% to 79.2% (p = .784). There was no observed difference with CD rates in group 1 although the group size decreased from 29.4% in 2008-2010 to 24.2% in 2017-2019 (p<.001). The CD rate in group 10 experienced a slight elevation, in 2008-2010 46.2% were delivered per CD and in 2017-2019 48.8% (p = .553). The overall size of group 10 decreased, contributing 8.9% in 2008-2010 and 8% in 2017-2019 (p<.05) to the overall birthrate. CONCLUSION The biggest contributors to the CD rate in our hospital remain multiparous women at term with a previous CD. The CD rates, as well as the overall size of this group, keep rising, resulting in a need to establish more effective ways to motivate women with one previous CD towards vaginal birth after caesarean delivery (VBAC). Furthermore, the CD rate in preterm deliveries is increasing and approaching 50%. This illustrates the need to discuss whether CD is the appropriate mode of delivery in half of the preterm infants.
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Affiliation(s)
- Taja Bracic
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Isabella Pfniß
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Nadja Taumberger
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | | | - Daniela Ulrich
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Wolfgang Schöll
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Philipp Reif
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
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13
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Tiefenbacher F, Weiss EC, Freimüller B, Tomasch G, Reif P, Schöll W. Schmerztherapie nach Sectio – orales Management übertrifft iv. Therapie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718048] [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)
| | - E.-C. Weiss
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - B. Freimüller
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - G. Tomasch
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - P. Reif
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - W. Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
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14
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Nanda M, Nanda R, Weiss EC, Reif P, Schöll W, Tomasch G. Mehrfache manuelle Reposition trotz fortgeschrittener Schwangerschaft eines Uterus incarceratus unter Lachgas – Fallbericht. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718302] [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)
- M Nanda
- Universitätsklinik Graz, Frauenheilkunde und Geburtshilfe
| | - R Nanda
- Universitätsklinik Graz, Frauenheilkunde und Geburtshilfe
| | - E-C Weiss
- Universitätsklinik Graz, Frauenheilkunde und Geburtshilfe
| | - P Reif
- Universitätsklinik Graz, Frauenheilkunde und Geburtshilfe
| | - W Schöll
- Universitätsklinik Graz, Frauenheilkunde und Geburtshilfe
| | - G Tomasch
- Universitätsklinik Graz, Frauenheilkunde und Geburtshilfe
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15
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Bracic T, Pfniß I, Kutllovci-Hasani K, Taumberger N, Ulrich D, Schöll W, Reif P. Entwicklung der Sectio Caesarea (CS) Raten an der Frauenklinik Graz im 10- jahres Intervall anhand der Robson 10-gruppen Klassifikation. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718000] [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)
- T Bracic
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz
| | - I Pfniß
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz
| | - K Kutllovci-Hasani
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz
| | - N Taumberger
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz
| | - D Ulrich
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz
| | - W Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz
| | - P Reif
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz
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16
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Grentner LB, Weiss EC, Ulrich D, Schöll W, Lakovschek IC. Vergleich der präpartalen sonographischen Gewichtsschätzung mit dem tatsächlichen Geburtsgewicht bei Kinder mit Schulterdystokie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717178] [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)
| | - EC Weiss
- Universitätsfrauenklinik Graz, Geburtshilfe
| | - D Ulrich
- Universitätsfrauenklinik Graz, Geburtshilfe
| | - W Schöll
- Universitätsfrauenklinik Graz, Geburtshilfe
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17
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Müller I, Ulrich D, Weiss EC, Schöll W, Lakovschek IC. Korrelation des neonatalen Outcomes mit der Schwere der Schulterdystokie gemessen an den notwendigen Schulter-Löse-Manöver. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717954] [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)
- I.J Müller
- Universitätsfrauenklinik Graz, Geburtshilfe
| | - D Ulrich
- Universitätsfrauenklinik Graz, Geburtshilfe
| | - E.-C Weiss
- Universitätsfrauenklinik Graz, Geburtshilfe
| | - W Schöll
- Universitätsfrauenklinik Graz, Geburtshilfe
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18
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Hochstätter R, Schütz A - M, Müller G, Tomasch G, Reif P, Tamussino K, Schöll W. Enhanced Recovery After Surgery (ERAS)-Empfehlungen bei der Kaiserschittentbindung – werden sie in Graz umgesetzt? Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713218] [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: 10/24/2022] Open
