80 results on '"H, Kentenich"'
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2. Überlegungen zum Verbot der Eizellspende
- Author
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H. Kentenich
- Subjects
business.industry ,Maternity and Midwifery ,Obstetrics and Gynecology ,Medicine ,business - Published
- 2021
3. Psychosomatically Oriented Diagnostics and Therapy for Fertility Disorders. Guideline of the DGPFG (S2k-Level, AWMF Registry Number 016/003, December 2019)
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Ingrid Rothe-Kirchberger, Michelle Röhrig, Almut Dorn, Matthias David, Maren Schick, Ada Borkenhagen, Anne Meier-Credner, Maren Goeckenjan, Stefan Siegel, Christoph Dorn, A. Tandler-Schneider, Anna Julka Weblus, Friedrich Gagsteiger, Tewes Wischmann, A. K. Ludwig, H. Kentenich, and Petra Thorn
- Subjects
medicine.medical_specialty ,business.industry ,Psychosomatics ,Family medicine ,Maternity and Midwifery ,Fertility Disorders ,Reproductive medicine ,medicine ,Obstetrics and Gynecology ,Guideline ,business - Abstract
Aim The purpose of this official guideline published and coordinated by the German Society for Psychosomatic Gynecology and Obstetrics [Deutsche Gesellschaft für Psychosomatische Frauenheilkunde und Geburtshilfe (DGPFG)] is to provide a consensus-based overview of psychosomatically oriented diagnostic procedures and treatments for fertility disorders by evaluating the relevant literature. Method This S2k guideline was developed using a structured consensus process which included representative members of various professions; the guideline was commissioned by the DGPFG and is based on the 2014 version of the guideline. Recommendations The guideline provides recommendations on psychosomatically oriented diagnostic procedures and treatments for fertility disorders.
- Published
- 2021
4. Bewegt sich was?
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Thomas Strowitzki and H. Kentenich
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Gynecology ,medicine.medical_specialty ,Reproductive Medicine ,business.industry ,Endocrinology, Diabetes and Metabolism ,Pediatrics, Perinatology and Child Health ,medicine ,Reproductive medicine ,Obstetrics and Gynecology ,business - Published
- 2021
5. Zum Verbot der Eizellspende: medizinische und ethische Überlegungen
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Klaus Diedrich and H. Kentenich
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Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,0302 clinical medicine ,business.industry ,medicine ,Obstetrics and Gynecology ,030212 general & internal medicine ,business - Abstract
Die Eizellspende ist nach deutschem Recht verboten. Etwa 3–4 % aller Frauen vor dem 40. Lebensjahr haben aufgrund ihres Eizellmangels keine Moglichkeit mehr, mit eigenen Eizellen schwanger zu werden. Medizinische Indikationen sind genetische Pradispositionen (z. B. Turner-Syndrom), Frauen ohne Ovarien oder mit Voroperationen an den Eierstocken, wie z. B. bei Endometriose III. Grades. Die Geburtenraten sind nach internationalen Daten relativ hoch (32–56 %). Der Verlauf der Schwangerschaft weist vermehrt schwangerschaftsinduzierten Hypertonus und Praeklampsie auf, woruber die Frauen, die mit Eizellspende schwanger werden wollen, auch aufgeklart werden sollten. In psychologischer Hinsicht sind die Mutter‑/Vater-Kind-Beziehung und die Entwicklung der Kinder als normal zu bezeichnen. Ein besonderer Schutz gilt der Eizellspenderin, da sie keinen eigenen Vorteil von der Behandlung hat. Medizinisch ist eine schonende Behandlung moglich durch moderne Formen der Stimulationsverfahren (Ovulationsinduktion mit GnRH[„gonadotropin releasing hormone“]-Agonisten). Der Schutz der Spenderin kann durch nationale Regulierungen wie in Grosbritannien gewahrleistet werden. Im Beratungsprozess erscheint wesentlich, dass der Arzt in Deutschland nicht aktiver Teil der Behandlung sein darf. Er sollte die Frauen uber mogliche Alternativen (Verzicht auf das Kind/Adoption/etc.) aufklaren. In vielen Landern ist nur eine anonyme Eizellspende moglich, bei der das Kind spater nicht die genetische Herkunft erfahren kann.
- Published
- 2020
6. Psychosomatische Grundversorgung in der Frauenheilkunde
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M. Werling, H. Kentenich, and A. J. Weblus
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Gynecology ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,business.industry ,Pain medicine ,Obstetrics and Gynecology ,Traditional Chinese medicine ,030227 psychiatry ,03 medical and health sciences ,0302 clinical medicine ,Complementary and alternative medicine ,Acupuncture ,Physical therapy ,Medicine ,Neurology (clinical) ,business - Abstract
Die Psychosomatische Grundversorgung ist seit etwa 20 Jahren Bestandteil der Facharztweiterbildung Gynakologie und Geburtshilfe. Die Pravalenz von psychischen Storungen ist hoch, in der Frauenarztpraxis ist durchschnittlich etwa jede dritte Patientin betroffen. Angst- und Panikstorungen sowie affektive Storungen sind bei Frauen besonders haufig. Ebenfalls berucksichtigt werden muss eine hohe Rate an Gewalterfahrung bei Frauen (ca. 13 % sexuelle, bis zu 35 % korperliche Gewalt). Ein psychosomatisches Krankheitsverstandnis beinhaltet die Kenntnis des biopsychosozialen Modells, das biologische, psychologische und soziale Faktoren fur sich genommen und in ihren komplexen Wechselwirkungen bei der Entstehung und Aufrechterhaltung von Krankheiten berucksichtigt. Nicht selten wird ein intrapsychischer Konflikt uber ein korperliches Symptom ausgedruckt. Wesentlich bei psychosomatischen Erkrankungen ist es, von Anfang an parallel zur Organdiagnostik auch psychosoziale Uberlegungen mit einzubeziehen und der Patientin gegenuber zu kommunizieren, um einer weiteren „Organfixierung“ und Chronifizierung vorzubeugen.
- Published
- 2019
7. Assistierte Reproduktion: aktuelle Problemlage
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H. Kentenich, Thomas Strowitzki, Jochen Taupitz, and Klaus Diedrich
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Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,Reproductive medicine ,Obstetrics and Gynecology ,business - Published
- 2018
8. Assistierte Reproduktion: Möglichkeiten und Grenzen
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Klaus Diedrich, H. Kentenich, and T. Strowitzki
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Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,0302 clinical medicine ,business.industry ,medicine ,Obstetrics and Gynecology ,business ,030217 neurology & neurosurgery - Abstract
Die Reproduktionsmedizin hat in den letzten Jahrzehnten gewaltige Fortschritte erzielt. Es konnen Schwangerschaftsraten erreicht werden, die denen bei Spontankonzeption vergleichbar sind. Methoden zur Patientensicherheit wie neue Stimulationsprotokolle und der elektive SET („single embryo transfer“) zur Verringerung der Mehrlingsrate stehen im Vordergrund. In Deutschland ist der elektive SET in vollem Umfang aber nicht moglich, was im Vergleich zum Ausland zu einer hoheren Belastung durch eine hohere Rate an Mehrlingsschwangerschaften fuhrt. Die Blastozystenkultur ist dagegen mittlerweile implementiert. Die Praimplantationsdiagnostik ist in Deutschland auch nur in einem begrenzten Rahmen erlaubt, das Aneuploidiescreening ist derzeit verboten.
- Published
- 2018
9. Medizinische und psychosoziale Aspekte der Beratung
- Author
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Tewes Wischmann, H. Kentenich, and Petra Thorn
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Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,0302 clinical medicine ,business.industry ,Obstetrics and Gynecology ,Medicine ,060301 applied ethics ,06 humanities and the arts ,0603 philosophy, ethics and religion ,business - Abstract
Arztliche Beratung bei Sterilitat/und Reproduktionsmedizin findet in Deutschland auf Grundlage der „Psychosomatischen Grundversorgung“ statt. Die Inhalte sind geregelt in der „(Muster‑)Richtlinie der Bundesarztekammer 2006“, die sowohl die medizinischen als auch die psychosozialen Aspekte der arztlichen Beratung festlegt. Diese Richtlinie wird nun durch eine Richtlinie nach § 16 b Abs. 1 TPG (Transplantationsgesetz) abgelost werden. Fur gesetzlich versicherte Ehepaare gilt die „Richtlinie uber kunstliche Befruchtung“ des G‑BA (Gemeinsamer Bundesausschuss). Auch hier sind die Inhalte der arztlichen und psychosozialen Beratung im Detail geregelt. Daruber hinaus ist eine unabhangige psychosoziale Beratung (nicht arztlich geleitet) sinnvoll, um eine behandlungsunabhangige zweite Sichtweise zu ermoglichen. Bei fremden Gameten (in erster Linie Samenzellen) und bei fremden Embryonen sollte die psychosoziale Beratung alle Aspekte beinhalten, die sich aus Schwangerschaft, Geburt und dem spaterem Leben mit Kindern ergeben. Eizellspende und die Leihmutterschaft sind (zurzeit) in Deutschland verboten. Gleichwohl gehen viele Paare zur Behandlung ins Ausland. Auch hier sollten im Vorfeld bereits medizinische und psychosoziale Fragen angesprochen und beraten werden.
