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Women with maturity-onset diabetes of the young (MODY) need tailored antenatal care and monitoring of their offspring. Each MODY subtype has different implications for glycaemic targets, treatment choices and neonatal management. Hyperglycaemia of MODY is often first diagnosed in adolescence or early adulthood and therefore is clinically relevant to pregnant women. MODY remains an under-recognised and undiagnosed condition. Pregnancy represents an opportune time to make a genetic diagnosis of MODY and provide precision treatment. This review describes the nuance of antenatal care in women with MODY and the implications for pregnancies affected by a positive paternal genotype. Mutations in hepatic nuclear factor 1-alpha (HNF1A) and 4-alpha (HNF4A) genes are associated with progressive βcell dysfunction resulting in early onset diabetes. Patients are largely managed with sulphonylureas outside of pregnancy. Macrosomia and persistent neonatal hypoglycaemia are reported in 54% and 15% of HNF4A genotype positive offspring respectively with a median increase in birthweight of 790 g. Close observation of foetal growth in utero allows optimal timing of delivery to minimise peri- and postpartum materno-foetal complications. Glucokinase (GCK)-MODY causes mild fasting hyperglycaemia which does not require treatment outside of pregnancy. Birthweight of offspring of maternal carriers is dependent on foetal genotype; heterozygous mutation carriers are usually normal weight while genotype negative offspring are large for gestational age (600 g heavier). Affected offspring of paternal carriers may be small for gestational age (500 g lighter). Serial growth scans with measurement of the abdominal circumference indirectly differentiate foetal genotype. Measurement of cell free foetal DNA in maternal blood from the late first trimester is superior to traditionally used ultrasound to distinguish foetal genotype. Cost and accessibility may limit its use. [ABSTRACT FROM AUTHOR]

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Introduction: Since 2015, same-sex couples in Austria have been able to fulfil their desire to have children with the help of reproductive medicine services. The aim of this study was to determine the needs of women and the special features of care for women in couple relationships during pregnancy and childbirth., Methodology: Eight interviews were conducted with Austrian women in same-sex relationships using a semi-structured guideline. The women were recruited by means of a convenience sample via an association and word of mouth. The content of the collected data was analysed using the recommended Mayring method., Results: In the obstetric accompaniment of same-sex female couples, it became obvious that the usual use of language was inappropriate and alternatives to the term father, such as the term co-mother, were insufficiently established. Openness, acceptance and understanding as well as being seen as a holistic family were considered important prerequisites for improving the quality of care. In addition, the inclusion of the non-pregnant mother was considered essential. Despite their non-traditional couple relationship, female couples wanted care without special status and prejudice., Discussion and Conclusion: A comprehensive socio-political discourse is still needed to promote the normality of family models beyond heteronormativity. Unbiased, supportive obstetric care can offer rainbow families a framework in which children can develop healthily from the outset., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

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Gestational diabetes mellitus (GDM) is an important risk factor for pregnancy complications. Since 2012, the Federal Joint Committee’s maternity directive recommends a two-step screening for GDM with a pre-test and subsequent diagnostic test if the pre-test is positive. This study analyses the implementation and development over time of GDM screening participation and prevalence in Germany. The data basis is the external inpatient obstetrics quality assurance documentation, which covers all births in hospital. Women with diabetes before pregnancy were excluded. The study defined women as GDM cases if the condition was documented in maternity records or if the ICD-10 diagnosis O24.4 was coded for inpatients at discharge and figures were determined for the years 2013 to 2018. As the documentation of screening tests has only been included in the data set since 2016, screening participation for the years 2016 to 2018 were estimated and evaluated based on the pre-test and/or diagnostic tests documented in maternity records. In 2018, the majority of all women who gave birth in hospitals had had a pre-test conducted (65.0%) or a pre-test and diagnostic test (18.2%) in line with the two-step procedure. A further 6.7% received a diagnostic test alone. GDM screening participation increased over time from 83.4% in 2016 to 89.9% in 2018. The prevalence of a documented GDM increased from 4.6% to 6.8% between 2013 and 2018. In 2018, this equates to 51,318 women with GDM. Reliably assessing the extent and causes of this development will require continuous analyses of screening implementation, documentation and changes in maternal risk factors.

