Kolben T, Schröder L, Kaiser-Rix C
… +10 more, Mahner S, Beyer S, Ehmann L, Czogalla B, Seifert C, Ganster F, Kost B, Burges A, Trillsch F, Keckstein S
Arch Gynecol Obstet
· 2026 Feb · PMID 41627498
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OBJECTIVE: The study aimed to evaluate the long-term outcomes of surgical management in patients with peritoneal endometriosis, focusing on postoperative pain trajectories, re-operation rates, fertility outcomes, and the...OBJECTIVE: The study aimed to evaluate the long-term outcomes of surgical management in patients with peritoneal endometriosis, focusing on postoperative pain trajectories, re-operation rates, fertility outcomes, and the potential influence of hormone therapy. METHODS: This retrospective study included 67 patients with histologically confirmed peritoneal endometriosis who underwent laparoscopic surgery. Surgical management consisted of excision in 62.7% of cases, ablation using bipolar coagulation in 13.4%, and a combination of both techniques in 23.9%. Pain symptoms (dysmenorrhea, dyspareunia, and chronic pelvic pain) were assessed preoperatively at 6 and 12 months, and at a median follow-up of 42 months. Associations between surgical technique, postoperative hormone therapy, and pain outcomes over time were analyzed using mixed linear models. RESULTS: Both excision and ablation were associated with significant and sustained reductions in pain symptoms over time. Dysmenorrhea showed improvement postoperatively, with additional benefit observed in patients receiving hormonal therapy. The type of surgery had no significant effect on dysmenorrhea. Dyspareunia and chronic pelvic pain also improved during follow-up, independent of surgical technique or hormone use. Re-operation was required in 17.9% of cases, with no difference between excision and ablation. Among the 27 patients who wished to conceive, 62.9% achieved pregnancy postoperatively, irrespective of surgical approach. CONCLUSIONS: Both excision and ablation using bipolar coagulation are effective surgical options for peritoneal endometriosis, leading to long-term pain relief and favorable fertility outcomes. Postoperative hormone therapy appears to enhance pain control, particularly for dysmenorrhea. Overall, symptom improvement was more strongly associated with time since surgery than with the specific surgical technique, supporting individualized and multimodal treatment strategies.
Piriyev E, Sadikova M, Dieter A
… +3 more, Schiermeier S, Renner SP, Römer T
Arch Gynecol Obstet
· 2026 Jan · PMID 41615509
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KEY MESSAGE: Transcervical radiofrequency ablation is a low-risk, uterus-preserving option for symptomatic fibroids in women with obesity with significant improvement of bleeding disorder, including ≥ 40 kg/m. Obesity sh...KEY MESSAGE: Transcervical radiofrequency ablation is a low-risk, uterus-preserving option for symptomatic fibroids in women with obesity with significant improvement of bleeding disorder, including ≥ 40 kg/m. Obesity should not preclude offering TFA. OBJECTIVE: To evaluate the safety and effectiveness of transcervical radiofrequency ablation (TFA) for uterine fibroids in women with obesity. METHODS: Retrospective multicenter cohort at two German Fibroid Centers. From 574 consecutive TFA cases, we included patients with BMI ≥ 30 kg/m and ≥ 6-month follow-up; those with incomplete data were excluded. Fibroids were characterized by ultrasound. TFA (Sonata®) was performed per instructions for use. Outcomes were perioperative complications and patient-reported improvement in abnormal uterine bleeding (AUB). RESULTS: Sixty patients were analyzed (age 43.59 ± 6.52 years; BMI 35.72 ± 6.72 kg/m). Mean operative and ablation times were 33.65 and 9.91 min, respectively. One intraoperative bleeding event (1.7%) was controlled with a balloon catheter; no postoperative complications occurred. Mean follow-up was 17.08 months (6-54). Overall, 42/60 (70.0%) reported AUB improvement. By BMI category: 30-34.9 kg/m 25/39 (64.1%), 35-39.9 kg/m 5/7 (71.4%), ≥ 40 kg/m 12/14 (85.7%) (p = 0.3168). Considering the initial assessment, 48/60 (80.0%) improved; six later recurred, yielding 42/60 (70.0%) at last follow-up. CONCLUSION: TFA showed a very low complication rate and clinically meaningful bleeding improvement in women with obesity, with comparable outcomes across BMI strata, including ≥ 40 kg/m. Obesity is not a barrier to safe, effective TFA. Prospective, BMI-stratified studies with validated bleeding measures and objective endpoints are warranted.
