Abstract:
:Introduction Fetal exposition to valproate can lead to a cluster of facial dysmorphism, congenital anomalies and neurodevelopmental retardation. Case Report In this report we describe 2 cases of fetal valproate syndrome. In the first case, the gravida had a valproate medication before and during pregnancy with additional folic acid. She delivered a male premature infant at 25+2 weeks of gestation due to preterm labor and rupture of the membranes. Physical examination showed even in the premature infant typical signs of fetal valproate syndrome with trigonocephaly, epicanthal folds, broad root of the nose, low-set ears, thin upper lip and anteverted nares. In the second case, the gravida was under antiepileptic therapy with valproate and lamotrigine before and during pregnancy without any prophylaxis with folic acid. Sonographic examination during pregnancy diagnosed a spina bifida, Chiari II malformation and clubfeet. A female newborn was delivered at 39+4 weeks of gestation. Besides the prenatally detected anomalies, facial dysmorphism including microcephaly, low-set ears, thin upper lip and shallow philtrum were seen after birth. Conclusion Valproate, a widely used anticonvulsant medication, is known for its teratogenic effects. The risk of congenital anomalies is even higher in combination with other antiepileptic drugs. Therefore, the avoidance of valproate or at least supplementation with a high dose prophylactic folic acid before and during pregnancy is highly recommended for women with epilepsy. :Einleitung Fetale Exposition gegenüber Valproat kann zu einem Symptomkomplex aus fazialen Dysmorphiezeichen, kongenitalen Fehlbildungen und Entwicklungsverzögerung führen. Fallbericht In diesem Artikel beschreiben wir 2 Fälle mit fetalem Valproatsyndrom. Im ersten Fall hat die Schwangere vor und während der Schwangerschaft Valproat in Kombination mit Folsäure eingenommen. Aufgrund vorzeitiger Wehentätigkeit und einer Plazentalösung wurde Ihr Kind als Frühgeborenes von 25+2 Schwangerschaftswochen geboren. Die klinische Untersuchung postnatal zeigte selbst bei dem Extremfrühgeborenen typische Zeichen eines fetalen Valproatsyndroms mit Trigonocephalus, Epikanthus, breitem Nasenrücken, tiefem Ohransatz, schmaler Oberlippe und antevertierten Nasenlöchern. Im zweiten Fall war die Schwangere vor und während der Schwangerschaft unter antiepileptischer Therapie mit Valproat und Lamotrigin ohne Folsäureprophylaxe. Die sonographische Untersuchung während der Schwangerschaft diagnostizierte eine Spina bifida, Chiari II Malformation und Klumpfüße. Mit 39+4 Schwangerschaftswochen wurde ein weibliches Neugeborenes geboren. Neben den bereits pränatal diagnostizierten Anomalien fielen postnatal eine Mikrocepahlie sowie faziale Dysmorphiezeichen wie tiefsitzender Ohransatz, schmales Oberlippenrot und ein flaches Philtrum auf. Schlussfolgerung Valproat, ein vielfach eingesetztes Antikonvulsivum, ist bekannt für seine teratogenen Effekte. Das Risiko kongenitaler Fehlbildungen vergrößert sich in Kombination mit anderen Antiepileptika. Deshalb empfehlen wir eindringlich die Vermeidung von Valproat bei Frauen mit Epilepsie und Kinderwunsch oder zumindest die Einnahme einer hochdosierten Folsäureprophylaxe.
