Diagnostik und Management postpartaler Blutungskomplikationen (PPH)

Dr. med. Stephanie Hecht, Dr. rer. nat. Sabine Heublein, Dr. med. Michael Kaspar, PD Dr. med. Uwe Hasbargen


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  12. Milman N (2011), Postpartum anemia I: definition, prevalence, causes, and consequences. Ann Hematol, 90(11):1247-1253.
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  19. Briley A, Seed P, Tydeman G, Ballard H, Waterstone M, Sandall J, Poston L, Tribe R, Bewley S (2014), Reporting errors, incidence and risk factors for postpartum haemorrhage and progression to severe PPH: a prospective observational study. BJOG.
  20. Bateman B, Hernandez-Diaz S, Huybrechts K, Palmsten K, Mogun H, Ecker J, Seely E, Fischer M (2013), Outpatient calcium-channel blockers and the risk of postpartum haemorrhage: a cohort study. BJOG.
  21. Ford JB, Roberts CL, Bell JC, Algert CS, Morris JM (2007), Postpartum haemorrhage occurrence and recurrence: a population-based study. Med J Aust, 187(7):391-393.
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  31. Rath W (2009), Prevention of postpartum haemorrhage with the oxytocin analogue carbetocin. Eur J Obstet Gynecol Reprod Biol, 147(1):15-20.
  32. Hofmeyr GJ, Gulmezoglu AM, Novikova N, Lawrie TA (2013), Postpartum misoprostol for preventing maternal mortality and morbidity. Cochrane Database Syst Rev, 7:CD008982.
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  35. Ghirardini G, Alboni C, Mabrouk M (2012), Use of balloon tamponade in management of severe vaginal postpartum hemorrhage and vaginal hematoma: a case series. Gynecol Obstet Invest, 74(4):320-323.
  36. Dabelea V, Schultze PM, McDuffie RS, Jr. (2007), Intrauterine balloon tamponade in the management of postpartum hemorrhage. Am J Perinatol, 24(6):359-364.
  37. Doumouchtsis SK, Papageorghiou AT, Vernier C, Arulkumaran S (2008), Management of postpartum hemorrhage by uterine balloon tamponade: prospective evaluation of effectiveness. Acta Obstet Gynecol Scand, 87(8):849-855.
  38. Doumouchtsis SK, Papageorghiou AT, Arulkumaran S (2007), Systematic review of conservative management of postpartum hemorrhage: what to do when medical treatment fails. Obstet Gynecol Surv, 62(8):540-547.
  39. Sziller I, Hupuczi P, Papp Z (2007), Hypogastric artery ligation for severe hemorrhage in obstetric patients. Journal of Perinatal Medicine, 35(3):187-192.
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  41. Hayman RG, Arulkumaran S, Steer PJ (2002), Uterine compression sutures: surgical management of postpartum hemorrhage. Obstetrics and Gynecology, 99(3):502-506.
  42. El-Refaeey AA, Gibreel A, Fawzy M (2014), Novel modification of B-Lynch uterine compression sutures for management of atonic postpartum hemorrhage: VV uterine compression sutures. J Obstet Gynaecol Res, 40(2):387-391.
  43. Mostfa AA, Zaitoun MM (2012), Safety pin suture for management of atonic postpartum hemorrhage. ISRN Obstet Gynecol, 2012:405795.
  44. Kayem G, Kurinczuk JJ, Alfirevic Z, Spark P, Brocklehurst P, Knight M (2011), Uterine compression sutures for the management of severe postpartum hemorrhage. Obstetrics and Gynecology, 117(1):14-20.
  45. B-Lynch C, Coker A, Lawal AH, Abu J, Cowen MJ (1997), The B-Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported. Br J Obstet Gynaecol, 104(3):372-375.
  46. Ibrahim MI, Raafat TA, Ellaithy MI, Aly RT (2013), Risk of postpartum uterine synechiae following uterine compression suturing during postpartum haemorrhage. Aust N Z J Obstet Gynaecol, 53(1):37-45.
  47. Amorim-Costa C, Mota R, Rebelo C, Silva PT (2011), Uterine compression sutures for postpartum hemorrhage: is routine postoperative cavity evaluation needed? Acta Obstet Gynecol Scand, 90(7):701-706.
  48. Magann EF, Evans S, Chauhan SP, Lanneau G, Fisk AD, Morrison JC (2005), The length of the third stage of labor and the risk of postpartum hemorrhage. Obstetrics and Gynecology, 105(2):290-293.
  49. Wu S, Kocherginsky M, Hibbard JU (2005), Abnormal placentation: twenty-year analysis. American Journal of Obstetrics and Gynecology, 192(5):1458-1461.
  50. Mörtl MG, Fries D, Schlembach D (2012), Die postpartale Blutung. Der Gynäkologe, 45(3):178-183.
  51. Müller M (2012), Postpartale Hämorrhagie. Frauenarzt, 53(10).
  52. Pritchard JA (1959), Fetal death in utero. Obstetrics and Gynecology, 14:573-580.
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  54. Interdisziplinäre «D-A-CH»-Konsensusgruppe PPH (Deutschland – Österreich – Schweiz) (2013), Management der postpartalen Blutung - Der «D-A-CH»-Algorithmus. Schweiz Med Forum, 13(50):1033–1038.
  55. Franchini M, Lippi G, Franchi M (2007), The use of recombinant activated factor VII in obstetric and gynaecological haemorrhage. BJOG, 114(1):8-15.
  56. De Loor JA, van Dam PA (1996), Foley catheters for uncontrollable obstetric or gynecologic hemorrhage. Obstetrics and Gynecology, 88(4 Pt 2):737.
  57. Chan C, Razvi K, Tham KF, Arulkumaran S (1997), The use of a Sengstaken-Blakemore tube to control post-partum hemorrhage. Int J Gynaecol Obstet, 58(2):251-252.
  58. Johanson R, Kumar M, Obhrai M, Young P (2001), Management of massive postpartum haemorrhage: use of a hydrostatic balloon catheter to avoid laparotomy. BJOG, 108(4):420-422.
  59. Bakri YN, Amri A, Abdul Jabbar F (2001), Tamponade-balloon for obstetrical bleeding. Int J Gynaecol Obstet, 74(2):139-142.
  60. Akhter S, Begum MR, Kabir Z, Rashid M, Laila TR, Zabeen F (2003), Use of a condom to control massive postpartum hemorrhage. MedGenMed, 5(3):38.