Endrass J, Krbanjevic V, Khattab K
… +3 more, Pavicic E, Zwahlen M, Stute P
Arch Gynecol Obstet
· 2026 Jan · PMID 41615481
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BACKGROUND: Cardiovascular diseases (CVD) are the leading cause of death among women, with risk increasing after menopause. Lipid levels are key biomarkers, yet conventional blood tests remain invasive and underutilized....BACKGROUND: Cardiovascular diseases (CVD) are the leading cause of death among women, with risk increasing after menopause. Lipid levels are key biomarkers, yet conventional blood tests remain invasive and underutilized. Non-invasive technologies and machine learning (ML) may offer new approaches to lipid monitoring and risk assessment using wearable devices and biosensors. OBJECTIVE: This systematic review investigates the availability, accuracy, and clinical applicability of minimally and non-invasive lipid monitoring methods and ML-based cardiovascular risk estimation in adults. METHODS: A systematic search was conducted in MEDLINE, Embase, Cochrane Library, Web of Science, Scopus, and ClinicalTrials.gov (2010-2024). Studies in English were included; case reports and animal studies were excluded. Data extraction focused on devices, measurement approach, and predictive utility for cardiovascular outcomes. Methodological heterogeneity was addressed through narrative synthesis and thematic grouping (Thomas in Cochrane Handb Syst Rev Interv, 2024). RESULTS: From 14,863 records, 37 studies were included. Near-infrared, saliva-based, and smartphone-enabled fingertip devices showed promising accuracy. ML models using wearable-derived physiological data demonstrated moderate success in predicting cardiovascular risk and lipid levels. CONCLUSION: Minimally and non-invasive lipid monitoring and ML-based risk prediction may support accessible, personalized cardiovascular risk management. Despite encouraging findings, validation in large-scale, long-term studies is essential before clinical adoption. TRIAL REGISTRATION: Title registration number (on PROSPERO): CRD420251105896.
Wolff K, Gumin D, Shqara RA
… +4 more, Sharon A, Sgayer I, Lowenstein L, Aiob A
Arch Gynecol Obstet
· 2026 Jan · PMID 41611996
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PURPOSE: Atypical endometrial hyperplasia (AEH) is a known precursor to endometrioid endometrial carcinoma. However, occult carcinoma may already be present at diagnosis, complicating surgical planning. Accurate preopera...PURPOSE: Atypical endometrial hyperplasia (AEH) is a known precursor to endometrioid endometrial carcinoma. However, occult carcinoma may already be present at diagnosis, complicating surgical planning. Accurate preoperative risk stratification is crucial, especially for guiding the selective use of sentinel lymph node biopsy. This study aimed to identify predictors of occult carcinoma and develop a model to estimate the risk of malignancy. METHODS: We conducted a retrospective case-control study of 101 women diagnosed with AEH who underwent hysterectomy between 2010 and 2024 at Galilee Medical Center. Clinical, metabolic, and imaging data were extracted. Patients were stratified based on the final pathology into two groups: those with occult carcinoma and those with AEH only. Multivariable logistic regression was employed to identify independent predictors and construct a predictive model. RESULTS: Occult endometrial carcinoma was identified in 37 women (36.6%). Women with occult endometrial carcinoma were older and more likely to present with postmenopausal bleeding. Occult carcinoma was more frequently detected after Pipelle biopsy than after hysteroscopy or dilation and curettage (43.2% vs. 17.2%). In multivariable analysis, Pipelle biopsy (OR 4.68), hyperlipidemia (OR 5.86), obesity (OR 2.97), and increasing age (OR 1.07 per year) were independently associated with occult carcinoma. A predictive model estimated individual risk ranging from 5.6% to 95.0% according to accumulation of risk factors. CONCLUSION: Older age, biopsy method, obesity, hyperlipidemia, and bleeding presentation are independently associated with an occult endometrial carcinoma in women with atypical endometrial hyperplasia. The proposed model may support preoperative risk stratification and counseling, but it requires external validation before clinical use, including decisions regarding sentinel lymph node biopsy.
