Sensitivity, specificity, and diagnostic accuracy of WHO 2013 criteria for diagnosis of gestational diabetes mellitus in low risk early pregnancies: international, prospective, multicentre cohort study.

Objective: To evaluate the predictability of gestational diabetes mellitus wth a 75 g oral glucose tolerance test (OGTT) in early pregnancy, based on the 2013 criteria of the World Health Organization, and to test newly proposed cut-off values.

Design: International, prospective, multicentre cohort study.

Setting: Six university or cantonal departments in Austria, Germany, and Switzerland, from 1 May 2016 to 31 January 2019.

2D pelvic floor ultrasound imaging in identifying levator ani muscle trauma agrees highly with 4D ultrasound imaging.

Introduction And Hypothesis: The objective was to evaluate the agreement between 2D and 4D translabial ultrasound (TLUS) technique in showing levator ani muscle (LAM) states after vaginal birth.

Methods: In a prospective observational cohort study between March 2017 and April 2019 we evaluated LAM states (intact, hematoma, partial, complete avulsion) of primiparous women having given birth vaginally with singletons in vertex presentation ≥ 36+0 gestational weeks by using 2D and 4D TLUS within 1-4 days postpartum (assessment A1) and again 6-10 weeks postpartum (assessment A2). Cohen's Kappa analysis was performed for each side separately to evaluate the test agreement between the two ultrasound techniques at every assessment period.

The evolution of levator ani muscle trauma over the first 9 months after vaginal birth.

Introduction And Hypothesis: The objective was to investigate the evolution of levator ani muscle (LAM) trauma over the first 9 months after birth and to evaluate their agreement between different assessment periods.

Methods: From March 2017 to April 2019 we prospectively evaluated LAM states (intact, hematoma, partial or complete avulsion) of primiparous women after vaginal birth by using 4D translabial ultrasound (TLUS) at three different assessment periods. All women were examined 1-4 days (A1) and 6-10 weeks (A2) postpartum, and women with a trauma additionally 6-9 months postpartum (A3).

Association between levator ani muscle avulsions and technique of vacuum extraction - a prospective exploratory study.

Aims Of The Study: Trauma of the levator ani muscle in the form of partial or complete avulsions is common after vaginal births, especially after vaginal-operative births. As there is little information available regarding associations between the technique of vaginal-operative births and levator ani muscle trauma, we aimed to evaluate the association between the process of vacuum extraction and the occurrence of levator ani muscle trauma.

Methods: As part of a prospective cohort study at the University Hospital of Zurich between March 2017 and April 2019, we sub-analysed vacuum extractions in nulliparous women with singletons in vertex presentation ≥36+0 gestational weeks.

[Placental Locations in Subsequent Pregnancies - A Retrospective Study].

Introduction: Different locations of the placenta are associated with specific risks during pregnancy and labor. Knowledge of the placental location helps to provide better care for the expectant mother and her unborn child. Whereas multiple studies show a higher risk for a recurrent placenta previa, hardly any such data is available for any other placental location.

Association between the side of levator Ani muscle trauma and fetal position at birth - a prospective observational study.

Introduction: Trauma of the levator ani muscle (LAM) is common after vaginal birth and can most reliably be diagnosed by 3-dimensional (3D) translabial ultrasound (TLUS). Multiple risk factors are known in general, but not in association to a specific side of the body. Therefore, our aim was to evaluate different impact factors which cause LAM trauma on either side of the body or bilateral by focusing on the fetal position at birth.

Birth tears after spontaneous and vacuum-assisted births with different vacuum cup systems - a retrospective cohort study.

Objectives Birth tears are a common complication of vaginal childbirth. We aimed to evaluate the outcomes of birth tears first by comparing the mode of vaginal birth (VB) and then comparing different vacuum cups in instrumental VBs in order to better advise childbearing women and obstetrical professionals. Methods In a retrospective cohort study, we analyzed nulliparous and multiparous women with a singleton pregnancy in vertex presentation at ≥37 + 0 gestational weeks who gave birth vaginally at our tertiary care center between 06/2012 and 12/2016.

Prediction of levator ani muscle avulsion by genital tears after vaginal birth-a prospective observational cohort study.