Neue gesetzliche Regelungen der PID - Hintergründe, Umsetzung und Auswirkungen

PD Dr. med Tina Buchholz

  1. Mastenbroek S et al. N Engl J Med 2007; 357: 9–17.
  2. BGH Urteil - juris.bundesgerichtshof.de/cgi-bin/rechtsprechung/document.py
  3. PräimpG - www.gesetze-im-internet.de/eschg/__3a.html
  4. RVO - www.bmg.bund.de/fileadmin/dateien/Downloads/P/PID/PIDVE_121114.pdf
  5. ESchG - www.gesetze-im-internet.de/eschg/
  6. Frommel M et al. J Reproduktionsmed Endokrinol 2013; 10 (1)

Moderne Therapieoptionen beim Ovarialkarzinom

Sven Mahner, Fabian Trillsch, Philipp Harter, Felix Hilpert, Jacobus Pfisterer, Andreas du Bois, Uwe Wagner

  1. du Bois, A. et al. Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: by the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and the Groupe d'Investigateurs Nationaux Pour les Etudes des Cancers de l'Ovaire (GINECO). Cancer 115, 1234-1244, doi:10.1002/cncr.24149 (2009).
  2. S3-Leitlinie Diagnostik, Therapie und Nachsorge maligner Ovarialtumoren. AWMF-Register-Nummer (032-035OL). Langversion 1.0. (Dezember 2012).
  3. Harter, P. et al. Prognostic factors for complete debulking in first- and second-line ovarian cancer. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society 19 Suppl 2, S14-17, doi:10.1111/IGC.0b013e3181bffb3f (2009).
  4. Vergote, I. et al. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. The New England journal of medicine 363, 943-953, doi:10.1056/NEJMoa0908806 (2010).
  5. du Bois, A. et al. A randomized clinical trial of cisplatin/paclitaxel versus carboplatin/paclitaxel as first-line treatment of ovarian cancer. Journal of the National Cancer Institute 95, 1320-1329 (2003).
  6. Mahner, S. et al. Prognostic impact of the time interval between surgery and chemotherapy in advanced ovarian cancer: analysis of prospective randomised phase III trials. Eur J Cancer 49, 142-149, doi:10.1016/j.ejca.2012.07.023 (2013).
  7. Ozols, R. F. et al. Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer: a Gynecologic Oncology Group study. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 21, 3194-3200, doi:10.1200/JCO.2003.02.153 (2003).
  8. Katsumata, N. et al. Dose-dense paclitaxel once a week in combination with carboplatin every 3 weeks for advanced ovarian cancer: a phase 3, open-label, randomised controlled trial. Lancet 374, 1331-1338, doi:10.1016/S0140-6736(09)61157-0 (2009).
  9. Pignata, S., Scambia, G., Lauria, R. & Raspagliesi, F. A randomized multicenter phase III study comparing weekly versus every 3 week carboplatin (C) plus paclitaxel (P) in patients with advanced ovarian cancer (AOC): Multicentre Italian Trials in Ovarian Cancer (MITO-7)– European Network of Gynaecological Oncological Trial Groups (ENGOT-ov-10)–Gynecologic Cancer Intergroup (GCIG ) trial. . Journal of Clinical Oncology, 2013 ASCO Annual Meeting Proceedings (Post-Meeting Edition). 31, No 15_suppl (2013).
  10. Armstrong, D. K. et al. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. The New England journal of medicine 354, 34-43, doi:10.1056/NEJMoa052985 (2006).
  11. Herman, T. S. et al. Effect of hyperthermia on cis-diamminedichloroplatinum(II) (rhodamine 123)2[tetrachloroplatinum(II)] in a human squamous cell carcinoma line and a cis-diamminedichloroplatinum(II)-resistant subline. Cancer research 48, 5101-5105 (1988).
  12. Verwaal, V. J. et al. Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 21, 3737-3743, doi:10.1200/JCO.2003.04.187 (2003).
  13. Yang, X. J. et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improves survival of patients with peritoneal carcinomatosis from gastric cancer: final results of a phase III randomized clinical trial. Annals of surgical oncology 18, 1575-1581, doi:10.1245/s10434-011-1631-5 (2011).
  14. Yonemura, Y. et al. Intraoperative chemohyperthermic peritoneal perfusion as an adjuvant to gastric cancer: final results of a randomized controlled study. Hepato-gastroenterology 48, 1776-1782 (2001).
  15. Mahner, S. & Pfisterer, J. Towards individualised treatment in ovarian cancer. The lancet oncology 14, 101-102, doi:10.1016/S1470-2045(13)70006-8 (2013).