Bale CA, Pearce JV, Deng X
… +7 more, Bandyopadhyay D, Yarden N, Sport C, Miller DT, Randall LM, Fields E, Sullivan SA
Arch Gynecol Obstet
· 2026 Jan · PMID 41609820
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PURPOSE: This study sought to determine the relationship between cervical cancer recurrence and post-treatment change in standardized uptake value (SUV) of 18F-2-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG...PURPOSE: This study sought to determine the relationship between cervical cancer recurrence and post-treatment change in standardized uptake value (SUV) of 18F-2-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) in the cervix and lymph nodes. METHODS: This retrospective cohort study included patients who received curative intent radiation therapy for biopsy-proven stage I-IVA locally advanced cervical cancer at a single tertiary referral center from 2009 to 2021. The exposure was percent change in SUV from pre- to post-treatment FDG-PET scans at the cervix and lymph nodes. The primary outcome was recurrence rate, and secondary outcomes were overall and progression-free survival. Firth's penalized logistic regression and Cox proportional hazards models were used to assess associations. RESULTS: 55 patients met eligibility criteria. Recurrence rate was 27% (15/55); of these, 33% had local recurrence (5/55) and 67% had distant recurrence (10/55). Median percent decrease of cervical SUV after treatment in those with and without recurrence was similar (71.4 vs 68.8, p = 0.89); this remained consistent when analyzing those with local recurrence only (70.5, p = 0.95). When the percent decrease in cervical SUV was examined in intervals (< 25%, 25-50%, 50-75%, > 75%), this was also not predictive of local (p = 0.91) or overall (p = 0.75) recurrence. Median percent decrease at the most avid and distant lymph node in those with and without recurrence was not significantly different (p > 0.05). Neither change in cervical nor lymph node SUV was associated with overall or progression-free survival. CONCLUSION: Changes in SUV after treatment may not be a reliable stand-alone marker for predicting recurrence or survival in locally advanced cervical cancer after treatment with radiation therapy.
Bashan Y, Shalev Maman E, Rosenberg R
… +4 more, Yekel Y, Weintraub A, Duvdevani NR, Pasternak Y
Arch Gynecol Obstet
· 2026 Jan · PMID 41606285
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OBJECTIVES: To estimate the success rates and risks of vaginal birth after cesarean delivery (VBAC) based on the number of prior successful VBACs. METHODS: A retrospective cohort study of women with one cesarean section...OBJECTIVES: To estimate the success rates and risks of vaginal birth after cesarean delivery (VBAC) based on the number of prior successful VBACs. METHODS: A retrospective cohort study of women with one cesarean section in the past who attempted vaginal delivery between 2013 and 2022, using data from our Medical Center registry. Outcomes were compared based on the number of prior successful VBACs. RESULTS: Among 2912 deliveries meeting the eligibility criteria, the success rate of VBAC increased with the number of prior VBACs: 73.2% for those with no prior VBAC, rising to 92.3%, 94.7%, 94.0%, and 97.0% for individuals with 1, 2, 3, 4, and 5 or more prior VBACs, respectively. The history of at least one prior VBAC was associated with a 5.17-fold higher likelihood of achieving VBAC success. However, no significant differences in success rates were observed between groups with higher numbers of prior VBACs (≥ 2) compared to individuals with only one prior VBAC. In addition, the duration of hospitalization for both mother and neonate was longer in cases with no prior VBAC history. There was also a higher risk of requiring blood transfusion in the group without a prior history of VBAC. CONCLUSIONS: Women with prior successful VBAC have a high likelihood of achieving another successful VBAC. After two prior VBACs, the success rate remains stable. In addition, women with one or more previous VBACs experience a reduced risk of blood transfusion and shorter hospitalization durations for both the mother and newborn.