journal_name
Z Geburtshilfe Neonatoljournal_title
Zeitschrift fur Geburtshilfe und Neonatologieauthors
Wiedemann K,Stüber T,Rehn M,Frieauff Edoi
10.1055/s-0043-107619subject
Has Abstractpub_date
2017-10-01 00:00:00pages
243-246issue
5eissn
0948-2393issn
1439-1651journal_volume
221pub_type
杂志文章abstract:BACKGROUND:Specific DNA probes allow rapid prenatal diagnosis of numerical chromosome disorders (chromosomes 13, 18, 21, X, Y) by FISH on interphase nuclei. The diagnostic reliability is presently under evaluation. STUDY GROUP:In a period of 1.5 years a total 1126 amniotic fluid samples was investigated by FISH compar...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章,评审
doi:10.1055/s-2000-10189
更新日期:2000-01-01 00:00:00
abstract::Fetal heart rate pathology is seen in up to 40% of complications of the umbilical cord. We report a case in which long lasting bradycardia was associated with fetal grasping of the umbilical cord. Using colour doppler, the reason for the bradycardia could be detected. After vibro-acoustic stimulation the fetus release...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract:PURPOSE:Aim of the investigation is to assess the anxiety in pregnant women with prior miscarriage and without prior miscarriage before and after prenatal testing for congenital anomalies. MATERIAL AND METHODS:Are sampling is carried of 50 pregnant women with prior miscarriage and 224 pregnant women without prior misc...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-0035-1554684
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:In 25 % of patients who develope gestosis a Hemolysis- Elevated- Liver-enzymes-and- Low- Platelet-count-Syndrome (HELLP-Syndrome) may occur, which is characterized by activation of the coagulation mechanism and bone marrow alterations. Besides this therapeutical steroid application and an elevated age of pri...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-2003-45172
更新日期:2003-11-01 00:00:00
abstract::An 28 years old women came on his 7. post partum day with an lower abdominal pain on the right hand side with the diagnosis of an unilateral rotating ovarian tumor. After computed tomography, ultrasound and laparoscopy the adnectomia dextra by laparotomy was performed. In the histology we find an ovarian vein thrombos...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:Meconium aspiration syndrome is a disease in near term infants which requires invasive techniques to decrease mortality. Lavage of the tracheobronchial tree with exogenous surfactant has been shown to be effective in animal studies. We studied the effectiveness of this technique in newborn infants and compar...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-2002-20945
更新日期:2002-01-01 00:00:00
abstract::Frühgeburtenrate in 6 Perinatalzentren in Baden-Württemberg – Potential zur Reduktion der Frühgeborenenzahl Sehr geehrte Damen und Herren,mit großem Interesse haben wir die Arbeit von Trotter et al. 1 gelesen und teilen die Auffassung, dass eine Vermeidung von Frühgeburten und eine Reduzierung der Frühgeburtenrate unb...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/a-0950-6770
更新日期:2019-08-01 00:00:00
abstract::Several prospective clinical trials have indicated an association between maternal periodontal status and adverse pregnancy outcome, e.g., low birth weight, pre-term birth and pre-eclampsia. However, the translation of these findings into clinical care and decision making is still a matter of debate. Gynecologists and...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1385859
更新日期:2014-12-01 00:00:00
abstract::Angiogenic factors like placental growth factor (PlGF) and its anti-angiogenic antagonists soluble fms-like tyrosine kinase 1 (sFlt1) and soluble endoglin (sEng) are closely related to the pathogenesis of preeclampsia and intrauterine growth restriction (IUGR). The discovery and investigation of these angiogenic facto...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章,评审
doi:10.1055/s-0029-1224142
更新日期:2009-06-01 00:00:00
abstract::Congenital diaphragmatic hernia is a malformation presenting with varying degrees of severity. An accurate prediction of outcome is crucial for parental counselling and therapeutic planning. In selected cases, foetal endoscopic tracheal occlusion (FETO) can improve foetal outcome. Timely referral to a highly specialis...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1367041
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:During pregnancy about 30 grams of calcium are transferred to a full-term neonate. The enormous demand for calcium can be regulated by compensatory mechanisms in the maternal metabolism such as elevated steroid hormone levels, increased intestinal absorption of dietary calcium, and renal conservation, but als...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-2006-951742
更新日期:2006-10-01 00:00:00
abstract::The delivery of a 23 para I who was born herself with a sacrococcygeal teratoma of the type II is reported. After the extirpation of the tumor and of the coccyx an anomaly of the pelvis is found in the sense of a pygopagic pelvis (stretching and bending of the sacrum towards the dorsum). This anomaly and the scars in ...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:
更新日期:1997-07-01 00:00:00
abstract::Careful analysis of current adjudication reveals increasing demand of adequate record-keeping as well as meticulously documented informed consent forms regarding all aspects of medicine. Although standardized informed consent forms or explicit guidelines for obtaining procedural consent already exist in surgical disci...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1398520
更新日期:2015-06-01 00:00:00
abstract::We report the case of a 24-year-old Gravida II/Para I who was diagnosed with Hodgkin's disease (stage 2A) at week 28 of pregnancy. Due to clinical progression, a dose-reduced adriamycin, bleomycin, vincristin, dacarbazine chemotherapy was started at week 32. After unsuccessful induction of labor at week 35, secondary ...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-2003-39153
更新日期:2003-03-01 00:00:00