- Published
- 2018
10. Ein Fortpflanzungsmedizingesetz für Deutschland
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Hartmut Kreß, Horst Dreier, Hans-Peter Zenner, Jochen Taupitz, Christian J. Thaler, H. Kentenich, Petra Thorn, Eva Schumann, A. K. Ludwig, J. S. Krüssel, Henning M. Beier, Thomas Strowitzki, Martin Bujard, Klaus Diedrich, Helmut Frister, and Claudia Wiesemann
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Gynecology ,medicine.medical_specialty ,Reproductive Medicine ,business.industry ,Endocrinology, Diabetes and Metabolism ,Pediatrics, Perinatology and Child Health ,medicine ,Obstetrics and Gynecology ,business - Abstract
Die rechtliche Regelung der Fortpflanzungsmedizin ist dringend reformbedurftig. Das Embryonenschutzgesetz von 1990 erfasst die neuesten technischen Entwicklungen nicht, ist in manchen Bereichen unstimmig und luckenhaft, setzt die betroffenen Frauen, Paare und Kinder unnotigen gesundheitlichen Risiken aus, erschwert paradoxerweise die Durchsetzung von Kinderrechten und erzeugt Gerechtigkeitsprobleme und Rechtsunsicherheit fur die betroffenen Paare und die behandelnden Arztinnen und Arzte. Das Embryonenschutzgesetz enthalt zudem nur strafrechtliche Verbote. Diese erlauben keine angemessene Reaktion auf die medizinische Entwicklung und den gesellschaftlichen Wandel und werden der Komplexitat der Materie nicht gerecht. Diese Probleme mussen gelost werden. Der Bundesgesetzgeber verfugt seit mehr als 20 Jahren uber die Kompetenz zur Regelung der Fortpflanzungsmedizin. Er sollte in der kommenden Legislaturperiode ein umfassendes Fortpflanzungsmedizingesetz schaffen.
- Published
- 2018
11. Medizinhistorische Therapievorstellungen. Historische Entwicklungen in den Ursachentheorien zur Hyperemesis gravidarum – eine Literaturübersicht für die Jahre 1870–1970
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H. Kentenich, Matthias David, K. Mattig, and Andreas D. Ebert
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03 medical and health sciences ,030219 obstetrics & reproductive medicine ,0302 clinical medicine ,business.industry ,Maternity and Midwifery ,Obstetrics and Gynecology ,Medicine ,business - Published
- 2016
12. Fortpflanzung im höheren Alter
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A. Jank and H. Kentenich
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Gynecology ,medicine.medical_specialty ,Reproductive Medicine ,business.industry ,Endocrinology, Diabetes and Metabolism ,Pediatrics, Perinatology and Child Health ,medicine ,Obstetrics and Gynecology ,business - Abstract
Schwangerschaften mit eigenen und fremden Eizellen nach dem 40. Lebensjahr gehen mit gemeinsamen Problemen einher, die durch das Alter der Frau oder mogliche Veranderungen der Gebarmutter, z. B. Myome, bedingt sein konnen. Im vorliegenden Beitrag sollen die Einflusse und Auswirkungen eines fortgeschrittenen Alters auf den Schwangerschaftsverlauf zusammengefasst werden. Dabei wird sowohl auf die Situation nach Spontankonzeption mit eigenen Eizellen als auch auf die Verhaltnisse nach Eizellspende eingegangen. Zu diesem Zweck wurde eine Literaturrecherche durchgefuhrt. Altersabhangig entwickelt sich in der Schwangerschaft haufiger ein Gestationsdiabetes, Hypertonus oder eine Praeklampsie. Bei Konzeption mit eigenen Eizellen dominiert das Abortproblem, das durch die Aneuploidierate der Eizellen bedingt ist. Bei Eizellspende ist die Fehlgeburtenrate aufgrund des jungeren Alters der Spenderin geringer. Allerdings ist die Wahrscheinlichkeit von Hypertonus und Praeklampsie ebenfalls erhoht. Weiterhin haben psychosoziale Aspekte eine Bedeutung, da die naturlichen Krafte, die fur die Betreuung der Kinder notwendig sind, abnehmen. Der Arzt sollte der alteren Patientin bzw. dem Paar eine intensive Beratung bezuglich der aufgefuhrten Probleme anbieten.
- Published
- 2016
13. Effects of medical causes, role concepts and treatment stages on quality of life in involuntary childless men
- Author
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C. Thöne, Tewes Wischmann, Maren Schick, H. Kentenich, Bettina Toth, A. Jank, Sabine Rösner, and T. Strowitzki
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Adult ,Male ,Gerontology ,Infertility ,medicine.medical_specialty ,Urology ,media_common.quotation_subject ,Significant group ,Reproductive Behavior ,Fertility ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Quality of life (healthcare) ,Surveys and Questionnaires ,Role Concepts ,Humans ,Medicine ,030212 general & internal medicine ,Psychiatry ,Infertility, Male ,media_common ,030219 obstetrics & reproductive medicine ,business.industry ,Treatment process ,Gender Identity ,General Medicine ,medicine.disease ,Fertility clinic ,Social Class ,Quality of Life ,Female ,business ,Psychosocial ,Stress, Psychological - Abstract
Summary Goal of this study was to investigate differences in quality of life in men contingent upon various fertility treatment stages, infertility causes and adoption of roles. A quantitative study with n = 115 men in three German fertility centres was devised. Participants completed a standardised, fertility-specific questionnaire devised for men (TLMK), sociodemographic and role items. Men having experienced severe medical conditions, for example cancer, reported significant higher quality of life compared to men with other infertility reasons [F(1,56) = 12.77, P = 0.001]. Furthermore, allocating participants into distinctive groups by means of kind and duration of treatment revealed significant group differences [F(2,111) = 4.94, P = 0.009], with quality of life decreasing with the use of more invasive fertility methods. A higher satisfaction with life was also stated by men adopting many tasks in the treatment process. The high quality of life displayed by men having experienced severe medical conditions contains valuable and far-reaching information about possible resilience factors that need to be researched more in detail. The finding of decreasing quality of life in men with the use of more invasive methods in treatment applies for increased psychosocial services in fertility clinics.