Affiliation(s)
- R Hochstätter
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - M Schütz A -
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - G Müller
- Klinische Abteilung für Allgemeine Anästhesiologie, Notfall- und Intensivmedizin, Medizinische Universität Graz
| | - G Tomasch
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - P Reif
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - K Tamussino
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - W Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
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19
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Müller IJ, Weiss EC, Ulrich D, Schöll W, Lakovschek I - C. Unterschiede der perinatalen Morbidität in Abhängigkeit der schwere einer Schulterdystokie, gemessen an den notwendigen Schulter-Löse-Manöver. Eine retrospektive Studie der letzten 10 Jahre an der UFK Graz. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713223] [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: 10/24/2022] Open
Affiliation(s)
- I J Müller
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Abteilung für Geburtshilfe, Medizinische Universität Graz
| | - E-C Weiss
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Abteilung für Geburtshilfe, Medizinische Universität Graz
| | - D Ulrich
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Abteilung für Geburtshilfe, Medizinische Universität Graz
| | - W Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Abteilung für Geburtshilfe, Medizinische Universität Graz
| | - C Lakovschek I -
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Abteilung für Geburtshilfe, Medizinische Universität Graz
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20
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Hochstätter R, Schütz A - M, Müller G, Tomasch G, Reif P, Tammaa A, Oppelt P, Husslein PW, Hartmann B, Ramoni A, Reisenberger K, Maier B, Mörtl M, Wagner T, Hefler L, Gamper C, Aigmüller T, Tamussino K, Schöll W. Enhanced Recovery After Surgery (ERAS)-Empfehlungen bei der Kaiserschittentbindung – wie weit werden sie in Österreich angewandt? Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713217] [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: 10/24/2022] Open
Affiliation(s)
- R Hochstätter
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - M Schütz A -
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - G Müller
- Klinische Abteilung für Allgemeine Anästhesiologie, Notfall- und Intensivmedizin, Medizinische Universität Graz
| | - G Tomasch
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - P Reif
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - A Tammaa
- Abteilung für Gynäkologie und Geburtshilfe, Krankenhaus Nord Floridsdorf
| | - P Oppelt
- Gynäkologie, Geburtshilfe und Gyn. Endokrinologie, Kepler Universitätsklinikum Linz
| | - P W Husslein
- Univ. Klinik für Frauenheilkunde, AKH – Medizinische Universität Wien
| | - B Hartmann
- Geburtshilflich-Gynäkologische Abteilung, Sozialmedizinisches Zentrum Ost Wien
| | - A Ramoni
- Univ.-Klinik für Gynäkologie und Geburtshilfe, Medizinische Universität Innsbruck
| | - K Reisenberger
- Abteilung für Frauenheilkunde und Geburtshilfe, Klinikum Wels-Grieskirchen, Standort Wels
| | - B Maier
- Gynäkologisch-geburtshilfliche Abteilung, Wilhelminenspital Wien
| | - M Mörtl
- Abteilung für Gynäkologie und Geburtshilfe, LKH Klagenfurt
| | - T Wagner
- Gynäkologisch-geburtshilfliche Abteilung, Sozialmedizinisches Zentrum Süd Wien
| | - L Hefler
- Abteilung für Gynäkologie & Geburtshilfe, BHB Linz
| | - C Gamper
- Abteilung für Gynäkologie und Geburtshilfe, Landesklinikum Wiener Neustadt
| | - T Aigmüller
- Abteilung für Frauenheilkunde und Geburtshilfe, Landeskrankenhaus Hochsteiermark, Standort Leoben
| | - K Tamussino
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - W Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe
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21
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Nanda M, Weiss EC, Stern C, Mayer-Pickel K, Schöll W. Schwere Schwangerschaftskomplikationen bei Neurofibromatose – ein Fallbericht. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713220] [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: 10/24/2022] Open
Affiliation(s)
- M Nanda
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Auenbruggerplatz 14, 8036 Graz
| | - E-C Weiss
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Auenbruggerplatz 14, 8036 Graz
| | - C Stern
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Auenbruggerplatz 14, 8036 Graz
| | - K Mayer-Pickel
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Auenbruggerplatz 14, 8036 Graz
| | - W Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Auenbruggerplatz 14, 8036 Graz
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22
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Weiss EC, Tiefenbacher F, Freimüller B, Tomasch G, Reif P, Schöll W. Schmerztherapie nach Sectio – orales Management übertrifft iv. Therapie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713227] [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: 10/24/2022] Open
Affiliation(s)
- E-C Weiss
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Graz
| | - F Tiefenbacher
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Graz
| | - B Freimüller
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Graz
| | - G Tomasch
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Graz
| | - P Reif
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Graz
