Zusammenfassung Belastende Geburtserfahrungen können mit posttraumatischen Belastungssymptomen, emotionaler Belastung, Vermeidungsverhalten und Einschränkungen des psychosozialen Wohlbefindens einhergehen. Nicht alle betroffenen Frauen erfüllen jedoch die Kriterien einer psychischen Erkrankung. Gleichzeitig können nach einer belastenden Geburt unterschiedliche Unterstützungsbedarfe bestehen: medizinische und geburtshilfliche Information, emotionale und psychosoziale Unterstützung sowie ein fortbestehender Bedarf an strukturierter Auseinandersetzung mit dem konkreten Geburtserlebnis. Der vorliegende Beitrag unterscheidet diese Funktionen und betrachtet ihr Zusammenspiel innerhalb vorhandener Versorgungsstrukturen. Internationale und deutschsprachige Forschung zeigt, dass Information, emotionale Unterstützung, Betreuungserleben und soziale Ressourcen unterschiedliche Dimensionen postpartaler Versorgung darstellen. Strukturierte Interventionen nach belastender Geburt können darüber hinaus ereignisbezogene Elemente enthalten. Für diese spezifische Funktion wird der Begriff „ereignisbezogene emotionale Nachsorge“ verwendet. Sie bezeichnet eine strukturierte und fachlich begleitete Auseinandersetzung mit einem fortbestehend belastenden konkreten peripartalen Erlebnis. Sie ersetzt weder medizinische Klärung noch psychosoziale Unterstützung oder die Behandlung psychischer Erkrankungen und kann diese ergänzen. Ein niedrigschwelliger Zugang zu Gesprächen über das Geburtserleben kann zugleich dazu beitragen, bislang nicht erkannte Belastung sichtbar zu machen. Das AS-Geburtsnachsorgegespräch (AS=Achtsame Selbstverbindung) wird als exemplarisches Verfahren ereignisbezogener emotionaler Nachsorge dargestellt. Seine bisherige Evidenzbasis ist explorativ. Weitere Forschung sollte insbesondere untersuchen, welche Unterstützungsformen bei unterschiedlichen Belastungskonstellationen zu günstigen und nachhaltigen Ergebnissen beitragen.
Aim This study aims to examine the relationship between clinical anxiety and depression and prenatal attachment, pregnancy-related maternal identity, and body image in high-risk pregnancies. Methods This research uses a descriptive correlational design. It was conducted between October 2024 and May 2025 in the high-risk pregnancy unit of a hospital in Central Anatolia and included 311 high-risk pregnant women. Results This study found that the level of prenatal attachment was significantly negatively correlated with the number of pregnancies, gestational week, and anxiety and depression scores ( p <0.05). Maternal perception was found to be negatively correlated with anxiety and depression ( p <0.05). Conversely, body image showed a positive association with age, the duration of marriage, the number of children, anxiety, and depression, suggesting that these factors are associated with more negative body image ( p <0.05). Furthermore, an extended family structure, receiving care at a private clinic, frequent doctor visits, hospitalization due to bleeding, lower gestational age, and elevated levels of depression were identified as significant risk factors for prenatal attachment ( p <0.05). Negative body image was also associated with factors such as higher education, being employed, perceiving a low income, experiencing unplanned pregnancies or miscarriage, irregular prenatal follow-up, choosing private clinics, having preeclampsia or eclampsia, older maternal age, longer marriage duration, and elevated anxiety levels ( p <0.05). Conclusion In conclusion, this study revealed that higher levels of anxiety and depression are associated with lower prenatal attachment and maternal perception, while body image is adversely affected by both psychological and demographic factors. These findings underscore the need for early psychosocial support and a holistic approach to pregnancy care.
Fetomaternal hemorrhage refers to the transfer of fetal erythrocytes into the maternal circulation. Although clinically significant fetomaternal hemorrhage is rare, it can result in severe fetal anemia with substantial morbidity and mortality. Early recognition remains challenging due to a nonspecific clinical presentation. This study aimed to identify maternal and obstetric characteristics associated with fetomaternal hemorrhage that may serve as early clinical warning signs. In this retrospective multicenter descriptive study, singleton pregnancies with a positive Kleihauer-Betke test from five obstetric care centers in Berlin (2009-2026) were analyzed. Clinical and demographic data were evaluated descriptively. A total of 39 cases were included. The mean maternal age was 31.9 years and the mean gestational age at delivery was 37.3 weeks. Pathological cardiotocography was observed in 79% of cases, including 42% with a sinusoidal pattern. Reduced fetal movements were reported in 51% of cases. Elevated middle cerebral artery peak systolic velocity, suggestive of fetal anemia, was documented in 50% of cases with an overall documentation rate of 31%; abdominal trauma was present in 15% of cases. Caesarean section was performed in 82% of cases, including 31% emergency procedures. Intrauterine fetal death occurred in 5% of cases. Reduced fetal movements and abnormal cardiotocography patterns, particularly sinusoidal tracings, represent key clinical warning signs of fetomaternal hemorrhage and should prompt immediate diagnostic evaluation. Given the small sample size, findings are exploratory. Prospective studies are needed to establish validated risk profiles and diagnostic pathways.
Background Preterm and sick neonates are at increased risk for swallowing and feeding problems. In Germany, structural standards for speech-language pathology (SLP) services in neonatal care are lacking, as are validated assessment tools for this context. The aim of this study was to systematically describe feeding problems using clinically feasible instruments. Methods In a prospective observational study, a SLP service was implemented in neonatal units at a German university hospital. Data were analyzed from infants referred due to feeding difficulties. Nutritional status was assessed using the German version of the FOIS-p, and parental perception and burden were evaluated using the newly developed questionnaire S&F 0-6. Results A total of 148 infants with a mean postmenstrual age of 41 weeks (+/- 7.0; 33-68) were included in the analysis, of whom 58.8% were born preterm. The most common diagnosis was weak suck and/or suck-swallow-breathe discoordination (70%), followed by dysphagia (15%) and feeding disorder (6%). The FOIS-p indicated partial oral feeding for the majority of infants. Parents reported the highest burden scores in the domain of concerns about thriving and weight gain. Conclusion Swallowing and feeding difficulties in preterm and sick infants are common in the inpatient setting and require differentiated SLP assessment and intervention. Simple measures such as the FOIS-p could in future provide the basis for a robust data foundation across the inpatient stay.
Viele nationale und internationale Leitlinien sehen keine routinem & auml;ss ige sonografische Beurteilung des fetalen Wachstums im sp & auml;ten dritten Trimenon vor. Eine nicht erkannte sp & auml;te fetale Wachstumsrestriktion erh & ouml;ht allerdings das perinatale Risiko erheblich. Wie h & auml;ufig wird im Rahmen eines zus & auml;tzlichen Ultraschalls eine SGA (Small for Gestational Age)-Situation detektiert? Und wie wirkt sich dies auf die Sectiorate und die neonatale Morbidit & auml;t aus?