- Published
- 2016
14. Fertilitätserhalt bei onkologischen Erkrankungen. Leitlinie der DGGG, DGU, DGRM (S2k-Level, AWMF-Registernummer 015/082, September 2017) - Empfehlungen und Statements bei Mädchen und Frauen
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Tanja Fehm, Stefan Schlatt, Maren Goeckenjan, Julia Meißner, Ariane Germeyer, Thorsten Diemer, Frank-Michael Köhn, Oliver Micke, Ute Hehr, Beate Hornemann, Frank Nawroth, Anja Borgmann-Staudt, Wilfried Hoffmann, Michael P. Lux, Nicole Reisch, Ludwig Wildt, Dagmar Guth, Laura Lotz, Najib Nassar, Ramona Beck, Franc Hetzer, Patricia G. Oppelt, Annekathrin Sender, Matthias Korell, Verena Nordhoff, Christian Denzer, Friederike Siedentopf, Michael von Wolff, Dorothea Riesenbeck, H. Kentenich, Wolfgang Cremer, Jens Hirchenhain, Jana Liebenthron, Petra Thorn, Sigurd Lax, Andreas N. Schüring, Sabine Kliesch, Ludwig Kiesel, R Schwab, Pirus Ghadjar, Andreas Jantke, Matthias W. Beckmann, Almut Dorn, Berthold P. Hauffa, Karolin Behringer, Steffen Wagner, Jörg Pelz, Ralf Dittrich, Pauline Wimberger, Tewes Wischmann, Rüdiger Gaase, Falk Ochsendorf, Magdalena Balcerek, DM Baston-Büst, Beate Rau, Kristina Geue, and Martin Götte
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medicine.medical_specialty ,fertility preservation ,Fertilitätserhalt ,Medizin ,Reproductive medicine ,onkologische Erkrankungen ,610 Medicine & health ,Reproductive age ,Commission ,Guideline/Leitlinie ,Malignant disease ,German ,03 medical and health sciences ,0302 clinical medicine ,Maternity and Midwifery ,Medicine ,GebFra Science ,Fertility preservation ,Leitlinie ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics and Gynecology ,Guideline ,language.human_language ,oncologic diseases ,030220 oncology & carcinogenesis ,Family medicine ,language ,Professional association ,business ,guideline - Abstract
Aim The aim of this official guideline published by the German Society of Gynecology and Obstetrics (DGGG) and coordinated with the German Society of Urology (DGU) and the German Society of Reproductive Medicine (DGRM) is to provide consensus-based recommendations, obtained by evaluating the relevant literature, on counseling and fertility preservation for prepubertal girls and boys as well as patients of reproductive age. Statements and recommendations for girls and women are presented below. Statements or recommendations for boys and men are not the focus of this guideline. Methods This S2k guideline was developed at the suggestion of the guideline commission of the DGGG, DGU and DGRM and represents the structured consensus of representative members from various professional associations (n = 40). Recommendations The guideline provides recommendations on counseling and fertility preservation for women and girls which take account of the patient's personal circumstances, the planned oncologic therapy and the individual risk profile as well as the preferred approach for selected tumor entities. Ziel Das Ziel dieser offiziellen Leitlinie, die von der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) publiziert und zusammen mit der Deutschen Gesellschaft für Urologie (DGU) sowie Deutschen Gesellschaft für Reproduktionsmedizin (DGRM) koordiniert wurde, ist es, durch die Evaluation der relevanten Literatur konsensbasierte Handlungsempfehlungen für die Beratung und den Einsatz von fertilitätserhaltenden Maßnahmen bei präpubertären Mädchen und Jungen sowie für Patienten/-innen im reproduktiven Alter zu geben. Im Folgendem werden die Statements und Empfehlungen für Mädchen und Frauen dargestellt. Die Statements und Empfehlungen für Jungen und Männer sind nicht Inhalt dieser Publikation. Methoden Diese S2k-Leitlinie wurde durch einen strukturierten Konsens von repräsentativen Mitgliedern verschiedener Fachgesellschaften (n = 40) im Auftrag der Leitlinienkommission der DGGG, DGU und DGRM entwickelt. Empfehlungen Es werden Empfehlungen zur Beratung und dem Einsatz von fertilitätserhaltenden Maßnahmen bei Patientinnen unter Berücksichtigung der Lebensumstände, der geplanten onkologischen Therapie und des individuellen Risikoprofils dargestellt sowie über das Vorgehen bei ausgewählten Tumorentitäten.
- Published
- 2018
- Full Text
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15. Umsetzung der PID-Verordnung in Deutschland
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H. Kentenich, T. Buchholz, C. Dorn, K. Diedrich, and U. Hilland
- Subjects
Gynecology ,medicine.medical_specialty ,Reproductive Medicine ,business.industry ,Endocrinology, Diabetes and Metabolism ,Pediatrics, Perinatology and Child Health ,medicine ,Reproductive medicine ,Obstetrics and Gynecology ,business - Published
- 2015
16. A Couple Who Cannot Conceive: Coping with Infertility
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Tewes Wischmann and H. Kentenich
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0301 basic medicine ,Infertility ,Coping (psychology) ,030219 obstetrics & reproductive medicine ,Marital stress ,Medical treatment ,business.industry ,Avoidance coping ,medicine.disease ,03 medical and health sciences ,Distress ,030104 developmental biology ,0302 clinical medicine ,Health care ,medicine ,Life crisis ,Psychology ,business ,Clinical psychology - Abstract
The experience of infertility and its medical treatment is for most couples an emotional challenging life crisis. For a successful coping with this crisis, it is essential to use only effective coping strategies. These are mainly active-confronting and meaning-based coping strategies, whereas avoidance coping strategies usually increase the personal and marital stress of both partners. In this chapter some typical issues in the relationship between health care professional and the infertile couples will be described. One important didactical goal will be to increase the knowledge on favorable coping strategies in infertility and how to address these coping strategies adequately as an Ob/Gyn-professional.
- Published
- 2017
17. Psychosoziales Outcome bei Labienreduktionsplastiken
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H. Kentenich, S. Preiß, and A. Borkenhagen
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Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,Head and neck surgery ,Surgery ,business - Abstract
Plastische Chirurgen und Gynakologen westlicher Lander sind zunehmend mit der Nachfrage nach einer kosmetischen Verkleinerung der Labiae minorae konfrontiert. Bis vor Kurzem existierten keine belastbaren Daten zum psychosexuellen Outcome der kosmetischen Labienplastik. Der Artikel gibt einen Uberblick uber das psychosexuelle Outcome nach kosmetischer Labienreduktion. Bisher liegen zwei prospektive Studien zur Korperbildveranderung und zum psychosexuellen Outcome vor, die zeigen, dass eine Labienreduktion zu einer signifikanten und nachhaltigen positiven Veranderung des genitalen Korperbildes fuhrt, jedoch nur zu einer kurzfristigen Verbesserung der sexuellen Funktion. Guidelines, die den Umgang mit dem Wunsch und der Nachfrage nach einer Labienreduktion behandeln, wurden entwickelt und stellen einen wichtigen Schritt im Rahmen der Qualitatssicherung dar. Die Weiterentwicklung eines standardisierten Trainings der Behandler ware ein weiterer wunschenswerter Schritt.
- Published
- 2014
18. Implantation und Frühschwangerschaft
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G. Griesinger, Thomas Strowitzki, and H. Kentenich
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Gynecology ,medicine.medical_specialty ,Reproductive Medicine ,business.industry ,Endocrinology, Diabetes and Metabolism ,Pediatrics, Perinatology and Child Health ,Reproductive medicine ,medicine ,Obstetrics and Gynecology ,business - Published
- 2018
19. In-vitro-Fertilisation und intrazytoplasmatische Spermieninjektion
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C. Sibold, A. Tandler-Schneider, and H. Kentenich
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Gynecology ,medicine.medical_specialty ,Infertility therapy ,business.industry ,Treatment outcome ,Public Health, Environmental and Occupational Health ,medicine ,business - Abstract
Im Jahr 1978 wurde das erste Kind nach In-vitro-Fertilisation (IVF) geboren. Seitdem hat sich die auserkorperliche Befruchtung zu einem Standardverfahren der Sterilitatstherapie entwickelt. Jahrlich werden in Deutschland 78.000 IVF-Behandlungszyklen durchgefuhrt mit einer durchschnittlichen Geburtenrate pro Embryotransfer von etwa 20 %. Die kumulative Geburtenrate nach 3 Behandlungszyklen liegt bei uber 50 %. Das medizinische Hauptproblem bei der IVF ist die hohe Rate an Mehrlingsschwangerschaften (von uber 20 %) mit den damit einhergehenden erhohten Risiken fur die Mutter (z. B. bei einer Praeklampsie) und Kinder (erhohte Fruhgeburtlichkeitsrate, z. B. Unreife der Lunge, zerebrale Probleme). Auch bei Einlingsschwangerschaften werden IVF-Kinder haufiger zu klein und zu fruh geboren. Daher ist eine sorgsame Aufklarung der Paare vor der Behandlung erforderlich. Neue Labormethoden tragen zur Erhohung der IVF-/ICSI-Erfolgsrate bei. Die Kryokonservierungstechnik der Vitrifizierung erlaubt es, Eizellen, Vorkernstadien und Embryonen einzufrieren, wenn diese im akuten Behandlungszyklus nicht benotigt werden. Die kontinuierliche Beobachtung der Embryonen mit Zeitrafferaufnahmen (Time-Laps-Imaging) tragt dazu bei, entwicklungsfahige Embryonen leichter zu identifizieren. Die aktuellen Regelungen im Embryonenschutzgesetz (ESchG) sind ein wesentliches Problem: So bleibt unklar, wie viele befruchtete Eizellen kultiviert werden durfen, um zum Transfer von 1 bis 3 Embryonen zu gelangen. Auch das Verbot der Eizellspende und der Leihmutterschaft erscheint den Autoren aus medizinischer, psychologischer und ethischer Sicht nicht nachvollziehbar. Die Kostenerstattung fur IVF/ICSI wird in Deutschland bei gesetzlich versicherten Patienten – anders als im Ausland – restriktiv gehandhabt: Bei Ehepaaren werden grundsatzlich nur 3 Behandlungsversuche zur Halfte erstattet, nicht verheiratete Paare erhalten uberhaupt keine Kostenerstattung.