| | - W Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Graz
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23
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Bracic T, Pfniß I, Kutllovci-Hasani K, Taumberger N, Schöll W, Reif P. Entwicklung der Sectio caesarea (CS) Raten an der Frauenklinik Graz im 10-Jahresintervall anhand der Robson-10 Gruppen-Klassifikation. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713212] [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: 10/24/2022] Open
Affiliation(s)
- T Bracic
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, LKH-Univ. Klinikum Graz
| | - I Pfniß
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, LKH-Univ. Klinikum Graz
| | - K Kutllovci-Hasani
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, LKH-Univ. Klinikum Graz
| | - N Taumberger
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, LKH-Univ. Klinikum Graz
| | - W Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, LKH-Univ. Klinikum Graz
| | - P Reif
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, LKH-Univ. Klinikum Graz
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24
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Nanda M, Nanda R, Weiss EC, Bacher H, Lemmerer MM, Reif P, Schöll W, Tomasch G. Mehrfache manuelle Reposition trotz fortgeschrittener Schwangerschaft eines Uterus incarceratus unter Lachgas – Fallbericht. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713221] [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: 10/24/2022] Open
Affiliation(s)
- M Nanda
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Auenbruggerplatz 14, 8036 Graz
| | - R Nanda
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Auenbruggerplatz 14, 8036 Graz
| | - E-C Weiss
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Auenbruggerplatz 14, 8036 Graz
| | - H Bacher
- Universitätsklinik für Chirurgie, Auenbruggerplatz 29, 8036 Graz
| | - M M Lemmerer
- Universitätsklinik für Chirurgie, Auenbruggerplatz 29, 8036 Graz
| | - P Reif
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Auenbruggerplatz 14, 8036 Graz
| | - W Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Auenbruggerplatz 14, 8036 Graz
| | - G Tomasch
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Auenbruggerplatz 14, 8036 Graz
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25
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Grentner LB, Weiss EC, Ulrich D, Schöll W, Lakovschek I - C. Präpartale sonographische Gewichtsschätzung und Korrelation mit dem tatsächlichen Geburtsgewicht bei Kindern mit Schulterdystokie. Eine retrospektive Analyse der letzten 10 Jahre an der UFK, Graz. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713216] [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: 10/24/2022] Open
Affiliation(s)
- L B Grentner
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Abteilung für Geburtshilfe, Medizinische Universität Graz
| | - E-C Weiss
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Abteilung für Geburtshilfe, Medizinische Universität Graz
| | - D Ulrich
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Abteilung für Geburtshilfe, Medizinische Universität Graz
| | - W Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Abteilung für Geburtshilfe, Medizinische Universität Graz
| | - C Lakovschek I -
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Abteilung für Geburtshilfe, Medizinische Universität Graz
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26
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Mayer-Pickel K, Stern C, Cervar-Zivkovic M, Schöll W, Moertl M. Preeclampsia before fetal viability in women with primary antiphospholipid syndrome- materno-fetal outcomes in a series of 7 cases. J Reprod Immunol 2020; 138:103101. [PMID: 32114217 DOI: 10.1016/j.jri.2020.103101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 09/12/2019] [Revised: 02/11/2020] [Accepted: 02/13/2020] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Preeclampsia complicates about 10-17 % of pregnancies with antiphospholipid syndrome (APS). It is often severe and might occur sometimes at early gestation. The development of preeclampsia before fetal viability is a huge challenge for obstetricians and demands an intensive discussion regarding the therapeutical options. PATIENTS AND METHODS We retrospectively reviewed the data of 7 women with primary APS who developed preeclampsia before 24 weeks of gestation. Plasma exchange had been performed in four of the cases and two women received corticosteroids. One of the women had received 20 mg of pravastatin daily, starting at 18 weeks of gestation. Neonatal outcome was: live birth in four cases and IUFD in three cases. The main pediatric complications were noted in a 28-week-old premature born boy, who developed severe IRDS and thrombocytopenia. At the present time, the boy continues to have a retarded status. DISCUSSION This retrospective analysis revealed that women with APS can develop severe preeclampsia even before 20 weeks of gestation. Several management options for prolongation of pregnancy such as plasma exchange, pravastatin, LMHW, hydroxychloroquine/HCQ, or TNF-alpha blocker should be discussed with the patients. Optimal management of preeclampsia before 24 weeks of gestation usually depends on weighing the maternal and fetal complications from expectant management with prolongation of pregnancy versus the predominant fetal and neonatal risks of extreme prematurity from "aggressive" management with immediate delivery.
