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Introduction: This study's objective was to identify prenatal criteria helping differential diagnosis of bilateral enlarged, hyperechogenic kidneys, especially looking at development of renal volume and amniotic fluid volume with increasing gestational age., Method: Retrospective analysis (single-center database) of all bilateral enlarged, hyperechogenic kidneys between 2000-2018. Renal enlargement was defined as renal volume>90 th percentile. Evaluation included development of renal and amniotic fluid volume during pregnancy and fetal outcome., Results: 23 cases fulfilled the inclusion criteria. 12 pregnancies were terminated. For 11 continued pregnancies, longitudinal information on amniotic fluid volume and renal volume were available. 4 cases with oligohydramnios showed a progressive reduction; 6 cases with normal/increased amniotic fluid volume remained stable; in 1 case amniotic fluid volume normalized from initially being oligohydramnios. Regarding renal volume, 4 cases showed exponential enlargement, 3 cases linear progression; in 2 cases renal volume stabilized after initial progression; 2 cases showed initial progression and secondary regression. 4 fetuses survived: 3 autosomal dominant polycystic kidney diseases, 1 Bardet-Biedl syndrome., Conclusion: Progressive reduction of amniotic fluid volume with exponential increase of renal volume is highly suggestive for autosomal recessive polycystic kidney disease. Cases of autosomal dominant polycystic kidney disease show a linear progression of renal volume>90 th percentile and mostly normal amniotic fluid volume., Competing Interests: The authors declare that they have no conflict of interest. The content of this paper was presented orally at the Annual Conference of Gynécologie Suisse (SGGG) in June 2019 in St. Gallen, Switzerland., (Thieme. All rights reserved.)

Aims: This is an official guideline of the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (ÖGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The aim of this guideline is to improve the prediction, prevention and management of preterm birth based on evidence obtained from recently published scientific literature, the experience of the members of the guideline commission and the views of self-help groups., Methods: The members of the participating medical societies and organizations developed Recommendations and Statements based on the international literature. The Recommendations and Statements were adopted following a formal consensus process (structured consensus conference with neutral moderation, voting done in writing using the Delphi method to achieve consensus)., Recommendations: Part 2 of this short version of the guideline presents Statements and Recommendations on the tertiary prevention of preterm birth and the management of preterm premature rupture of membranes., Competing Interests: Die Interessenkonflikterklärungen aller Autoren finden Sie in der Langversion der Leitlinie., (© Georg Thieme Verlag KG Stuttgart · New York.)

Aims: This is an official guideline of the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (ÖGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The aim of this guideline is to improve the prediction, prevention and management of preterm birth based on evidence obtained from recent scientific literature, the experience of the members of the guideline commission and the views of self-help groups., Methods: Based on the international literature, the members of the participating medical societies and organizations developed Recommendations and Statements. These were adopted following a formal process (structured consensus conference with neutral moderation, voting was done in writing using the Delphi method to achieve consensus)., Recommendations: Part I of this short version of the guideline lists Statements and Recommendations on the epidemiology, etiology, prediction and primary and secondary prevention of preterm birth., Competing Interests: Die Interessenkonflikterklärungen aller Autoren finden Sie in der Langversion der Leitlinie., (© Georg Thieme Verlag KG Stuttgart · New York.)

The current study demonstrates for the first time the presence of ear acupuncture points in prematurely delivered triplets of 31 weeks and two days gestational age. Pregnancy was an IVF pregnancy and caesarean section was performed because of preeclampsia. Ear acupuncture points were determined with the Svesa point selector 1070 and correlated well with the clinical state of the neonates meaning that the sickest child demonstrated the most active ear points. Psychotropic points were not found. For the future ear acupuncture points may be further used for diagnostics and therapy in neonates.

Background: Although Misoprostol is an already widely used medication in gynecology and obstetrics, extended studies on dosage and safety are still missing. As far as the application of Misoprostol in gynecology and obstetrics is concerned, we are moving between legality and illegality, because in countries like Switzerland and Germany this drug wasn't officially approved for obstetric-gynecologic indications yet., Materials: The aim of the recent work is to give an overview on the indications of Misoprostol in gynecology and obstetrics, the dosages and side effects. Indications are as follows: 1. induction of abortion in the first and second trimester (maximum up to the 22nd week of gestation) 2. cervical ripening and induction of labour in the third trimester (from 36th week of gestation) 3. prevention and therapy of postpartal hemorrhage., Results: There is no doubt that Misoprostol is an efficient drug for both the obstetrical management at the end of normal pregnancy and the third stage labour as well as termination of pregnancy and induction of abortion in the first and second trimester of pregnancy. This has been concluded from many randomized trials. The side effects of this drug however, have become more obvious over time, especially uterine rupture and the probably elevated perinatal morbidity secondary to the hyperstimulation syndrome., Conclusions: The application of Misoprostol for labour induction in an outpatient setting is absolutely contraindicated. As long as not all critical questions are answered conclusively, this beneficial drug should only be applied under hospital conditions with close surveillance.

In utero transplantation of hematopoietic stem cells is a most promising fetal therapy. The aim is to treat a genetic disease prenatally before the onset of irreversible organ damage. As the fetus is immunoincompetent in the first and early second trimester of pregnancy and thus tolerant to foreign antigen, engraftment of transplanted stem cells is possible without rejection and without the need for immunosuppression. Additionally, there is enough space available in the fetal bone marrow for the homing of transplanted stem cells, and the intrauterine environment is protective for the fetus, thus typical complications of postnatal transplantation like graft rejection could be avoided. Good results of in utero treatment of severe congenital immunodeficiencies have been achieved in different animal models as well as in humans. No success, however, has been reported as yet in genetic diseases without immunodeficiency, mainly because it seems to be difficult to achieve a clinically significant level of chimerism. Ongoing research projects are focussed on the search for alternative stem cell sources like umbilical cord blood or fetal liver, optimizing the in vitro stem cell processing by using special enrichment techniques, adding early growth factors to the transplant or expanding stem cells ex vivo and finding the ideal stem cell dose. In non-immunodeficient recipients the "window of opportunity" seems to be exclusively at the end of the first trimester; thus early administration of the transplant is mandatory. Induction of tolerance against donor cells is possible, though the clinical relevance for postnatal transplantation remains to be proven.

The accuracy of cervicovaginal fetal fibronectin as a predictor of preterm birth was studied in patients with increased risk for preterm delivery (according to the Creasy-score). In a prospective blind observational study the smear from the posterior fornix vaginae of 56 pregnant patients without PROM was examined using a quantitative immunoassay for the detection of fetal fibronectin. The patients who tested positively for fetal fibronectin had significantly more preterm deliveries than those with a negative result (CHI square-test, p < 0.01, RR 5.1). Overall, sensitivity, specificity, positive and negative predictive values were 56%, 87%, 45% and 91%, respectively. In patients with preterm labor these values were 75%, 87%, 60%, and 93%, respectively. No patient with a negative result delivered preterm during the following two weeks. It is concluded that performing the fetal fibronectin test in patients with preterm labor is useful for the prediction of preterm birth. Routine testing in patients at increased risk (asymptomatic patients) is not recommended for lack of effectiveness.