- Published
- 2013
20. Soziokulturelle Aspekte und Frauengesundheit
- Author
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W. Küpker, H. Kentenich, and M. David
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Gynecology ,medicine.medical_specialty ,Reproductive Medicine ,business.industry ,Endocrinology, Diabetes and Metabolism ,Pediatrics, Perinatology and Child Health ,Reproductive medicine ,medicine ,Obstetrics and Gynecology ,business - Published
- 2017
21. Cryoconservation of Oocytes in a Patient with Breast Cancer and Intrauterine Early Pregnancy
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A. Tandler-Schneider, G. Stief, A. Siemann, M Werling, and H. Kentenich
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Pregnancy test ,medicine.medical_specialty ,Pregnancy ,Aromatase inhibitor ,business.industry ,medicine.drug_class ,media_common.quotation_subject ,Letrozole ,Obstetrics and Gynecology ,Stimulation ,medicine.disease ,Triptorelin ,Article ,Andrology ,Endocrinology ,Internal medicine ,Maternity and Midwifery ,Medicine ,business ,Ovulation ,Menstrual cycle ,media_common ,medicine.drug - Abstract
Case Report: A 38-year-old patient newly diagnosed with invasive ductal breast cancer wished to cryoconserve her unfertilised oocytes. Stimulation was started on the 26th day of her menstrual cycle with daily administration of 300 IE hMG s. c. and a GnRH antagonist (cetrorelix 0.25 mg s. c.). The patient additionally received an aromatase inhibitor during the first 5 days of stimulation (letrozole 5 mg p. o.). Induction of ovulation occurred on the 11th day of stimulation with hCG (10 000 IE s. c.) and a GnRH agonist (triptorelin 0.2 mg s. c.). Seventeen oocytes were retrieved during follicle puncture and 11 were cryopreserved. Despite the administration of cetrotide (a GnRH antagonist) no luteolysis occurred during stimulation. A pregnancy test was therefore done on the 11th day of stimulation and the result was positive (β-HCG 3493 mIU/ml). Sonography showed an intrauterine pregnancy. The patient was in gestational week 5 + 0. The aspirated oocytes mostly showed a normal morphology (metaphase II) despite high progesterone levels during stimulation. The patient decided to terminate the pregnancy before starting adjuvant chemotherapy. Conclusion: We describe the case of a patient who underwent stimulation for cryopreservation of oocytes during a spontaneous pregnancy conceived in the same cycle just before starting stimulation. Stimulation was done over a short period using a combination of a GnRH antagonist and an aromatase inhibitor to ensure the lowest possible estradiol levels. The quality of the oocytes does not appear to have been negatively affected by the high progesterone levels of early pregnancy.
- Published
- 2012
22. NICE-Leitlinie zur Diagnostik und Therapie von Fertilitätsstörungen
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H. Kentenich
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Gynecology ,medicine.medical_specialty ,Reproductive Medicine ,business.industry ,Endocrinology, Diabetes and Metabolism ,Pediatrics, Perinatology and Child Health ,Obstetrics and Gynecology ,Medicine ,business - Abstract
Einer Frau im reproduktiven Alter, die nach einem Jahr mit ungeschutztem vaginalem Geschlechtsverkehr keine Schwangerschaft erreicht hat, sollte, soweit die Ursache der Infertilitat nicht bekannt ist, eine weiterfuhrende klinische Beurteilung und Untersuchung angeboten werden [neu 2012; 1.2.13.4]. Eine fruhere Uberweisung an einen Spezialisten zur Beratung uber die Moglichkeiten, eine Schwangerschaft zu erreichen, weitere Untersuchungen und eine angemessene Behandlung sollte angeboten werden, wenn: die Frau ≥36 Jahre alt ist; eine Ursache der Infertilitat bekannt ist oder sich pradisponierende Faktoren fur eine Infertilitat in der Anamnese finden [neu 2012; 1.2.13.7]. Kommentar Klare Worte: Wenn eine Frau mindestens 36 Jahre alt ist, sollte sie nicht ein Jahr abwarten, um mit der Sterilitatsdiagnostik zu beginnen, sondern fruher zur Diagnostik kommen. Sollte ein Grund fur eine vermutete Infertilitat vorliegen, sind selbstverstandlich fruhere Untersuchungen angezeigt.
- Published
- 2012
23. The State of Reproductive Medicine in Germany
- Author
-
Klaus Diedrich, H. Kentenich, and T. Strowitzki
- Subjects
Gynecology ,medicine.medical_specialty ,Economic growth ,business.industry ,Scientific progress ,media_common.quotation_subject ,Reproductive medicine ,Obstetrics and Gynecology ,Reproductive technology ,language.human_language ,Patient care ,German ,State (polity) ,Maternity and Midwifery ,language ,medicine ,Line of communication ,business ,Scientific activity ,media_common - Abstract
In the 1960s and 70s, Germany played a leading role in the field of gynaecological endocrinology, which was reflected by the scientific activity of German universities during this period. More recently, however, a dramatic change occurred, resulting in a decreasing number of publications in this field. This has undoubtedly contributed to the marginal scientific position of Germany in gynaecological endocrinology today. This change is reflected by the decreasing number of university centres carrying out active scientific research in the fields of gynaecological endocrinology, reproductive medicine and andrology. Universities now lack mid- and upper-level faculty staff, as interesting and senior positions in the field of reproductive medicine, andrology and reproductive medicine no longer exist. Moreover, in 1991 the German embryo protection law came into force, which severely curtailed scientific research and blocked scientific efforts in this area. German scientists and, of course, childless couples were cut off from scientific advances, e.g. the possibility of single embryo transfer. Germany's scientific position in the fields of gynaecological endocrinology, reproductive medicine and andrology needs to be strengthened. The creation of appropriate structures in German universities is therefore necessary. These would include important cooperations with private medical practices, which currently account for about 75 % of patient care. The lines of communication between the groups representing reproductive medicine in Germany need to be greatly improved. Moreover, we suggest that an important step would be the development of a general human embryology and fertilisation act which would allow German couples to benefit from the global advances in the field of reproductive technology. Germany must stop its policy of scientific obstruction and permit scientific progress in this field in German universities.Deutschland hat in den 1960er- und 70er-Jahren weltweit im Bereich der gynäkologischen Endokrinologie eine führende Rolle gespielt. Dies spiegelt sich auch wider in den wissenschaftlichen Aktivitäten im Bereich der deutschen Universitäten. In den letzten Jahren hat sich dies dramatisch geändert. Es zeigt sich in einem abnehmenden publizierten Forschungsoutput, in dem Deutschland im Gegensatz zu früher eine Randstellung einnimmt. Dies geht einher mit einer abnehmenden Präsenz der Bereiche Endokrinologie, Reproduktionsmedizin und Andrologie an den Universitäten. Es ist zu einem Verlust des akademischen Ober- und Mittelbaus an den Universitäten gekommen, da an den Universitäten keine entsprechenden zukunftsträchtigen Positionen und Perspektiven geboten werden konnten. Darüber hinaus wirkt auch das seit 1991 bestehende Embryonenschutzgesetz in vielen Bereichen der Reproduktionsmedizin eher forschungshemmend. Dies hat dazu geführt, dass die deutschen Forscher und damit auch die kinderlosen Paare am Fortschritt der Reproduktionsmedizin, wie z. B. beim Single Embryo Transfer, nicht teilhaben können. Der Forschungsstandort Deutschland im Bereich der Reproduktionsmedizin, Endokrinologie und Andrologie muss gestärkt werden. Dazu müssen an den Universitäten entsprechende Strukturen geschaffen werden, und es muss die Vernetzung zwischen den niedergelassenen Praxen, in denen 75 % der Patientenbehandlungen im Bereich der Reproduktionsmedizin stattfindet, und den Universitäten gefördert werden. Es muss deshalb der Kontakt zwischen den verschiedenen Gruppierungen, die in Deutschland die Reproduktionsmedizin vertreten, verbessert werden. Darüber hinaus muss ein Fortpflanzungsmedizingesetz erarbeitet werden, das es ermöglicht, auch die deutschen Paare an den Fortschritten der Reproduktionsmedizin teilhaben zu lassen. Es kann nicht sein, dass Deutschland auf einer einsamen Insel lebt und um uns herum der Fortschritt in diesem wichtigen Bereich der Medizin blüht.