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Lakovschek IC, Tomasch G, Fleck S, Görög CM, El-Shabrawi A, Uranüs S, Lang U, Schöll W. Fulminanter Verlauf eines Ileus während der Schwangerschaft mit plötzlichem Fruchttod und abdominellem Kompartmentsyndrom – Fallbericht. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1693880] [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: 10/26/2022] Open
Affiliation(s)
- IC Lakovschek
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Graz
| | - G Tomasch
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Graz
| | - S Fleck
- Universitätsklinik für Anästhesiologie und Intensivmedizin, Graz
| | - CM Görög
- Universitätsklinik für Anästhesiologie und Intensivmedizin, Graz
| | - A El-Shabrawi
- Universitätsklinik für Chirurgie, Klinische Abteilung für Allgemeinchirurgie, Graz
| | - S Uranüs
- Universitätsklinik für Chirurgie, Klinische Abteilung für Allgemeinchirurgie, Graz
| | - U Lang
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Graz
| | - W Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Graz
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28
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Lakovschek IC, Freimüller B, Wölfler M, Lang U, Schöll W. Das modifizierte Zavanelli-Manöver: Lösung der vorderen Schulter von abdominal nach Pfannenstiel-Laparotomie und Uterotomie bei schwerer Schulterdystokie – Fallbericht. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1693879] [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: 10/26/2022] Open
Affiliation(s)
- IC Lakovschek
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Graz
| | - B Freimüller
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Graz
| | - M Wölfler
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Graz
| | - U Lang
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Graz
| | - W Schöll
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Graz
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29
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Reif P, Pichler G, Griesbacher A, Lehner G, Schöll W, Lang U, Hofmann H, Ulrich D. Do time of birth, unit volume, and staff seniority affect neonatal outcome in deliveries at ≥34
+0
weeks of gestation? BJOG 2017; 125:884-891. [DOI: 10.1111/1471-0528.15000] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2017] [Indexed: 11/27/2022]
Affiliation(s)
- P Reif
- Department of Obstetrics and Gynaecology Medical University of Graz Graz Austria
| | - G Pichler
- Division of Neonatology Department of Paediatrics Medical University of Graz Graz Austria
| | - A Griesbacher
- Risk Assessment, Data and Statistics Austrian Agency for Health and Food Safety Graz Austria
| | - G Lehner
- Department of Obstetrics and Gynaecology Medical University of Graz Graz Austria
| | - W Schöll
- Department of Obstetrics and Gynaecology Medical University of Graz Graz Austria
| | - U Lang
- Department of Obstetrics and Gynaecology Medical University of Graz Graz Austria
| | - H Hofmann
- Department of Obstetrics and Gynaecology Hospital Feldbach Feldbach Austria
| | - D Ulrich
- Department of Obstetrics and Gynaecology Medical University of Graz Graz Austria
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30
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Reif P, Pichler G, Lehner G, Ulrich D, Schöll W, Lang U. Which factors affect neonatal outcome? Impact of time of birth, maternity units' volume and staff's experience level on the neonatal outcome of deliveries. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1602337] [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: 10/19/2022] Open
Affiliation(s)
- P Reif
- Department of Obstetrics and Gynecology, Medical University of Graz
| | - G Pichler
- Division of Neonatology. Department of Pediatrics, Medical University of Graz
| | - G Lehner
- Department of Obstetrics and Gynecology, Medical University of Graz