Arch Gynecol Obstet
· 2026 Jan · PMID 41606252
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PURPOSE: To assess the incidence, risk factors, and prognostic impact of ovarian metastasis in early-stage cervical cancer using a large population-based registry. METHODS: We retrospectively analyzed 983 patients with c...PURPOSE: To assess the incidence, risk factors, and prognostic impact of ovarian metastasis in early-stage cervical cancer using a large population-based registry. METHODS: We retrospectively analyzed 983 patients with cervical cancer classified as pT1a1-pT2b according to the TNM system treated with primary surgery and bilateral oophorectomy. The association between clinicopathological variables and ovarian metastasis was evaluated using Chi-square tests and binary logistic regression. Survival outcomes were assessed with Kaplan-Meier curves and Cox regression. RESULTS: Ovarian metastases were identified in 0.8% of cases (n = 8). Histologic subtype was significantly associated with ovarian metastasis (p = 0.010). In multivariate logistic regression, adenocarcinoma histology was an independent predictor of metastasis (OR 9.94, 95% CI 1.99-49.6, p = 0.005). Patients with ovarian metastases had significantly worse disease-free and overall survival (p < 0.001). Due to the rarity of events, multivariable survival analysis incorporating treatment parameters was limited. CONCLUSION: Ovarian metastasis is rare in early-stage cervical cancer but associated with significantly impaired prognosis. Adenocarcinoma histology was independently associated with ovarian metastasis and may be considered when discussing ovarian preservation, although validation in larger cohorts is warranted. These findings support the individualized selection of patients for ovary-sparing surgery.
Arch Gynecol Obstet
· 2026 Jan · PMID 41606172
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BACKGROUND: Sleep quality has been shown to be strongly associated with a variety of health outcomes, but its role in assisted reproductive technology (ART) treatment outcomes has not been clarified. The study aims to sy...BACKGROUND: Sleep quality has been shown to be strongly associated with a variety of health outcomes, but its role in assisted reproductive technology (ART) treatment outcomes has not been clarified. The study aims to systematically evaluate the relationship between sleep quality and the outcomes of assisted reproductive technology. METHODS: This study systematically searched databases such as PubMed, Embase, Web of Science, and the Cochrane Library from its inception to 1 April 2025 to screen observational studies assessing the relationship between sleep quality and ART outcomes. The quality of the included studies was evaluated using the Newcastle-Ottawa Scale (NOS), and meta-analysis was performed using Stata 15.0 software. RESULTS: A total of 8 studies (N = 6754) were included to assess the relationship between good sleep quality and clinical pregnancy, and the combined analysis showed that good sleep significantly increased the clinical pregnancy rate [OR = 1.53, 95% CI (1.16, 2.03)]; sensitivity analysis suggested that Liu (2023) was the main source of heterogeneity, and heterogeneity declined to 33.2% after exclusion, which resulted in a stable outcome [OR = 1.59, 95% CI (1.28, 1.96)]. 3 studies evaluated the relationship between good sleep and embryo implantation rate, and the results showed that good sleep significantly increased the implantation rate [OR = 1.41, 95% CI (1.04, 1.92)]. 2 studies investigated the relationship between good sleep and live birth rate, and the results did not show any statistical difference [OR = 0.84, 95% CI (0.44, 1.61)]. CONCLUSIONS: Good sleep quality is associated with higher clinical pregnancy and implantation rates in couples undergoing ART. Its effect on live birth remains inconclusive and warrants further investigation.