- Published
- 2012
24. POSTER VIEWING SESSION - PSYCHOLOGY AND COUNSELLING
- Author
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I. Daly, C. Lampic, A. Skoog Svanberg, G. Sydsjo, N. Fryk, O. Shyshak, Z. Donarelli, G. Lo Coco, S. Gullo, A. Marino, A. Volpes, A. Allegra, L. Hinton, J. J. Kurinczuk, S. Ziebland, Y. Frederiksen, R. Zachariae, L. Schmidt, H. J. Ingerslev, L. Vercammen, D. Stoop, M. De Vos, N. P. Polyzos, J. Nekkebroeck, P. Devroey, S. Graham, V. Jadva, M. Morrissette, S. Golombok, J. Hamilton, H. Behan, R. Venables, B. Maher, C. Moorhead, C. Hughes, E. Mocanu, J. M. J. Smeenk, C. M. Verhaak, N. Valladolid, J. A. Guijarro, M. Brod, M. P. H. Simone Crespi, P. Hein Fennema, L. Blake, J. Readings, P. Casey, C. Jordan, P. Broderick, C. Winter, F. Belva, M. Bondulle, U. Van den Broeck, M. Vandermeeren, D. Vanderschueren, P. Enzlin, K. Demyttenaere, T. M. D'Hooghe, C. Harrison, L. Bunting, I. Tsibulsky, J. Boivin, A. Overbeek, M. H. van den Berg, L. Louwe, C. Hilders, M. A. Veening, C. B. Lambalk, A. M. Stiggelbout, E. van Dulmen-den Broeder, M. M. Ter Kuile, A. Indekeu, T. D'Hooghe, P. De Sutter, B. Vanderschot, M. Welkenhuysen, P. Rober, H. Colpin, P. Riedel, I. T. Baeckert-Sifedine, V. Iversen C., O. Ludwig, S. Ludwig, H. Kentenich, S. Brandstrom, A. L. Geijervall, J. Gudmundsson, P. O. Karlstrom, N. G. Solensten, A. J. C. M. Van Dongen, J. A. M. Kremer, P. H. J. Van Sluisveld, W. L. D. M. Nelen, A. Galhardo, M. Cunha, J. Pinto-Gouveia, D. A. Huppelschoten, J. W. M. Aarts, I. W. H. van Empel, W. L. Nelen, H. Ockhuysen, A. Hoogen, N. S. Macklon, A. Aarts, P. van den Haak, W. Nelen, W. Tuil, M. Faber, J. Kremer, C. W. Bak, H. H. Seok, S. H. Song, S. W. Yoo, W. S. Lee, and T. K. Yoon
- Subjects
Gynecology ,Coping (psychology) ,medicine.medical_specialty ,Reproductive Medicine ,business.industry ,Rehabilitation ,Recurrent miscarriage ,Obstetrics and Gynecology ,Medicine ,business ,medicine.disease ,Bracing ,Clinical psychology - Published
- 2011
25. Positionspapier – Stand der Reproduktionsmedizin in Deutschland
- Author
-
T. Strowitzki, H. Kentenich, and Klaus Diedrich
- Subjects
Gynecology ,Economic growth ,medicine.medical_specialty ,business.industry ,Scientific progress ,Reproductive medicine ,Obstetrics and Gynecology ,Reproductive technology ,language.human_language ,Patient care ,German ,Maternity and Midwifery ,language ,Medicine ,Line of communication ,business ,Scientific activity - Abstract
In the 1960s and '70s, Gemany played a leading role in the field of gynaecological endocrinology, which was reflected by the scientific activity of German universities during this period. More recently, however, a dramatic change occurred, resulting in a decreasing number of publications in this field. This has undoubtedly contributed to the marginal scientific position of Germany in this gynaecological endocrinology today. This change is reflected by the decreasing number of university centres carrying out active scientific research in the fields of gynaecological endocrinology, reproductive medicine and andrology. Universities now lack mid- and upper-level faculty staff, as interesting and senior positions in the field of reproductive medicine, andrology and reproductive medicine no longer exist. Moreover, in 1991 the German embryo protection law came into force, which severely curtailed scientific research and blocked scientific efforts in this area. German scientists and, of course, childless couples were cut off from scientific advances, e. g. the possibility of “single embryo transfer”. Germany's scientific position in the fields of gynaecological endocrinology, reproductive medicine and andrology needs to be strengthened. The creation of appropriate structures in German universities is therefore necessary. These would include important cooperations with private medical practices, which currently account for about 75 % of patient care. The lines of communication between the groups representing reproductive medicine in Germany need to be greatly improved. Moreover, we suggest that an important step would be the development of a general human embryology and fertilisation act which would allow German couples to benefit from the global advances in the field of reproductive technology. Germany must stop its policy of scientific obstruction and permit scientific progress in this field in German universities.
- Published
- 2010
26. Einstellungen von Kinderwunschpaaren zum Umgang mit kryokonservierten Embryonen und Eizellen im Vorkernstadium – Übersichtsarbeit
- Author
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C. Albani, U. Montag, H. Kentenich, C. Sibold, A. Dinkel, R. Armbrust, Ada Borkenhagen, and H. Berth
- Subjects
Infertility ,Gynecology ,medicine.medical_specialty ,Pregnancy ,business.industry ,Obstetrics ,media_common.quotation_subject ,Embryo donation ,Obstetrics and Gynecology ,Fertility ,medicine.disease ,Fertility clinic ,Cryopreservation ,Embryo cryopreservation ,Donation ,embryonic structures ,Maternity and Midwifery ,Medicine ,business ,media_common - Abstract
Two new treatments for couples experiencing infertility, cryopreservation of pronuclear stages which is a routine practice in German fertility clinics, and cryopreservation of embryos, which is mostly done in foreign countries, give these couples a chance to make additional attempts at pregnancy. The aim of this paper is to provide an overview of studies on acceptability, attitudes, concerns and the decision-making process of infertile couples with regard to their cryopreserved embryos and cryopreserved pronuclear stages. A total of 24 studies on this topic were found. All of the studies were published in the period between 2000 and September 2008. Most of the studies involved questioning infertile couples about their attitudes towards their cryopreserved embryos, while studies dealing with the attitudes of infertile couples towards cryopreserved pronucleates were rare. The analysis showed that the majority of infertile couples use their cryopreserved embryos for their own fertility treatment. In addition, many infertile couples choose to discard their cryopreserved embryos. This is due to several main factors: they have completed their families, they have undergone an unsuccessful IVF-treatment, or there are other personal circumstances that preclude these infertile couples from using their cryopreserved human embryos. Many other factors can influence a couple's decision. Thus, it is clear that the attitudes of infertile couples towards their cryopreserved embryos vary widely. Despite the great acceptance of infertile couples of the concept of embryo donation to other infertile couples or for research purposes, the donation option is fairly uncommon. While such a decision-making process is driven mainly by altruistic motives, making such a decision about the fate of surplus frozen embryos has been reported to be emotionally distressing.