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Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article provides information on the importance of medical counseling for pregnancy conflict in Austria. It also discusses the interview questions of different counselors on pregnancy conflict law. Topics discussed includes advices of donum vitae, medical counseling and sex education, and importance of unborn life in pregnancy.

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Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article introduces a heuristic for the sociological analysis of technological-medical practices. It operates with a feminist science studies perspective which analyzes phenomena in their specificity and ambivalences without assuming an overarching paradigm of optimization. The article relies on the theoretical perspective of agential realism developed by science studies scholar Karen Barad. Core concepts of agential realism are introduced in a first step. The article then introduces two studies based on agential realism. One focuses on prenatal risk diagnosis in Denmark, the other deals with the ‘traveling' of a technical artifact (from the US to Sweden) and analyzes the validity of gynecological simulators in agential realist terms. The article concludes that it is a simplification to understand the technological developments in medical practice simply as enhancements. It proposes instead that technological-medical practices first be understood as practices of modification. Modifications may very well be inscribed into a paradigm of optimization, but this cannot be presupposed and must first be shown through analysis of their specific articulations. [ABSTRACT FROM AUTHOR]

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Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article offers information on a meeting of the Gemeinsame Bundesausschuss (G-BA) held on April 15, 2021 in Germany on non-invasive prenatal tests (NIPT) for trisomies on insured patients. It also reports on discussion on inclusion of information for the insured in the maternity guidelines in the meeting.

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Introduction: In 2019 38 million people were living with HIV worldwide, more than half of them girls and women. Knowledge about maternal HIV status enables HIV transmission prophylaxis, reducing mother-to-child transmission<1%. We aimed to investigate the implementation of the mandatory documentation of counseling and optional HIV testing in the maternity records as recommended in the German maternity guidelines., Methods: In the Obstetric Department of the University Hospital Bonn, maternity records were reviewed from June to October 2020, and pregnant women were interviewed regarding the patients' recall of counseling and HIV testing as well as their attitude towards a universal screening strategy using an anonymous questionnaire., Results: Documentation was incomplete in 11% of maternal records: in 8% there was neither documentation of counseling nor of HIV testing, in 3% documentation of counseling only. In 291 questionnaires 47% of pregnant women could not recall counselling. 90% of pregnant women were in favor of universal HIV testing in pregnancy, 9% were undecided, and 1% opposed it. 55% would support change from an "opt-in" to an "opt-out" screening policy in pregnancy., Summary: Documentation of counseling and HIV testing was incomplete in 11% of cases, and nearly half of the women could not recall counselling. New strategies from midwives and obstetricians need to be developed to achieve universal HIV testing in pregnant women leading to zero HIV mother-to-child transmissions., Competing Interests: C.B. hat Honorare für Vorträge oder Beratungstätigkeiten erhalten von AbbVie, Gilead, Janssen, MSD, ViiV, weiterhin Drittmittelunterstützung durch Dt. Leberstiftung, DZIF, Hector Stiftung, NEAT ID. J.R. hat Honorare für Vorträge oder Beratungstätigkeiten erhalten von Gilead, Janssen, Merck und ViiV., (Thieme. All rights reserved.)

Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Diabetologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The choice of anesthesia procedure for surgical interventions in pregnancy is particularly important considering the responsibility for the unborn child and the patient. Uncertainties with the treatment of this patient group and lacking routine are common. Nevertheless, 0.5–2% of pregnant women require non-gynecological surgery. In this respect knowledge about the interrelationship between physiological changes and pharmacological effects with potentially negative impact for the embryo, fetus or neonate is of particular importance. In this article the physiology relevant for anesthesia during pregnancy is discussed and commonly used drugs are reviewed to enable anesthesiologists to formulate concepts to preclude adverse effects for the mother and child and to provide an adequate therapy. [ABSTRACT FROM AUTHOR]

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The article discusses the court case OLG Hamm, Urt. v. 26.3.2019 – 26 U 151/18 (LG Detmold – 1 O 185/16) wherein special features of the medical liability process of doctors is seen in which child born is given incorrect prenatal care as it was born in 25th week of pregnancy to the defendant. It points out to paying of compensation due to extreme premature birth leading to mental and physical damage to health.

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