Plöger R, Ludwig C, Nowozin G
… +4 more, Winkler K, Abramian A, Faridi A, Recker F
Arch Gynecol Obstet
· 2026 Jan · PMID 41580544
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BACKGROUND: In breast care, ultrasound examination is a very important tool used to detect breast tumors, to monitor core needle biopsies, for preparing surgical operations, and for tracking postoperative developments. S...BACKGROUND: In breast care, ultrasound examination is a very important tool used to detect breast tumors, to monitor core needle biopsies, for preparing surgical operations, and for tracking postoperative developments. So far, stationary high-end ultrasound devices (SHUD) based on piezoelectric technology are most commonly used but lack the mobility and thus the possibility to practice point-of-care ultrasound (POCUS) in senology. In contrast, handheld ultrasound devices based on silicon chips (HHUD) offer a high mobility and different penetration depths through its all-in-one probe principle and thus may improve patient treatment. Therefore, this study investigates the diagnostic reliability of breast lesions examined with HHUD based on silicon chips versus those examined with SHUD based on conventional piezoelectric technology. METHODS: Each patient received an ultrasound examination using SHUD (Voluson S10, GE Healthcare) and HHUD (Butterfly iQ, Butterfly Network) in a random order. The morphologic descriptors and the BI-RADS categories, as well as the histological results, in the case of the biopsy, were compared, and the agreement rate and the Cohen's kappa were analyzed. A quantitative analysis of the lesions' sizes examined by the two devices was assessed statistically through intra-class correlation coefficient (ICC), Bland-Altman plots, and Pearson correlation coefficient (PCC). Subgroup analysis was performed in lesions' type, skin-to-lesion distance, and lesions' volume. RESULTS: 105 lesions found in 84 females were analyzed regarding the reliability of SHUD and HHUD. The BI-RADS categories matched perfectly between both the devices and the available histological outcomes. The agreements of the measured diameters were excellent (ICC 0.926-0.969). The subgroup analysis revealed a slightly superior agreement for malignant cases, for lesions over 0.5 ml and for a skin-to-lesion distance over 5 mm. CONCLUSION: The categories and measurements from HHUD matched closely with those obtained using conventional SHUD. This research demonstrates that HHUD offers a good alternative to SHUD for breast lesion evaluation which becomes especially useful during point-of-care applications.
Lüchinger JE, Pavicic E, Giachino CL
… +1 more, Stute P
Arch Gynecol Obstet
· 2026 Jan · PMID 41575573
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PURPOSE: Lipedema is a chronic disorder that affects the subcutaneous adipose tissue of the lower and upper limbs and results in painful fat accumulations. During the reproductive life span, about 11% of women are affect...PURPOSE: Lipedema is a chronic disorder that affects the subcutaneous adipose tissue of the lower and upper limbs and results in painful fat accumulations. During the reproductive life span, about 11% of women are affected; however, there are a high number of suspected undiagnosed and thus untreated cases. METHODS: The aim of this systematic review was to evaluate the association between hormones and the pathophysiological mechanisms of lipedema development. Inclusion criteria were: lipedema, lipoedema, estrogen, estrogen antagonists, female sex hormones, hormones, insulin, puberty, pregnancy, menopause, subcutaneous fat tissue, and subcutaneous adipose connective tissue. RESULTS: The literature search yielded 121 hits; after deduplication, 64 records were screened. After abstract and full-text screening 15 publications were suitable for being included in the systematic review. Overall, four different pathophysiological hypotheses were postulated: (1) general hormonal imbalance, (2) changes in growth hormone balance, (3) metabolic imbalance such as changes in adipose stem cells in relation to adipokines or leptin in association with the transcription factor PPARγ, and (4) changes in estrogen metabolism as well as alterations in the function of estrogen receptors. CONCLUSION: Lipedema appears to be a multifactorial condition primarily driven by hormonal dysregulation-especially involving estrogen-alongside metabolic and possible genetic components. The findings support the reclassification of lipedema as a hormonally influenced disorder distinct from obesity, emphasizing the need for further research into diagnostic biomarkers, targeted therapies, and the role of genetic susceptibility.