- Published
- 2009
27. Intraperitoneal immune cell status in infertile women with and without endometriosis
- Author
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F. Siedentopf, H. Kentenich, Petra C. Arck, Sandra M. Blois, Nadja Tariverdian, Burghard F. Klapp, and Mirjam Rücke
- Subjects
Adult ,Infertility ,Pathology ,medicine.medical_specialty ,Immunology ,Endometriosis ,Cell Separation ,Pelvic Pain ,Natural killer cell ,Immune system ,Antigens, CD ,Leukocytes ,medicine ,Ascitic Fluid ,Humans ,Immunology and Allergy ,Cell Lineage ,IL-2 receptor ,Cell Proliferation ,business.industry ,Peritoneal fluid ,Pelvic pain ,Obstetrics and Gynecology ,Cell Differentiation ,Dendritic Cells ,HLA-DR Antigens ,Dendritic cell ,Flow Cytometry ,medicine.disease ,medicine.anatomical_structure ,Reproductive Medicine ,Disease Progression ,Female ,Laparoscopy ,medicine.symptom ,business - Abstract
Endometriosis is a widespread chronic disease characterized by endometrial tissue located outside the uterine cavity. Clinical signs are chronic pelvic pain and infertility. Emerging evidence indicates that the immune system is profoundly involved in the onset and/or progression of endometriosis. However, mechanistic pathways have not yet been conclusively specified. In this study, women undergoing diagnostic laparoscopy due to infertility were recruited, and classified as early-stage endometriosis (n=30), advanced-stage endometriosis (n=8) or no endometriosis (n=31). The frequency and phenotype of leukocytes were evaluated in peritoneal fluid. While the frequency of lymphocytes was not significantly different, neutrophils were increased in endometriosis. Flow cytometry analysis revealed an increased frequency of CD4(+) and CD8(+) cells in peritoneal fluid of endometriosis patients. In addition, the frequency of CD4(+)CD25(+)CD103(+) cells and lineage(-)HLA-DR(+)CD11c(+)CD123(+) dendritic cells was decreased in peritoneal fluid in endometriosis, whereas CD57(+) NK cells and CD8(+)CD28(-) T suppressor cells remained largely unaltered. We conclude that therapeutic approaches in endometriosis might focus on peritoneal leukocytes as a target or surveillance marker; however, immune alterations in peritoneal fluid are subtle and their analysis will require highly standardized and harmonized protocols.
- Published
- 2009
28. Quality of care of VLBW neonates: relationship between unit volume and outcome is different between metropolitan and rural regions
- Author
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M Abou-Dakn, D Elling, B Distler, M Untch, K Schunk, G Laske, F Jochum, A V.Moers, V Hesse, W Mendling, B Schmidt, M Dombrowsky, H Kentenich, and T Grüning
- Subjects
Male ,Rural Population ,Pediatrics ,medicine.medical_specialty ,Neonatal intensive care unit ,Urban Population ,Birth weight ,Unit volume ,Unit (housing) ,Germany ,Intensive Care Units, Neonatal ,medicine ,Humans ,Infant, Very Low Birth Weight ,Quality of care ,Quality of Health Care ,Retrospective Studies ,business.industry ,Infant Welfare ,Infant, Newborn ,General Medicine ,Metropolitan area ,humanities ,Low birth weight ,Pediatrics, Perinatology and Child Health ,Female ,Rural area ,medicine.symptom ,business ,Demography - Abstract
Background: Recent studies from predominantly rural areas in Germany show that neonatal outcome of very low birth weight (VLBW) neonates is (on average) inferior with lower NICU (neonatal intensive care unit) volume. However, there are no data available which show that study results of one specific region can be transferred to other areas with possibly different medical infrastructure and needs. Aim: It was investigated whether a systematic difference of treatment quality between smaller (1000–2000 births/year; ≤20 neonatal beds) vs. larger neonatal centres in Berlin (>3000 births/year; >20 neonatal beds) exists. Furthermore, the results are compared to data from a rural region in order to discuss transferability between regions. Methods: Retrospectively, completely, and for the first time, the data of all centres which treat VLBW neonates (≤1500 g birth weight) in the city-state of Berlin, Germany, from the years 2003/2004 were reviewed. Results: Our study showed no difference in the treatment quality of smaller vs. larger neonatal units in Berlin. This result differs from those of a study in Baden-Wurttemberg, a predominately rural state, with different medical infrastructure than Berlin. Conclusion: The present study suggests that regional investigations on the infrastructure vs. treatment outcome are not transferable between areas. Patient volume/unit appears inadequate for predicting the future treatment quality of neonatal departments. Direct quality indicators are stable for the assessed departments and should be preferably used to organize medical infrastructure.
- Published
- 2008
29. Body Image and the Decision-Making Process in Breast Cancer Patients
- Author
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Friederike Siedentopf, M. Nagel, H. Kentenich, and K. Weidner
- Subjects
Coping (psychology) ,medicine.medical_specialty ,business.industry ,Breast surgery ,medicine.medical_treatment ,General surgery ,Significant difference ,Case-control study ,Obstetrics and Gynecology ,medicine.disease ,Surgery ,Breast cancer ,Maternity and Midwifery ,Medicine ,Decision-making ,Time point ,business ,Mastectomy - Abstract
PURPOSE: Breast cancer in combination with consecutive surgery of the breast may have numerous psychological consequences. The decision-making process for the operative approach is determined by the preoperative findings and also depends to a large extent on the patient's wishes. MATERIAL AND METHODS: Between January 2001 and January 2004, 60 breast cancer patients agreed to participate in this case control study. Interviews were carried out in the early postoperative stage. To evaluate the patients' body image we used a questionnaire based on the patient's assessment of her own body (FBeK). RESULTS: The mean scores of the FBeK scales for breast cancer patients were higher than those of healthy controls. A comparison of the scores, correlated to the operative intervention, showed a significant difference for scale 4 (p = 0.002). Patients after mastectomy were more satisfied than patients having undergone conservative breast surgery. Being able to personally influence the decision-making process was very important for 68.3 % of the patients (n = 41). The decision-making process was of greater importance for women with a mastectomy than for women with a breast-conserving therapy (p = 0.005). Most patients confirmed the assumption that their decision was shared with the doctor. DISCUSSION: Early postoperative reactions to breast cancer are influenced by the coping process and defence mechanisms. Problems with body image may be relevant only at a later time point. Therefore the oncological follow-up is highly important for patients and there should be enough time to discuss body image issues repeatedly during the course of disease.
- Published
- 2008
30. Diagnostik und Behandlung HIV-betroffener Paare mit Kinderwunsch
- Author
-
A. Tandler-Schneider, U. Sonnenberg-Schwan, and H. Kentenich
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Transmission rate ,Human immunodeficiency virus (HIV) ,Obstetrics and Gynecology ,Normal population ,Treatment options ,medicine.disease_cause ,Insemination ,Reproductive Medicine ,Reduced sperm motility ,Male patient ,Pediatrics, Perinatology and Child Health ,medicine ,In patient ,business - Abstract
In Deutschland sind ca. 56.000 Menschen mit HIV infiziert, davon etwa 19 % Frauen. 75 % der Patienten sind zwischen 20 und 40 Jahre alt. Der Kinderwunsch bei HIV-Infizierten entspricht der Normalbevolkerung. Die Moglichkeiten des Vorgehens bei HIV-Infektion der Frau umfassen die Selbstinsemination - und bei eingeschrankten reproduktionsmedizinischen Faktoren - samtliche Methoden der modernen Reproduktionsmedizin inkl. In-vitro-Fertilisation (IVF) und Mikroinjektion (ICSI). Uber das Restrisiko einer materno-fetalen Transmission muss ausfuhrlich aufgeklart werden. Die Behandlung sollte lediglich in speziellen Kinderwunsch-Zentren mit groser Erfahrung stattfinden. Bei HIV-Infektion des Mannes ist nach wie vor die Insemination der Goldstandard. Noch beobachtet werden mussen die Ergebnisse der Praexpositionsprophylaxe (PrEP) mit anschliesend geplantem Geschlechtsverkehr, die lediglich bei Normo- zoospermie und Viruslast unter der Nachweisgrenze in Frage kommt. Bei eingeschrankter Motilitat gibt es keine Kontraindikation gegen die In-vitro-Fertilisation (IVF) und Mikroinjektion (ICSI). Bei HIV-Konkordanz kann nach umfassender Beratung nur im Einzelfall uber eine reproduktionsmedizinische Unterstutzung entschieden werden. Schlusselworter: HIV-Diskordanz, AIDS, Kinderwunsch, IVF, ICSI, Insemination, Schwangerschaft Recommendations for Diagnostics and Treatment of HIV-discordant Couples Who are Trying to Conceive. In Germany 56,000 people are HIV-positive, about 19 % of these are females. 75 % of the patients are between 20 and 40 years old. The desire to have children is the same as in the normal population. Treatment options for HIV-positive women are self-insemination, in-vitro- fertilisation (IVF) and microinjection (ICSI). Although vertical transmission rate is below 1 % patients have to be prepared for the risk of materno-fetal-transmission. The treatment should only be performed in centres with experience treating those patients. If the male patient is HIV-infected, homologues insemination is still the gold standard. Two other options are possible: I. Pre- exposition-prophylaxis (PrEP) with timed intercourse should be done only in patients with normozoospermia and an undetectable seminal viral load. II Patients with reduced sperm motility should be offered IVF and ICSI treatment. The treatment options for HIV-concordant couples should be considered individually. J Reproduktionsmed Endokrinol 2008; 5 (4): 186-92.