  16. Perren, T. J. et al. A phase 3 trial of bevacizumab in ovarian cancer. The New England journal of medicine 365, 2484-2496, doi:10.1056/NEJMoa1103799 (2011).
  17. Burger, R. A. et al. Incorporation of bevacizumab in the primary treatment of ovarian cancer. The New England journal of medicine 365, 2473-2483, doi:10.1056/NEJMoa1104390 (2011).
  18. From ASCO-gynaecological cancer: Pazopanib in ovarian cancer delays progression. Nature reviews. Clinical oncology 10, 367, doi:10.1038/nrclinonc.2013.102 (2013).
  19. Eisenkop, S. M., Friedman, R. L. & Spirtos, N. M. The role of secondary cytoreductive surgery in the treatment of patients with recurrent epithelial ovarian carcinoma. Cancer 88, 144-153 (2000).
  20. Harter, P. et al. Surgery in recurrent ovarian cancer: the Arbeitsgemeinschaft Gynaekologische Onkologie (AGO) DESKTOP OVAR trial. Annals of surgical oncology 13, 1702-1710, doi:10.1245/s10434-006-9058-0 (2006).
  21. Sehouli, J. et al. Role of secondary cytoreductive surgery in ovarian cancer relapse: who will benefit? A systematic analysis of 240 consecutive patients. Journal of surgical oncology 102, 656-662, doi:10.1002/jso.21652 (2010).
  22. Woelber, L. et al. Perioperative morbidity and outcome of secondary cytoreduction for recurrent epithelial ovarian cancer. European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 36, 583-588, doi:10.1016/j.ejso.2010.04.012 (2010).
  23. Harter, P. et al. Prospective validation study of a predictive score for operability of recurrent ovarian cancer: the Multicenter Intergroup Study DESKTOP II. A project of the AGO Kommission OVAR, AGO Study Group, NOGGO, AGO-Austria, and MITO. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society 21, 289-295, doi:10.1097/IGC.0b013e31820aaafd (2011).
  24. Gladieff, L. et al. Carboplatin and pegylated liposomal doxorubicin versus carboplatin and paclitaxel in partially platinum-sensitive ovarian cancer patients: results from a subset analysis of the CALYPSO phase III trial. Annals of oncology : official journal of the European Society for Medical Oncology / ESMO 23, 1185-1189, doi:10.1093/annonc/mdr441 (2012).
  25. Monk, B. J. et al. Trabectedin plus pegylated liposomal Doxorubicin in recurrent ovarian cancer. J Clin Oncol 28, 3107-3114, doi:10.1200/jco.2009.25.4037 (2010).
  26. Aghajanian, C. et al. OCEANS: a randomized, double-blind, placebo-controlled phase III trial of chemotherapy with or without bevacizumab in patients with platinum-sensitive recurrent epithelial ovarian, primary peritoneal, or fallopian tube cancer. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 30, 2039-2045, doi:10.1200/JCO.2012.42.0505 (2012).
  27. Sehouli, J. et al. Nonplatinum topotecan combinations versus topotecan alone for recurrent ovarian cancer: results of a phase III study of the North-Eastern German Society of Gynecological Oncology Ovarian Cancer Study Group. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 26, 3176-3182, doi:10.1200/JCO.2007.15.1258 (2008).
  28. Harter, P. et al. Systemic therapy in recurrent ovarian cancer: current treatment options and new drugs. Expert review of anticancer therapy 10, 81-88, doi:10.1586/era.09.165 (2010).
  29. Pujade-Lauraine, E. et al. AURELIA: A randomized phase III trial evaluating bevacizumab (BEV) plus chemotherapy (CT) for platinum (PT)-resistant recurrent ovarian cancer (OC). J Clin Oncol 30s, abstr LBA5002 (2012).
  30. PRECEDENT: A Randomized Phase II Trial Comparing
    Vintafolide (EC145) and Pegylated Liposomal Doxorubicin
    (PLD) in Combination Versus PLD Alone in Patients With
    Platinum-Resistant Ovarian Cancer;R. Wendel Naumann, Robert L. Coleman, Robert A. Burger, Edward A. Sausville, Elzbieta Kutarska,Sharad A. Ghamande, Nashat Y. Gabrail, Stephen E. DePasquale, Elzbieta Nowara, Lucy Gilbert,Robert H. Gersh, Michael G. Teneriello, Wael A. Harb, Panagiotis A. Konstantinopoulos, Richard T. Penson,James T. Symanowski, Chandra D. Lovejoy, Christopher P. Leamon, David E. Morgenstern, and Richard A. Messmann