Flechtenmacher AS, Schiestl LJ, Singer S
… +1 more, Hasenburg A
Arch Gynecol Obstet
· 2026 Jan · PMID 41569439
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PURPOSE: To investigate sexual health in breast cancer survivors and their partners, focusing on sexual satisfaction, changes in satisfaction with partner sexuality before vs. after the diagnosis, and unmet informational...PURPOSE: To investigate sexual health in breast cancer survivors and their partners, focusing on sexual satisfaction, changes in satisfaction with partner sexuality before vs. after the diagnosis, and unmet informational needs on sexual health in the context of breast cancer. METHODS: Breast cancer patients and their partners were surveyed at a single time point 1-5 years after having completed primary therapy for breast cancer as part of a cross-sectional study. Study participants completed self-report-questionnaires covering personal characteristics, a question on satisfaction with partner sexuality before (retrospective assessment) versus after the diagnosis (based on the Sexual Medicine Questionnaire for Chronic Diseases (SFCE)), the EORTC (European Organisation for Research and Treatment of Cancer) Sexual Health Questionnaire (EORTC QLQ-SH22) together with the EORTC Quality of Life Core Questionnaire (EORTC QLQ-C30), and a questionnaire assessing sexual health care. Descriptive statistics were used to summarize demographic and clinical data. For group comparisons, dyadic dependencies were accounted for, applying paired t tests when normality (Shapiro-Wilk test) was met and Wilcoxon signed-rank test otherwise. RESULTS: A total of 128 participants (64 patients, 64 partners) were enrolled. Sexual satisfaction did not differ between patients (M = 55, SD = 20.9) and partners (M = 56.7, SD = 20) (t test, p = 0.46). A positive correlation was found between patients' and partners' sexual satisfaction (r = 0.62, p < 0.0001). Satisfaction with partner sexuality was lower after diagnosis (p < 0.001, r = 0.54)-with both patients and partners being less satisfied after the diagnosis (M = 2.58, SD = 0.95) than before (M = 3.14, SD = 0.74). Overall, 75% of the study participants reported not having received information about sexual health issues related to breast cancer, while 64% expressed a desire for more information. CONCLUSION: The findings of this study highlight the importance of considering couple dynamics in breast cancer care. Patients and partners have unmet needs concerning sexual health in the context of breast cancer. Addressing sexuality may improve quality of life and psychosocial adjustment. Future research should include larger, more diverse samples and focus on assessing sexuality and sexual health as multidimensional constructs in line with WHO (World Health Organization) definitions.
Arch Gynecol Obstet
· 2026 Jan · PMID 41563506
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This case report describes the prenatal diagnosis of the extremely rare Blepharo-Cheilo-Dontic syndrome. After sonographic diagnosis of the bilateral cleft lip and palate and the persistent open eyelids, amniocentesis wi...This case report describes the prenatal diagnosis of the extremely rare Blepharo-Cheilo-Dontic syndrome. After sonographic diagnosis of the bilateral cleft lip and palate and the persistent open eyelids, amniocentesis with subsequent molecular genetics confirmed the sonographically presumed de-novo mutation of the CDH1 gene and the Blepharo-Cheilo-Dontic Syndrome. After multidisciplinary counseling the patients termined the pregnancy.