Introduction: Visible birth tears and levator ani muscle (LAM) trauma are common after birth. For the diagnosis of LAM trauma ultrasound evaluation is advisable. As ultrasound equipment and trained personnel are not available everywhere at all times, we aimed to evaluate whether specific overt birth tears are an indicator for LAM trauma.

Birth Lacerations in Different Genital Compartments and their Effect on Maternal Subjective Outcome: A Prospective Observational Study.

Introduction: Lacerations are common in vaginal births, but little is known about tears other than perineal tears and their association with maternal impairment. This study aimed to evaluate the frequency and distribution of birth lacerations and their association with maternal discomfort.

Methods: From 2/2015 to 12/2016, we conducted a prospective observational study on 140 women with singletons in vertex presentation at term, who gave birth vaginally in our center and were affected by a laceration.

Maternal and neonatal outcome of reverse breech extraction of an impacted fetal head during caesarean section in advanced stage of labour: a retrospective cohort study.

Background: Caesarean section with extraction of a deeply impacted fetal head is technically challenging and is associated with serious maternal and neonatal complications. The purpose of the study was to identify risks and evaluate selected outcome parameters associated with difficult fetal head extraction during caesarean section in advanced labour comparing two different extraction techniques (head pushing vs. reverse breech).

[Association of Birth Trauma with the Implementation of Obstetrical Monitoring Tools: A Retrospective Cohort Study].

Introduction: Lacerations are common in vaginal births. They can result in immense physical and psychological morbidity. Ongoing efforts are being made to reduce birth trauma.

Video analysis for the evaluation of vaginal births: a prospective observational study.

Aims Of The Study: Video documentation is nowadays well established in many fields of medicine, but mostly in unreal situations such as simulation training. We here present the application of video for teaching and learning purposes during the birth process. The aim of video documentation during labour is to provide an observational tool for obstetric care by midwives and obstetricians, with the opportunity for evaluation and education afterwards, especially in absence of the woman in labour and her family.

Impact factors on cervical dilation rates in the first stage of labor.

Aims: To assess cervical dilation rates of nulliparous and multiparous women in the active first stage of labor and to evaluate significant impact factors.

Methods: In a retrospective cohort study between January 2007 and July 2014 at the University Hospital of Zurich in Switzerland, we analyzed 8378 women with singleton pregnancies in vertex presentation with a vaginal delivery at 34+0 to 42+5 gestational weeks. Median cervical dilation rates were calculated and different impact factors evaluated.

[Diastasis Recti Abdominis and Pregnancy].

Diastasis recti abdominis during pregnancy is a frequent phenomenon with a prevalence of 30–70%. It is associated with functional and cosmetic limitations. Gold standard in diagnosis during pregnancy is the transabdominal ultrasonography.

A survey on Swiss women's preferred menstrual/withdrawal bleeding pattern over different phases of reproductive life and with use of hormonal contraception.

Background: Today, options for bleeding-free lifestyle are actively promoted by the media, the pharmaceutical industry and health specialists. With regard to contraceptive counselling it is important to find out what women really want.

Methods: In the present study we collected information on women's attitudes towards monthly bleeding and preferences, if they could have the option to modify their individual bleeding pattern.

Maternal and neonatal outcome of labour induction at term comparing two regimens of misoprostol.

Aim: To compare the efficacy and safety of two misoprostol dosing regimens for induction of labour in primiparous (1P) and multiparous (>1P) women.

Methods: Retrospective study of induction of labour using vaginal misoprostol 25 μg vs. 50 μg every 6 h in 942 women at a tertiary centre.

Deep brain stimulation to reward circuitry alleviates anhedonia in refractory major depression.

Deep brain stimulation (DBS) to different sites allows interfering with dysfunctional network function implicated in major depression. Because a prominent clinical feature of depression is anhedonia--the inability to experience pleasure from previously pleasurable activities--and because there is clear evidence of dysfunctions of the reward system in depression, DBS to the nucleus accumbens might offer a new possibility to target depressive symptomatology in otherwise treatment-resistant depression. Three patients suffering from extremely resistant forms of depression, who did not respond to pharmacotherapy, psychotherapy, and electroconvulsive therapy, were implanted with bilateral DBS electrodes in the nucleus accumbens.