- Published
- 2008
31. Erfolgreiche assistierte Reproduktion bei einer HIV-infizierten Patientin - ethische und medizinische Aspekte
- Author
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G. Stief, A. Tandler-Schneider, A. Siemann, O. Buurman, P. Kölm, and H. Kentenich
- Subjects
Gynecology ,Infertility ,medicine.medical_specialty ,Pregnancy ,In vitro fertilisation ,business.industry ,Obstetrics ,medicine.medical_treatment ,media_common.quotation_subject ,Reproductive medicine ,Obstetrics and Gynecology ,Fertility ,medicine.disease ,Male infertility ,Quality of life ,Maternity and Midwifery ,medicine ,business ,Psychosocial ,media_common - Abstract
The development of highly effective treatment regimens for patients with HIV infection over the last decades has led to prolonged survival times and an improvement of quality of life. Furthermore, the current management of the treatment of pregnant HIV-infected women with an elective Cesarean section, a highly active antiretroviral therapy of mother and child and the renunciation of breast-feeding has resulted in a reduction of the risk of perinatal transmission to < 2 %. Therefore, more and more women with HIV infection wish to become pregnant. There is a strong ethical debate about the management of fertility problems and the use of assisted reproductive medicine in these women. In this case report we describe the treatment of sterility of a HIV discordant couple with HIV infection of the woman and male infertility because of an oligo-astheno-terato-zoospermia. Treatment of infertility was carried out at the Fertility Center Berlin at the hospital DRK Klinikum Westend by in vitro fertilisation. Beforehand, we consulted with the responsible ethics committee. Ethical, moral, psychosocial and legal aspects were discussed at length. The care of the couple occurred in cooperation with experts in the field of HIV infection. It included treatment of mother and child according to the general clinical standards. In February 2005 a healthy child without HIV infection was born.
- Published
- 2007
32. Intrapartum transfer from a birth centre to a hospital – reasons, procedures, and consequences1
- Author
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G. Berg, I. Werth, H Kentenich, A. Mansfeld, Matthias David, and J. Pachaly
- Subjects
Pregnancy ,medicine.medical_specialty ,Delivery rooms ,Obstetrics ,Birth centre ,business.industry ,Obstetrics and Gynecology ,Perinatal outcome ,General Medicine ,medicine.disease ,medicine ,Childbirth ,business ,Patient transfer - Abstract
Background. Investigation of the reasons for the transfer of women from a birth centre to a hospital in the course of childbirth as well as modalities and effects. Patients and method. In the prospective investigation from September 1, 1999 to August 31, 2001, information was collected for all women in Berlin and Bavaria transferred intrapartum from a birth centre to a hospital concerning the reason for the transfer, stage of delivery at the start of transfer, details of the transport, accompaniment, state of mother and medical diagnosis on arrival at the hospital, further progress of delivery, and the condition of the baby postnatum. Comparison groups were formed by all birth centre deliveries in Berlin and Bavaria 1999/2000 (n=3060) and hospital deliveries in Berlin and Bavaria 1998/1999 (selected data, n = 89 696 births). Results. Three hundred and sixty transfer cases could be evaluated, and a majority of these were nulliparous. The most frequent reasons for transfer were prior premature rupture of me...
- Published
- 2006
33. New challenges in medical education. The psychosomatic training program for gynecologists in Germany
- Author
-
F. Siedentopf, G Danzer, H Kentenich, and Martina Rauchfuss
- Subjects
medicine.medical_specialty ,MEDLINE ,Education ,Nursing ,Psychosomatic Medicine ,Germany ,Humans ,Psychology ,Medicine ,Curriculum ,Schools, Medical ,Physician-Patient Relations ,Medical education ,Education, Medical ,business.industry ,Psychosomatics ,Public health ,Obstetrics and Gynecology ,Psychophysiologic Disorders ,Psychiatry and Mental health ,Clinical Psychology ,Occupational training ,Reproductive Medicine ,Gynecology ,Patient Care ,Training program ,business ,Educational program - Published
- 2005
34. Einstellungen und Akzeptanz von Kinderwunsch- und Risikopatienten zur Präimplantationsdiagnostik, dem Embryonenscreening und der präkonzeptionellen Geschlechtswahl
- Author
-
Y. Stöbel-Richter, Ada Borkenhagen, E. Brähler, U. Meister, Carolyn Finck, and H. Kentenich
- Subjects
Gynecology ,Infertility ,medicine.medical_specialty ,business.industry ,Public health ,MEDLINE ,Obstetrics and Gynecology ,respiratory system ,Preimplantation genetic diagnosis ,medicine.disease ,Family medicine ,Maternity and Midwifery ,User group ,Eugenics ,medicine ,lipids (amino acids, peptides, and proteins) ,Risk factor ,Sex selection ,business - Abstract
The literature describing the views of potential users of preimplantation genetic diagnosis (PGD) is small. Overall, the vast majority of previous studies found that PGD and embryo screening are a highly acceptable technology for both consumer groups - couples at high risk and infertile couples. Aim of this paper is to give an overview of studies on acceptability, attitudes, concerns and expectations towards PGD, embryo selection and preimplantation diagnosis for social sexing. After a bibliometrical research in Medline, Pubmed and Psyndex and specialist German journals 12 studies were analysed which were published between 1990 and 2003. The analysis showed that the majority of patients expressed an overwhelmingly positive attitude towards PGD and expressed few concerns about the extension of the technology to testing for non-disease states such as sex. But for both user groups there were different factors which had a significant impact on the choice of PGD as a prospective reproductive option: reproductive history, especially the duration of infertility, is the main factor for infertile couples which determines the choice of PGD, whereas for couples at high risk previous experiences with PGD and having an affected child have most impact on the choice of PGD as a future reproductive treatment. However, despite its benefits PGD and embryo screening are associated with many ethical issues including concerns about the ethics of embryo manipulation and, especially, the issue of eugenics. The analysis shows that there is little demand for sex selection services in Western societies.
- Published
- 2005
35. Geburtsort Geburtshaus - Perinataldaten im Vergleich zu Klinikentbindungen in Bayern und Berlin
- Author
-
J. Pachaly, Matthias David, K. Vetter, and H Kentenich
- Subjects
Episiotomy ,medicine.medical_specialty ,Pregnancy ,Obstetrics ,business.industry ,medicine.medical_treatment ,Obstetrics and Gynecology ,Retrospective cohort study ,medicine.disease ,Delivery mode ,Infant mortality ,Maternity and Midwifery ,Pediatrics, Perinatology and Child Health ,Perineal tear ,medicine ,business ,Parity (mathematics) ,Socioeconomic status - Abstract
Question The purpose of this investigation is to find any differences between important maternal and infantile perinatal data from a clinic and a birth center group. Is the perinatal and/or maternal mortality in the birth center group higher? What influence do different socioeconomic factors have on the clinic group? Patients and methods We have carried out a retrospective comparison of the obstetric parameters from all birth center deliveries in the states Berlin and Bavaria for the years 1999 and 2000 (n = 3,060) and the perinatal data investigations of selected clinical groups of both states (n = 55,875). Results Objective parameters in both groups regarding week of potation at delivery, parity, age of pregnant women, infantile measures, primi- and multiparae and Apgar scales were comparable. There are significant differences in the delivery mode (spontaneous deliveries: birth centers > clinics; operative deliveries: birth centers clinics), in the episiotomy and perineal tear rate (birth centers clinics). The perinatal and maternal mortality in the groups were similar. Within the clinical group the socioeconomic status and a background of immigration had no significant influence on the perinatal data. Conclusion The retrospective data show that the more "invasive" clinical obstetrics leads to a similar postnatal condition of the neonates in comparison to the birth house group. Further comparative studies over several years are necessary to make statements about the occurrence of rare risks and maternal mortality in the free-standing birth center groups.