| | - D Ulrich
- Department of Obstetrics and Gynecology, Medical University of Graz
| | - W Schöll
- Department of Obstetrics and Gynecology, Medical University of Graz
| | - U Lang
- Department of Obstetrics and Gynecology, Medical University of Graz
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31
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Haas E, Pfniss I, Schöll W, Weiss EC. Geburtsmodus nach Einleitung bei IUGR – klinische Erfahrung eines Tertiärzentrums. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1602327] [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: 10/19/2022] Open
Affiliation(s)
- E Haas
- Universitätsfrauenklinik Graz, Abteilung für Geburtshilfe, Medizinische Universität Graz
| | - I Pfniss
- Universitätsfrauenklinik Graz, Abteilung für Geburtshilfe, Medizinische Universität Graz
| | - W Schöll
- Universitätsfrauenklinik Graz, Abteilung für Geburtshilfe, Medizinische Universität Graz
| | - EC Weiss
- Universitätsfrauenklinik Graz, Abteilung für Geburtshilfe, Medizinische Universität Graz
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Wölfler MM, Rutzinger A, Ballon M, Bjelic-Radisic V, Kollmann M, Lang U, Schöll W. Kryokonservierung von Ovarialgewebe zur Fertilitätsprotektion – erste Ergebnisse. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1582168] [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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Reif P, Ulrich D, Lakovschek I, Tappauf C, Lang U, Schöll W. Practicability of fetal scalp blood sampling during labor using microtubes and a point-of-care (POC) lactate testing device: difficulty assessment, sampling time and failure rates. Clin Chem Lab Med 2016; 53:e195-7. [PMID: 25781696 DOI: 10.1515/cclm-2015-0031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 02/17/2015] [Indexed: 11/15/2022]
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Reif P, Lakovschek I, Tappauf C, Haas J, Lang U, Schöll W. Validation of a point-of-care (POC) lactate testing device for fetal scalp blood sampling during labor: clinical considerations, practicalities and realities. Clin Chem Lab Med 2014; 52:825-33. [PMID: 24406288 DOI: 10.1515/cclm-2013-0732] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 12/02/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although fetal blood sampling for pH is well established the use of lactate has not been widely adopted. This study validated the performance and utility of a handheld point-of-care (POC) lactate device in comparison with the lactate and pH values obtained by the ABL 800 blood gas analyzer. METHODS The clinical performance and influences on accuracy and decision-making criteria were assessed with freshly taken fetal blood scalp samples (n=57) and umbilical cord samples (n=310). Bland-Altman plot was used for data plotting and analyzing the agreement between the two measurement devices and correlation coefficients (R²) were determined using Passing-Bablok regression analysis. RESULTS Sample processing errors were much lower in the testing device (22.8% vs. 0.5%). Following a preclinical assessment and calibration offset alignment (0.5 mmol/L) the test POC device showed good correlation with the reference method for lactate FBS (R²=0.977, p<0.0001, 95% CI 0.9 59-0.988), arterial cord blood (R²=0.976, p<0.0001, 95% CI 0.967-0.983) and venous cord blood (R²=0.977, p<0.0001, 95% CI 0.968-0.984). CONCLUSIONS A POC device which allows for a calibration adjustment to be made following preclinical testing can provide results that will correlate closely to an incumbent lactate method such as a blood gas analyzer. The use of a POC lactate device can address the impracticality and reality of pH sample collection and testing failures experienced in day to day clinical practice. For the StatStrip Lactate meter we suggest using a lactate cut-off of 5.1 mmol/L for predicting fetal acidosis (pH<7.20).