IVF ohne ausreichend strenge Indikation?

Prof. Dr. med. H. Kentenich, Prof. Dr. med. J.S. Krüssel, Dr. med. U. Hilland

  1. Martina Lenzen-Schulte: Retortenbabys – gedankenlos gezeugt?, Frankfurter Allgemeine Zeitung, 05.02.2014, Nr. 30, S. N1:
  2. Ein Interview mit Professor Dr. med. Jan-Steffen Krüssel zum Artikel im BMJ wurde bei Medscape.de veröffentlicht: www.medscapemedizin.de/artikel/4901889

Social Freezing: Die biologische Uhr einfach anhalten?

Verantwortlich für den Inhalt MSD SHARP & DOHME GMBH

  1. Statistisches Bundesamt: Geburtentrends und Familiensituation in Deutschland. Ausgabe 2012, Wiesbaden, November 2013
  2. Statistisches Bundesamt: Geburten in Deutschland. Ausgabe 2012. Wiesbaden, Januar 201
  3. Statistisches Bundesamt Destatis 2010
  4. Institut für Demoskopie Allensbach: Allensbacher Berichte: Unfreiwillige Kinderlosigkeit. 2007/Nr. 11
  5. Faddy MJ et al. Accelerated disappearance of ovarian follicles in mid-life: implications for forecasting menopause. Hum Reprod 1992; 7: 1342–1346 
  6. Lockwood M. Social egg freezing: the prospect of reproductive 'immortality' or a dangerous delusion? Reprod Biomed Online 2011; 23: 334-340
  7. Franasiak JM et al. The nature of aneuploidy with increasing age of the female partner: a review of 15,169 consecutive trophectoderm biopsies evaluated with comprehensive chromosomal screening. Fertil Steril 2013 Dec 16. doi: 10.1016/j.fertnstert.2013.11.004. [Epub ahead of print]
  8. Hirshfeld-Cytron J et al. Fertility preservation for social indications: a cost-based decision analysis. Fertil Steril 2012; 97: 665-670
  9. Fachinformation Elonva®, Stand Oktober 2011
  10. Devroey P et al. A double-blind, non-inferiority RCT comparing corifollitropin alfa and recombinant FSH during the first seven days of ovarian stimulation using a GnRH antagonist protocol. Hum Reprod 2009; 24, 3063-3072
  11. Corifollitropin alfa Ensure Study Group. Corifollitropin alfa for ovarian stimulation in IVF: a randomized trial in lower-body- weight woman. Reprod Biomed Online 2010; 21: 66–76
  12. Fachinformation Orgalutran®, Stand September 2013
  13. Fachinformation Puregon®, Stand September 2013
  14. Lan VT et al. Ovulation induction using low-dose step-up rFSH in Vietnamese women with polycystic ovary syndrome. Reprod Biomed Online 2009; 18: 516-521
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  16. Leader A. Improved monofollicular ovulation in anovulatory or oligo-ovulatory women after a low-dose step-up protocol with weekly increments of 25 international units of follicle-stimulating hormone. Fertil Steril 2006; 85: 1766-1773