abstract::The authors made an analysis of perinatal mortality on 680 cases of premature births recorded between 1982 and 1992 in the CHU maternity, Yaoundé (Cameroon). During this period, 13,555 births were recorded. The frequency of premature births stood at 5%. The most important etiological factors responsible for these 680 ...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract::Supine sleeping is recommended to prevent the sudden infant death syndrome (SIDS). Low birth weight infants are at increased risk for SIDS, which is increased further if they are placed prone. Prone sleeping, however, also has advantages for preterm infants, such as a reduced apnoea rate, an increased lung volume and ...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1004610
更新日期:2008-02-01 00:00:00
abstract::Because the coincidence of hyperthyroidism and pregnancy is rare, there is come uncertainty in the management of these patients. In order to avoid complications during the course of pregnancy, it is important to know--besides etiology and pathogenesis--the particularities in diagnosis and start of the appropriate ther...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章,评审
doi:
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Sub partu foetal heart-rate (FHR) patterns are difficult to evaluate. Until now we have no numerical criteria to reliably define what is a non-reassuring or even a 'pathological' FHR tracing. Computer-aided FHR analysis using the new WAS score offers the unique opportunity to assess numerical boundaries for ...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-0030-1261962
更新日期:2010-08-01 00:00:00
abstract::The cesarean section rate and the associated complications are still rising in Germany. An important indication is term breech in singletons. Not significant data concerning a higher morbidity or mortality in vaginal breech birth indicate the cesarean but a deficit in education and experience. ...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-0032-1309052
更新日期:2012-08-01 00:00:00
abstract:PATIENT REPORTS:We report on a male preterm infant (gestational age 31 weeks, birth weight 1420 g) and a male term infant (gestational age 38 weeks, birth weight 3680 g) with ornithine transcarbamylase (OTC) deficiency. After inconspicuous cardiopulmonary adjustment, both entered a state of metabolic crisis with respir...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-2001-19056
更新日期:2001-11-01 00:00:00
abstract:INTRODUCTION:Computer analysing software is required for the assessment of CTGs because of the low sensitivity and high intra- and interobserver variability. The German Society of Gynaecology and Obstetrics advises the use of computer analysing CTG software. This study is aimed at evaluating the use of a new foetal ECG...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-0028-1098718
更新日期:2008-12-01 00:00:00
abstract:PURPOSE:The aim of this study was to determine the quality of intrapartum uterine activity (UA) monitoring in daily practice during the first and second stages of labour. The total duration of inadequate UA monitoring is quantified in relation to the technique applied, namely, external tocodynamometry (TOCO) or electro...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0031-1291210
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND AND AIM:We have previously analysed neonatal characteristics and duration of pregnancy in Germany based on data from the German Perinatal Survey of 1995-1997. Here we describe neonatal characteristics and duration of pregnancy based on the German Perinatal Survey of 2007-2011. MATERIAL AND METHODS:We had be...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-0033-1361096
更新日期:2013-12-01 00:00:00
abstract::A fetal heart-rate pattern that has a reduced oscillation amplitude may indicate a physiological fetal dormant period but could also be an indication of fetal hypoxemia. In some rare cases such a fetal heart rate-pattern can be an indicator of cerebral or cardial fetal malformation or of an intoxication caused by seda...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-2003-40974
更新日期:2003-05-01 00:00:00
abstract::Objective: Review of anonymous data of all stillbirths in all 19 obstetrical departments in Berlin from 2013-2014 with the goal to develop strategies for prevention of stillbirths (≥500 g birth weight). Results: There were a total of 401 stillbirths,178 after fetocide or pregnancy termination and 223 were spontaneous ...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0042-118094
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Triploidy describes the presence of threefold haploid chromosome set and is a frequent cause of early abortion. Only few pregnancies reach the second trimester. CASE REPORT:Prenatal diagnosis of a fetus in the 28th week of gestation with a hypotriploidy and with characteristic ultrasonographic features is p...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-2001-15769
更新日期:2001-05-01 00:00:00
abstract::A few years ago recombinant human erythropoietin (rh-EPO) has been introduced for the prophylaxis of anaemia of prematurity. Aim of this controlled study was a cost-effectiveness analysis of the prophylaxis with rh-EPO versus sole transfusion with packed red blood cells. In the study group 33 infants (gestational age ...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 临床试验,杂志文章
doi:
更新日期:1999-12-01 00:00:00
abstract::In severe neonatal hyperammonemia, therapy must be started immediately to prevent irreversible CNS damage. Endogenous ammonia production can be quickly reduced if an anabolic condition is induced by means of high-dose glucose infusion. We applied this treatment to four newborn infants with hyperammonemia, this being a...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:
更新日期:1995-11-01 00:00:00
abstract::An inverted uterus is defined as the eversion of the uterus into the vagina. It is a very rare event but has to be treated as an emergency. A woman with an inverted uterus is in serious danger of developing atony with high blood loss in a short time. This can lead to hypovolemic shock and circulatory failure. Therapy ...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/a-0828-8696
更新日期:2020-02-01 00:00:00
abstract::The lethal Meckel-Gruber-Syndrome can be diagnosed prenatally during ultrasound screening between 16 and 20 weeks of pregnancy. Two case reports of Meckel-Gruber-Syndrome are given, which demonstrate the importance of a reliable ultrasound examination. The results supply the basis for an adequate counseling of the pat...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:
更新日期:1996-03-01 00:00:00