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Christoph P, Baumann M, Raio L, Surbek D, Schöll W. Secondary life-threatening postpartum hemorrhage – Case report. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388217] [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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Lakovschek IC, Reif P, Haas J, Lang U, Schöll W. Einsatz eines point-of-care testing (POCT) device zur Messung von Laktat in der Kreissaalüberwachung. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347813] [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] Open
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Reif P, Mautner E, Tappauf C, Schest EC, Schöll W, Lang U. Evaluierung des Trainingseffekts eines online Trainingsprogramms zur subpartualen fetalen Überwachung. Geburtshilfe Frauenheilkd 2012. [DOI: 10.1055/s-0032-1313689] [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
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Reif P, Haas J, Schöll W, Lang U. [Foetal scalp blood sampling: impact on the incidence of Caesarean section and assisted vaginal deliveries for non-reassuring foetal heart rate and its use according to gestational age]. Z Geburtshilfe Neonatol 2011; 215:194-8. [PMID: 22028059 DOI: 10.1055/s-0031-1287861] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
BACKGROUND Interpretation of a suspicious, non-reassuring or pathological foetal heart rate tracing does not provide any direct information about foetal oxygen saturation, blood gas status or the extent of changes in pH. Without foetal scalp blood sampling, such tracings often necessitate rapid intervention to deliver the baby by Caesarean section or assisted vaginal delivery. The aim of this study was to show the impact of foetal blood sampling on reducing the number of Caesarean sections and assisted vaginal deliveries in a clinical setting in such cases. MATERIALS AND METHODS A retrospective study of the mode of delivery in 669 women where foetal scalp blood sampling had been performed for suspicious or pathological foetal heart rate monitoring, in the period 2008-2009 was undertaken. The gestational age of the foetus was also investigated. RESULTS Because one or more results of foetal scalp pH were within the normal range an operative delivery could be avoided in 6.4% of the study population, in spite of the non-reassuring foetal heart rate monitoring. Foetal blood sampling was performed more frequently in post-term pregnancies. CONCLUSIONS Foetal blood analysis still is an effective tool to reduce unnecessary operative deliveries and should be regularly included in intrapartum monitoring. The risk of foetal complications is low compared with the reduction in the rate of Caesarean sections and assisted vaginal deliveries. Obstetricians are evidently becoming more willing to carry out foetal scalp blood sampling with rising gestational age.
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Affiliation(s)
- P Reif
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz, Graz, Österreich.
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Mayer-Pickel K, Mörtl M, Schöll W, Horn S, Stern C, Lang U, Cervar-Zivkovic M. Individuelles Management des Antiphospholipidsyndroms in der Schwangerschaft- eine Summationskasuistik. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1278609] [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] Open
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Reif P, Schöll W, Lang U. Mobile Cardiotocography – Nanoelectronics for Mobile Ambient Assisted Living Systems (MAS): Die Entwicklung einer neuen Generation der CTG-Überwachung. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1278611] [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] Open
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Tappauf C, Peuker A, Schöll W, Walcher W, Lang U. Fetales Steißbeinteratom – ein Fallbericht. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1278620] [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] Open
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Reif P, Schöll W, Klaritsch P, Lang U. Rupture of endometriotic ovarian cyst causes acute hemoperitoneum in twin pregnancy. Fertil Steril 2011; 95:2125.e1-3. [DOI: 10.1016/j.fertnstert.2011.01.023] [Citation(s) in RCA: 13] [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: 12/02/2010] [Revised: 12/13/2010] [Accepted: 01/06/2011] [Indexed: 10/18/2022]
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Schest E, Moser F, Häusler M, Lang U, Schöll W. Zervikalschwangerschaft mit Plazenta accreta – ein Fallbericht. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1278612] [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] Open
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Reif P, Walcher W, Schöll W, Lang U. Management der postpartalen Blutung nach Einführung des Bakri-Ballons – Eine Kasuistik von 5 Fällen. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0030-1271076] [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] Open
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Reif P, Haas J, Schöll W, Lang U. Reduktion der operativen Entbindungsrate durch den Einsatz von Mikroblutuntersuchungen bei auffälligem CTG unter Berücksichtigung des Gestationsalters. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1278540] [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] Open
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Magnet E, Schöll W, Walcher W, Lang U. Misoprostol zur Geburtseinleitung bei intrauterinem Fruchttod im 2. und 3. Trimester. Geburtshilfe Frauenheilkd 2010. [DOI: 10.1055/s-0030-1254938] [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
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Weiss EC, Schöll W. Case report: Falsch positives CTG durch manuelle Nabelschnurmanipulationen des Feten. Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-0029-1225165] [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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Schöll W, Reich O, Regauer S. Behandlung vulvärer intraepithelialer Neoplasie (VIN) mit topischem Cidofovir und Imiquimod. Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-0029-1225192] [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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Arikan G, Etschmaier S, Schöll W, Kainer F, Stein J, Haeusler M. Vergleich von Reflexionspulsoximetrie und von Kardiotokographie zur intrapartalen Überwachung bei fetaler Arrhythmie und kardialem Vitium. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2007-1023142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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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Schöll W, Haas J, Giuliani A, Petru E, Tamussino K, Gücer F, Arikan G, Winter R. Zervixkarzinom in der Schwangerschaft und bei Nicht-Graviden: Langzeitprognose im Vergleich. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2007-1023149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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