Di Michele S, Camoglio C, Chieppa P
… +5 more, Incognito GG, Caiazzo A, Cabras A, Picci F, Angioni S
Arch Gynecol Obstet
· 2026 Jan · PMID 41563503
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Growing evidence suggests that women with endometriosis may be particularly vulnerable to disordered eating behaviors (DEBs) and clinically defined eating disorders (EDs). This narrative review aims at integrating and cr...Growing evidence suggests that women with endometriosis may be particularly vulnerable to disordered eating behaviors (DEBs) and clinically defined eating disorders (EDs). This narrative review aims at integrating and critically analyzing the current evidence regarding the relationship between endometriosis and EDs, as well as highlighting the psychosocial and neurobiological vulnerabilities of women with endometriosis to DEBs. A large-scale genetic study showed a nearly threefold increase in the odds of EDs in women with endometriosis, and a significant genetic correlation. Although the prevalence of formal ED diagnoses appears low in small clinical samples, DEBs such as emotional eating, binge tendencies, and maladaptive dietary restriction, are common and strongly associated with pain intensity, and borderline BMI. Psychological factors, including body image disturbance, heightened self-criticism, emotional dysregulation, and the need for control further contribute to the vulnerability to EDs. At the biological level, the dysregulation of leptin, endocannabinoids, dopamine, brain-derived neurotrophic factor, and inflammatory cytokines, molecules involved in both appetite regulation and some aspects of the pathophysiology of endometriosis, suggests overlapping neuroimmune pathways that may link endometriosis to DEBs and EDs. Clinical management must, therefore, integrate screening for DEBs, supervised and personalized dietary counseling, balanced exercise prescription, and psychological interventions targeting pain coping, emotion regulation, and body image. A multidimensional, biopsychosocial framework is essential to prevent the onset or exacerbation of EDs in women with endometriosis.
Arch Gynecol Obstet
· 2026 Jan · PMID 41557193
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BACKGROUND: In Germany, first-trimester abortions are legally restricted but allowed under certain conditions, including mandatory counseling and a reflection period. Accessibility concerns persist. To address gaps in me...BACKGROUND: In Germany, first-trimester abortions are legally restricted but allowed under certain conditions, including mandatory counseling and a reflection period. Accessibility concerns persist. To address gaps in medical training, we developed an interdisciplinary learning module on first-trimester abortion care. METHODS: We piloted the module in two sessions giving access to all medical students as an extracurricular learning opportunity. We conducted non-paired surveys across the medical school prior to the module and with our participants after the module to identify changes in attitudes as well as in intentions to treat. RESULTS: We received a total of 297 responses. Most of the students (94%) were in favor of legalizing abortion laws. However, only 30% self-assessed their knowledge as sufficient, 40% of the students showed the willingness to perform abortions within the consultation clause and 43% of the students agreed to consult patients on abortion provision but not perform them themselves. The right for practitioners to object the performance of abortions was highly agreed upon (78%). After our pilot sessions, we received 53 evaluation surveys from 118 participants. Students reported a significant increase in knowledge. We observed a significant increase in general support and intention to treat after our module. CONCLUSIONS: Teaching about abortion is essential for our future healthcare providers. Overall, we see a great response to our new learning module and can hope for practice-changing effects on the provision of abortion care in the future. We integrated the module into our regular teaching catalogue.
