[Case Report on Treatment of Metastatic Breast Cancer with Trastuzumab during Pregnancy].

The increasing number of pregnant breast cancer patients calls for a therapy that is as efficient as possible. After 10 years of collecting data on pregnant breast cancer patients in the German Breast Group (GBG), proposals for diagnostic measures and therapy regarding this special situation have been developed on the basis of 500 observed cases. Chemotherapy is regarded as safe from the 14(th) week of gestation on, but it is strongly advised not to use trastuzumab.

Cytokines in noninvasively obtained amniotic fluid as predictors of fetal inflammatory response syndrome.

Background: In patients with preterm premature rupture of membranes, intrauterine inflammation and/or infection is frequently present, can lead to fetal inflammatory response syndrome, and is associated with adverse neonatal outcome. Clinical decision making requires balancing the potential benefits of pregnancy prolongation against the risk of intrauterine infection. Diagnostic tests in maternal serum are of moderate prediction value and amniocentesis is an invasive procedure.

[Pneumomediastinum related to the second stage of labour - a report on 2 cases].

We report on 2 primigravidae developing pneumomediastinum and subcutaneous emphysema associated with the second stage of labor. Both of the newborns had a comparatively high birth-weight (3,855 g and 4,245 g, respectively). In the first case, the patient felt a sudden chest pain during expulsion followed by dyspnea and swelling of the face.

German national consensus recommendations on nutrition and lifestyle in pregnancy by the 'Healthy Start - Young Family Network'.

Diet and physical activity before and during pregnancy affect short- and long-term health of mother and child. The energy needs at the end of pregnancy increase only by about 10% compared to nonpregnant women. An excessive energy intake is undesirable since maternal overweight and excessive weight gain can increase the risks for a high birth weight and later child overweight and diabetes.

[Nutrition in pregnancy - Practice recommendations of the Network "Healthy Start - Young Family Network"].

Nutrition, physical activity and lifestyle in pregnancy influence maternal and child health. The "Healthy start - Young Family Network" supported by the German Government with the national action plan IN FORM developed recommendations on nutrition in pregnancy. Folic acid supplements (400 µg/day) should be started before pregnancy and continue for at least the first trimester.

[Nutrition in pregnancy - Practice recommendations of the Network "Healthy Start - Young Family Network"].

Nutrition, physical activity and lifestyle in pregnancy influence maternal and child health. The "Healthy start - Young Family Network" supported by the German Government with the national action plan IN FORM developed recommendations on nutrition in pregnancy. Energy needs increase by only ≈10 % by the end of pregnancy whereas micronutrient needs increase much more.

Factors Associated with the Duration of Breastfeeding in the Freiburg Birth Collective, Germany (FreiStill).

The health benefits of breastfeeding for both infants and mothers are well-documented. The aim of this study was to clarify factors associated with successful breastfeeding. We performed a prospective, multi-centre cohort study of 443 mothers in person using a standardised questionnaire on postpartum day 1.

[Fractures in neonates as a result of birth trauma caused by caesarean section].

Background: The occurrence of 4 bone fractures associated with birth by Caesarean section (CS) prompted us to examine the incidence and predisposing factors of bone injuries sustained during birth.

Case Report And Method: The 4 cases with fractures were evaluated retrospectively and discussed in combination with a short review of the literature.

Conclusions: With the increasing number of Caesarean sections the incidence of birth trauma has decreased.

Life-threatening complications of transient abnormal myelopoiesis in neonates with Down syndrome.

Unlabelled: Neonates with Down syndrome can present with a haematological disorder called transient abnormal myelopoiesis (TAM). While TAM is usually a self-limiting disease, patients with severe complications such as hydrops fetalis, cardiorespiratory failure and liver fibrosis have been described. Here, we present five consecutive neonates with trisomy 21 and TAM, four of whom were critically ill and were therefore treated with cytosine-arabinoside.

Veno-occlusive disease in a fetus caused by pyrrolizidine alkaloids of food origin.

We report the occurrence of veno-occlusive disease in a preterm neonate who was symptomatic with hepatomegaly and ascites and was delivered by caesarean section for threatening fetal asphyxia and died shortly afterwards. Post mortem examination revealed veno-occlusive disease typical for pyrrolizidine alkaloid poisoning. The content of pyrrolizidine alkaloids in the liver could be confirmed.

[Fetomaternal transfusions in complicated and uncomplicated pregnancy].

Fetomaternal bleeding in pregnancy is the most common cause of rhesus immunization. In this study we evaluated the amount of fetomaternal bleeding during pregnancies with and without complications. The data from 1204 patients are analyzed.

[Fetomaternal transfusions in early pregnancy].

Fetomaternal bleeding is the major cause for rhesus immunization in pregnancy. This study evaluates the amount of fetomaternal bleeding in 345 pregnancies before 28th week of gestation. Fetomaternal bleeding was of clinical relevance (HbF greater than 0.

[Fetomaternal transfusion in relation to mode of delivery. Comparison of data from the DFG multicenter study "Rhesus negative" (1965-70) with data from the Freiburg University Gynecologic Clinic (1989)].

Fetomaternal hemorrhage with transfusion of more than 10-25 ml fetal blood into the maternal circulation ("macrotransfusion") is one possible cause of the failure of combined pre- and postpartal anti-D prophylaxis. We analyzed the data from 391 patients who delivered at the UFK Freiburg in 1989. We evaluated the amount of fetomaternal bleeding in different modes of delivery.

[Prognosis of pregnancy in diabetes mellitus].

From 1970-1984 116 pregnant diabetic patients were monitored and delivered at the University Hospital of Freiburg, Department of Obstetrics and Gynecology. During these 15 years, a decrease in maternal and fetal complications was observed. Today the risk of some complications in diabetic pregnancy is not greater than that of pregnancy in nondiabetic women.

[Rhesus erythroblastosis, monitoring and treatment].

From 1975-1984 92 pregnancies with suspicion of a morbus hemolyticus fetalis were monitored at the University Hospital of Freiburg, Department of Obstetrics and Gynecology. Most of the patients had antibodies against the rhesusfactor D. Amniocentesis was carried out regularly; the bilirubin level and protein content of the amniotic fluid were measured using chemical methods and the bilirubin/protein ratio was determined.

[The mean blood pressure in the second trimester (map-2) as a valuable aid in the early recognition of the pregnancies with a risk of hypertension (author's transl)].

The mean blood pressure in the second trimester of pregnancy was calculated with a formula (Formula: see text) which stands for systolic pressure plus twice diastolic pressure divided by 3 equals mmHg. In 285 patients 43% had a MPA-2 value of 85 mmHg. or higher.