Publications by authors named "Ralf Schmitz"

Objectives: The aim of this study was to compare the adrenal gland size of fetuses with congenital heart diseases (CHD) and normal fetuses.

Methods: In this cross-sectional prospective study we measured the fetal adrenal gland size (total width, cortex width, medulla width, adrenal gland ratio of total width divided by medulla width) in 62 fetuses with CHD and 62 gestational-age-matched controls between 20 + 0 and 39 + 3 weeks of gestation. First, we clustered three CHD subgroups: CHD group_1 with a normal outflow tract (n=7), CHD group_2 with an altered outflow tract and anterograde flow in the ascending aorta (n=39) and CHD group_3 with an altered outflow tract and retrograde flow in the ascending aorta (n=16).

View Article and Find Full Text PDF

Objectives: This study aimed to investigate dyssynchronous heart failure in fetuses of mothers with diabetes mellitus (FDM) and fetal controls (FC) using two-dimensional speckle tracking echocardiography (2D-STE) and novel M-mode prototype software (PS).

Methods: In this cohort study 174 fetuses were analyzed, 87 in the FDM-cohort and 87 gestational age-matched fetuses in the FC-cohort. A subgroup of 38 fetuses formed the final case group, with a high median frame rate of approximately 160 frames/s.

View Article and Find Full Text PDF

The introduction of hybrid diagnosis-related groups (DRG) presents new challenges for healthcare providers and health insurances. The same applied in 2023 to the institute designated by the Federal Ministry of Health (BMG) to extract medical procedures and calculate remuneration levels for the first hybrid DRGs. A responsible calculation methodology and a realistic data basis are required as the result of the calculation can lead to controversy, even to a splitting among specialist groups and constructs.

View Article and Find Full Text PDF

Objective: Prediction of fetal growth restriction (FGR) and small of gestational age (SGA) infants by using various ultrasound cardiac parameters in a logistic regression model.

Methods: In this retrospective study we obtained standardized ultrasound images of 357 fetuses between the 20th and 39th week of gestation, 99 of these fetuses were between the 3rd and 10th growth percentile, 61 smaller than 3rd percentile and 197- appropriate for gestational age over the 10th percentile (control group). Several cardiac parameters were studied.

View Article and Find Full Text PDF

Introduction: HELLP syndrome is a serious disorder that can occur in pregnancy; it has many possible complications and is associated with adverse maternal outcome. Due to the lack of predictive parameters for HELLP syndrome, finding the right time for delivery is challenging. In contrast to preeclampsia, hypertension is not an essential part of the diagnosis; nevertheless, many women with HELLP syndrome are hypertensive.

View Article and Find Full Text PDF

Cases of hydatidiform moles with a coexisting fetus are sparse and patients are at high risk for severe complications. Patients and physicians often face the dilemma of the wish to continue pregnancy until viability of the fetus while the risk for maternal complications increases. We present an educational case of a twin pregnancy presenting with a hydatidiform mole and coexisting normal fetus with a placenta praevia.

View Article and Find Full Text PDF

Purpose: The aim of the study was to assess fetal ears on prenatal 3D ultrasound and compare ear surface patterns and measurements between fetuses with syndromes and healthy fetuses.

Materials And Methods: Our study is based on 3D ultrasound images of 100 fetuses between the 20th and 37th week of gestation. We compared 50 ears of fetuses with syndromes (syndrome group) to 50 gestational age-matched ears of healthy fetuses (control group).

View Article and Find Full Text PDF
Article Synopsis
  • Pregnant women with COVID-19 face higher risks of severe complications, especially those with multiple pregnancies due to physical changes in lung function caused by the growing fetus.
  • A study analyzed outcomes in 5514 women with symptomatic COVID-19 during pregnancy, focusing on the difference between those with multiple pregnancies and those with singletons.
  • Results showed that while the overall incidence of adverse outcomes was similar, multiple pregnancies had earlier onset of complications and certain factors like high preconceptional BMI significantly increased risks.
View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to assess the relationship between thymus size during the second trimester and low birth weight in fetuses, comparing those who were small for gestational age (SGA) to normal weight fetuses.
  • Researchers measured the fetal thymic-thoracic ratio (TT-ratio) using echocardiograms from a sample of 105 SGA and 533 control fetuses and analyzed the statistical significance of the results.
  • The findings indicated that a higher TT-ratio in SGA fetuses correlated with increased odds of low birth weight, suggesting that this measure could be a useful tool for prenatal screening, although further prospective studies are needed for validation.
View Article and Find Full Text PDF
Article Synopsis
  • * A systematic search identified three suitable CTG guidelines and two best practice guidelines for methods, which were evaluated with a structured consensus approach involving professional societies.
  • * The conclusion indicates that neither antepartum Doppler sonography nor CTG should be performed in low-risk cohorts during antenatal care, and the findings will be published in official professional journals.
View Article and Find Full Text PDF

Purpose:  The aim of this guideline was to find evidence on whether carrying out Doppler examinations and CTGs in low-risk cohorts of pregnant women improves outcomes.

Methods:  First, a systematic search for guidelines was carried out. Identified guidelines were evaluated using the DELPHI instrument of the AWMF.