Griewing S, Teske P, Wichmann J
… +13 more, Oftring Z, Knitza J, Keil C, Tauber N, Däumichen J, Potthast M, Wallwiener S, Wagner U, Wallwiener M, Gremke N, Leyer M, Gehling H, Kuhn S
Arch Gynecol Obstet
· 2026 Jan · PMID 41557177
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PURPOSE: Maternity care is a central component of any healthcare system and is largely provided by midwives. Considering increasing cost pressures and growing demand for efficiency within the German healthcare system, th...PURPOSE: Maternity care is a central component of any healthcare system and is largely provided by midwives. Considering increasing cost pressures and growing demand for efficiency within the German healthcare system, the development of efficient, digitally supported care models are both encouraged and actively promoted, especially in pregnancy. However, to date, no such model has been sustainably established in the field of maternity care. In particular, the perspectives of midwives have largely been neglected. METHODS: As part of an initial needs assessment for the Participatory Design of a digitally supported maternity care model, this study uses a cross-sectional web-based questionnaire to explore midwives' perceptions of their current work situation, use of digital tools and digital pregnancy care. RESULTS: 92.2% of participants (n = 129) perceive increasing strain on maternity care in Germany (5-point Likert; M = 4.49, SD = ± 0.69). 87.6% use a variety of digital tools in their professional environment, yet unvalidated and unauthorized solutions. Self-perceived digital competence is high (10-point NRS; 7.09 ± 1.48). The intention to use the technology decreases in parallel with the level of awareness, being highest for the electronic patient record (5-point Likert; 72.1%; 3.84 ± 0.97) and lowest for artificial intelligence (38.8%; 3.17 ± 1.05). CONCLUSION: The study highlights midwives' openness to digital solutions, their active, though informal, use of such tools, and emphasizes the need to integrate their perspectives into the development of certified, sustainable digital care models in maternity care within an increasingly strained healthcare system.
Oelgeschläger C, Weber EC, Gottschalk I
… +8 more, Jimenez-Cruz J, Geipel A, Strizek B, Kohaut J, Dübbers M, Oetzmann von Sochaczewski C, Heydweiller A, Berg C
Arch Gynecol Obstet
· 2026 Jan · PMID 41557046
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PURPOSE: Thoracoamniotic shunting (TAS) in fetuses with macrocystic congenital pulmonary airway malformation (CPAM) is mostly performed with pigtail shunts like the rocket shunt or the Harrison fetal bladder stent. The a...PURPOSE: Thoracoamniotic shunting (TAS) in fetuses with macrocystic congenital pulmonary airway malformation (CPAM) is mostly performed with pigtail shunts like the rocket shunt or the Harrison fetal bladder stent. The aim of this study was to assess the prenatal course, perinatal outcome and complications of TAS for severe macrocystic CPAM using the Somatex intrauterine shunt. METHODS: This was a two center (Cologne/Bonn) observational retrospective study of fetuses that underwent TAS using the Somatex intrauterine shunt for severe macrocystic CPAM with and without hydrops between 2016-2024. Outcome parameters were perinatal survival, complications, gestational age at delivery and visibility of the shunt outside the skin after birth. RESULTS: During the study period, 25 fetuses were treated with the Somatex shunt (13 = Cologne, 12 = Bonn), including 24 singletons and one fetus of a monochorionic-diamniotic twin pregnancy Mean gestational age at intervention was 24.7 weeks (range 19-30). The mean diameter of the dominant cyst within the lesion was 34 mm (range 18-55). Fetal hydrops prior to TAS (ascites and fetal scalp oedema) was present in 36% (9/25). Dislocation in the further course of pregnancy occurred in 8% (2/25) with the need for reintervention in two cases. Resolution of hydrops and regression of the lesion occurred in 96% (24/25). Mean gestational age at delivery was 38.3 weeks (range 26-41), the preterm birth rate < 37 weeks was 20% (5/25), 12% (3/25) were due to PPROM. Live birth rate was 100% and 92% (23/25) of neonates survived the neonatal period. Of the 12 liveborns delivered at the two study centers, in one case the shunt (8.3%) was dislocated in the amniotic cavity, 5 (41.7%) had a visible shunt outside the skin, whereas in the other 6 (50.0%) cases the shunt was covered with skin at birth. CONCLUSIONS: TAS in macrocystic CPAM with the Somatex shunt has a high technical success rate leading to high neonatal survival rates even in cases associated with hydrops. The intrauterine course and neonatal outcome are comparable to TAS for fetal macrocystic CPAM using other types of shunts. Therefore, the choice of the shunt in macrocystic CPAM can be made freely at the discretion of the physician in charge, the availability of devices and economic factors. Due to the short length of 25 mm and its straight design, the outer end of the Somatex shunt is covered by skin at birth in up to 50% of cases, which may complicate its removal.