Postmenopausale Hormonsubstitution und Thrombo-Embolierisiko: Unterschiedzwischen oraler und transdermaler Applikation ?

J. Neulen

  1. Olié V, Canonico M, Scarabin PY. (2011) Postmenopausal hormone therapy and venous thromboembolism. Thromb Res. 127: S26-29
  2. Scarabin PY, Oger E, Plu-Bureau G. (2003) Differential association of oral and transdermal oestrogen-replacement therapy with venous thromboembolism risk. Lancet 362: 428–432
  3. Renoux C, Dell’aniello S, Suissa S. (2010) Hormone replacement therapy and the risk of venous thromboembolism: population-based study. J Thromb Haemost 8: 979–986
  4. Canonico M, Fournier A, Carcaillon L, Olie V, Plu-Bureau G, Oger E,et al. (2010) Postmenopausal hormone therapy and risk of idiopathic venous thromboembolism: results from the E3N cohort study. Arterioscler Thromb Vasc Biol. 30: 340–345
  5. Oliè V, Canonico M, Scarabin PY. (2010) Risk of venous thrombosis with oral versus transdermal estrogen therapy among postmenopausal women. Curr Opin Hematol. 17: 457–463
  6. Oliè V, Plu-Bureau G., Conard J., Horellou MH., Canonico M., Scarabin PY. (2010) Hormone therapy and recurrence of venous thromboembolism among postmenopausal women. Menopause, Dez 21 (Epub ahead of Print) 
  7. Canonico M, Plu-Bureau G, Lowe GD, Scarabin PY. (2008) Hormone replacement therapy and risk of venous thromboembolism in postmenopausal women: systematic review and meta-analysis. BMJ Clin Res. 336: 1227–1231
  8. Straczek C, Oger E, Yon de Jonage-Canonico MB, Plu-Bureau G, Conard J, Meyer G, et al. (2005) Prothrombotic mutations, hormone therapy, and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration. Circulation 112: 3495–3500
  9. Canonico M, Oger E, Conard J, Meyer G, Levesque H, Trillot N, et al. (2006) Obesity and risk of venous thromboembolism among postmenopausal women: differential impact of hormone therapy by route of estrogen administration. The ESTHER Study. J Thromb Haemost. 4: 1259–1265
  10. Sandset PM, Høibraaten E, Eilertsen AL, Dahm A. (2009) Mechanisms of thrombosis related to hormone therapy. Thromb Res. 123 Suppl 2: S70-73
  11. Hemelaar M, van der Mooren MJ, Rad M, Kluft C, Kenemans P. (2008) Effects of nonoral postmenopausal hormone therapy on markers of cardiovascular risk: a systematic review. Fertil Steril. 90: 642–672
  12. Post MS, Christella M, Thomassen LG, van der Mooren MJ, van Baal WM, Rosing J, et al. (2003) Effect of oral and transdermal estrogen replacement therapy on hemostatic variables associated with venous thrombosis: a randomized placebo-controlled study in postmenopausal women. Arterioscler Thromb Vasc Biol 23: 1116–1121
  13. Oger E, Alhenc-Gelas M, Lacut K, Blouch MT, Roudaut N, Kerlan V, et al. (2003) Differential effects of oral and transdermal estrogen/progesterone regimens on sensitivity to activated protein C among postmenopausal women: a randomized trial. Arterioscler Thromb Vasc Biol. 23: 1671–1676