View Article and Find Full Text PDF

Modern humans have populated Europe for more than 45,000 years. Our knowledge of the genetic relatedness and structure of ancient hunter-gatherers is however limited, owing to the scarceness and poor molecular preservation of human remains from that period. Here we analyse 356 ancient hunter-gatherer genomes, including new genomic data for 116 individuals from 14 countries in western and central Eurasia, spanning between 35,000 and 5,000 years ago.

View Article and Find Full Text PDF

Introduction: Periodontal disease affects many pregnant women and may be associated with adverse pregnancy outcomes. The object of this study was to evaluate women's level of knowledge about this condition in pregnancy. We compared level of knowledge, participation in medical screening, and periodontal health status in pregnant women and nonpregnant controls.

View Article and Find Full Text PDF
Article Synopsis
  • The study analyzed 158 women with preeclampsia, focusing on the impact of maternal blood pressure and delivery mode on neonatal outcomes.
  • Higher maternal blood pressure was linked to earlier delivery and increased likelihood of caesarean sections, while lower blood pressure was associated with more induced labors.
  • Results suggested that vaginal delivery produced better neonatal outcomes compared to planned caesarean sections, prompting a call for further research on induced labor in preeclamptic pregnancies.
View Article and Find Full Text PDF

Objectives: This study was designed to establish new reference charts for BPD (biparietal diameter), OFD (occipitofrontal diameter), HC (head circumference), CM (cisterna magna), TCD (transverse cerebellar diameter), PCV (posterior cerebral ventricle), AC (abdominal circumference), FL (femur length), and HL (humerus length) and extend known charts to 42 weeks of gestation. These new charts were compared to studies carried out by Snijders and Nicolaides, the INTERGROWTH 21st Project, and the WHO Fetal Growth Charts.

Methods: In this retrospective cross-sectional single-center study of 12,972 low-risk pregnancies, biometric data between the 15th and 42nd weeks of gestation were evaluated.

View Article and Find Full Text PDF

Purpose: Congenital limb defects are common malformations that are often associated with other organ defects and genetic disorders. Since prenatal detection is challenging and classification is often complex, the aim of this study was to describe a large cohort of fetuses with congenital limb defects and to identify characteristics that are essential for prenatal evaluation, counselling, and management.

Materials And Methods: In this retrospective cohort study, all cases of confirmed fetal limb defects from two centers for prenatal ultrasound between 2001 and 2021 were evaluated.

View Article and Find Full Text PDF

Objectives: The aim of this study was to assess the value of cervical strain elastography and Cervical Sliding Sign (CSS) for predicting spontaneous preterm birth (sPTB).

Methods: In our case-control study we performed an elastographic assessment of the cervix in 82 cases of preterm birth (preterm group) and 451 control pregnancies (control group) between the 20th and 37th week of gestation. We divided the anterior cervical lip first into two ("Intern2", "Extern2") and into three sectors ("Intern3", "Middle3", "Extern3").

View Article and Find Full Text PDF

Objectives: In fetal growth restriction (FGR), Doppler ultrasound is the most important method for the detection and management. However, additional parameters are needed to improve the distinction between constitutionally small fetuses and fetuses affected by FGR.

Methods: A total of 445 singleton pregnancies between 23 and 40 weeks of gestation were included in our retrospective study, of which 67 with FGR and 378 normal fetuses.

View Article and Find Full Text PDF

The aim of this study was to identify growth-restricted fetuses using biometric parameters and to assess the validity and clinical value of individual ultrasound parameters and ratios, such as transcerebellar diameter/abdominal circumference (TCD/AC), head circumference/abdominal circumference (HC/AC), and femur length/abdominal circumference (FL/AC). In a retrospective single-center cross-sectional study, the biometric data of 9292 pregnancies between the 15th and 42nd weeks of gestation were acquired. Statistical analysis included descriptive data, quantile regression estimating the 10th and 90th percentiles, and multivariable analysis.

View Article and Find Full Text PDF

Objectives: To compare two prostaglandin analogs and two application intervals between mifepristone and the prostaglandin analog administration on the time to abortion in second trimester termination of pregnancy. Other endpoints were live birth rate and fetal lifetime after expulsion.

Methods: Retrospective data of 373 abortions performed were evaluated.

View Article and Find Full Text PDF

Patients with high blood pressure levels are at high risk for acute complications as well as serious long-term consequences. Women with preeclampsia often experience very high blood pressure levels during pregnancy and postpartum and are also known to have a higher cardiovascular risk in later life. In our single-centre retrospective cohort study, we analysed 158 pregnancies complicated by preeclampsia in regard to maternal outcome.

View Article and Find Full Text PDF

Maternally derived antibodies are a key element of neonatal immunity. So far, limited data has shown transplacental transmission of antibodies after coronavirus disease 2019 (COVID-19) vaccination with BNT162b2 in the third trimester. Our aim was to detect vertically transferred immunity after COVID-19 vaccination with BNT162b2 (Comirnaty, BioNTech-Pfizer) or mRNA-1273 (Spikevax, Moderna) in the first, second or third trimester of pregnancy, and investigate the impact of maternal characteristics on umbilical cord antibody titre in newborns after delivery.

View Article and Find Full Text PDF