- Published
- 2004
36. Der chronische Unterbauchschmerz der Frau
- Author
-
H. Kentenich and F. Siedentopf
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,Obstetrics and Gynecology ,Medicine ,business - Abstract
In diesem Ubersichtsbeitrag werden die pathophysiologischen Mechanismen des chronischen Unterbauchschmerzes der Frau erlautert. Es wird ein Uberblick uber die historische Entwicklung des Krankheitsverstandnisses gegeben. Die psychosomatischen Zusammenhange und wichtigen organischen Ursachen dieses letztlich noch sehr unklaren und vielschichtigen Krankheitsbildes werden diskutiert. Auf einen grosen Teil der betroffenen Frauen treffen die Diagnosekriterien der somatoformen Schmerzstorung (ICD-10: F45.4) zu. Die therapeutischen Moglichkeiten, welche zum Grosteil auf Erfahrungsmedizin basieren, werden dargestellt. Fur die Auseinandersetzung mit dem chronischen Unterbauchschmerz der Frau sind psychosomatische Kenntnisse von groser Bedeutung und tragen zu einer zufrieden stellenden Arzt/Arztin-Patientinnen-Beziehung bei.
- Published
- 2003
37. Erwartungen und Zufriedenheit deutscher und türkischsprachiger Patientinnen im Krankenhaus - eine vergleichende Befragung in einer Berliner Frauenklinik
- Author
-
H. Kentenich, M. David, and Theda Borde
- Subjects
Gerontology ,medicine.medical_specialty ,business.industry ,Turkish ,media_common.quotation_subject ,Public health ,Immigration ,Public Health, Environmental and Occupational Health ,language.human_language ,German ,Patient satisfaction ,Family medicine ,Cultural diversity ,Health care ,medicine ,language ,business ,Psychosocial ,media_common - Abstract
Although cultural diversity in German metropolises is rapidly increasing, immigrant patients are rarely included in clinical studies. Specific needs of these patients are hardly known. In a comparative study, 320 German and 262 Turkish immigrant women, respectively, were interviewed via bilingual questionnaires to assess their expectations from and their satisfaction with provided health care services. While no significant differences could be found between basic expectations concerning anticipated health care standards between the two study groups, women of Turkish origin were markedly less satisfied with provided health care services. High expectations of immigrant patients towards information during their stay, communication with doctors and nurses and psychosocial services were only insufficiently met. The results indicate that specific health-relevant factors, such as social and educational status, knowledge of German language and health knowledge together with structural deficiencies of a health care service that is not prepared to correspond properly to patients of different social and cultural backgrounds, have a negative impact on patient satisfaction for migrant women.
- Published
- 2002
38. Untersuchungen auf Toxoplasma-Infektionen in der Sterilitätsbehandlung
- Author
-
K. Schleyer, G. Stoffels, H. Kentenich, and K. Janitschke
- Subjects
medicine.medical_specialty ,biology ,business.industry ,Obstetrics ,Sterility ,Obstetrics and Gynecology ,Acute infection ,chemical and pharmacologic phenomena ,Igg avidity ,medicine.disease ,Toxoplasmosis ,Serology ,parasitic diseases ,Maternity and Midwifery ,Immunology ,biology.protein ,Medicine ,Avidity ,Antibody ,business ,Low avidity - Abstract
Purpose: This study will try to give recommendations for an extended serological screening for women with Toxoplasma antibodies and the optimal time frame for conception during sterility treatment. Material and Methods: 964 women consulting an infertility clinic were serologically tested for Toxoplasma antibodies. Patients with Toxoplasma-IgG-antibodies submitted to further testing for Toxoplasma-lgM-antibodies (VIDAS TOXO IgM/bio Merieux). Positive sera for IgM were tested in IgG-Avidity (VIDAS TOXO IgG AVIDITY). Results: Out of all 964 women, 472 (49%) patients were tested positive for Toxoplasma-IgG-antibodies and were further screened for IgM-antibodies, 32 of those 472 women (6.78%) showed IgM-antibodies. Of those 32 women with IgM-positive-antibodies 29 were tested for IgG-Avidity. Low avidity was detected in 7 (24.1 %) of 29 women with IgM-antibodies tested for avidity, which may indicate an acute infection. Conclusion: Screening for Toxoplasma infection should be a mandatory part before sterility treatment. An acute primary infection is a risk for the woman as well as the unborn child. Especially for children conceived through assisted reproduction the possibility of a vertical infection must be avoided. Screening for IgG- and IgM-antibodies can be completed with a further testing for IgG-Avidity. The suggested three-step screening procedure (IgG, IgM and IgG-Avidity) can help to minimize the risk of a prenatal Toxoplasma infection.
- Published
- 2002
39. Sexuality, Self-Esteem and Partnership Quality in Infertile Women and Men
- Author
-
H. Kentenich, T. Strowitzki, Bettina Toth, Tewes Wischmann, K. Schilling, K. Wohlfarth, and Sabine Rösner
- Subjects
Infertility ,Gynecology ,medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Self-esteem ,Alternative medicine ,Obstetrics and Gynecology ,Fertility ,Human sexuality ,Sexual relationship ,medicine.disease ,Article ,General partnership ,Maternity and Midwifery ,medicine ,Quality (business) ,business ,media_common ,Clinical psychology - Abstract
Introduction: Infertile couples often report quality-of-life impairments, especially in terms of sexuality, self-esteem and partnership quality. So far, there have been no systematic studies of the sex lives and behaviour of infertile women and men before and after the emergence of their mutual desire for a child. Materials and Methods: From February 2010 to August 2010 all couples starting treatment either at Heidelberg Universityʼs Womenʼs Hospital or at the Fertility Center Berlin were asked to fill out the Self-Esteem and Relationship Questionnaire (SEAR). A total of n = 158 women and n = 153 men participated in the study. Results: Decreasing tendencies were observable for both partners in the domains Sexual Relationship Satisfaction and Confidence and in the subscales Self-Esteem and Overall Relationship Satisfaction. There were especially clear indications of a loss of spontaneous sexuality during the experience of infertility. We were also able to establish that infertility has a negative impact on womenʼs self-esteem. Discussion: The results of this study indicate that SEAR can be used as a feasible instrument for identifying infertile women and men whose infertility has a negative effect on their relationship quality and/or sex lives.
- Published
- 2014
40. Integrated psychosomatic medicine in a gynecology and obstetrics department
- Author
-
M. Braun and H. Kentenich
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,Obstetrics and Gynecology ,business - Abstract
Die psychosomatische Sichtweise hat in viele gynakologische Praxen Eingang gefunden. In den Kliniken ist eine Integration aber von nicht leicht zu bewaltigenden strukturellen Veranderungen und personellen Voraussetzungen abhangig. Letztere konnen mit Einfuhrung der “psychosomatischen Grundversorgung”, die Bestandteil der Facharztausbildung ist, optimistisch eingeschatzt werden. Psychosomatik ist “Beziehungsmedizin”, eine tragfahige Arzt-Patient-Beziehung ist ihre essentielle Voraussetzung. Wie diese auch in der Klinik realisiert werden kann, ist Inhalt aktueller Strukturdiskussionen. Uber Teambildung auf den Stationen und Dezentralisierung von Entscheidungen, durch Erlangung psychosozialer Kompetenz moglichst vieler Mitarbeiter und die Uberwindung der Trennung von ambulanter und stationarer Behandlungart kann eine Wandlung von der traditionellen Frauenklinik in ein “Frauengesundheitszentrum” stattfinden, was den Anspruchen und Erwartungen der Frauen besser entsprechen kann.
- Published
- 2001
41. Present-day status of psychosomatic gynecology
- Author
-
M. Neises and H. Kentenich
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,Obstetrics and Gynecology ,Medicine ,business - Abstract
Die psychosomatische Frauenheilkunde konnte sich in den letzten Dekaden zunehmend etablieren, da die Beachtung des Psychischen sowohl von Professionellen der Frau zugeschrieben wird als auch von Frauen aktiv eingefordert wird. Betrachtet man die Krankheitsbilder der psychosomatischen Frauenheilkunde, wird die Bedeutung des Fachgebiets offensichtlich und die Bedeutung in der Arzt-Patientin-Beziehung mit Forderung an eine kommunikative Kompetenz unumganglich. Vor diesem Hintergrund konnte ein Weiterbildungscurriculum seit Anfang der 90er Jahre etabliert werden mit Angeboten von Theorieseminaren, Balint-Gruppen und Seminaren zur verbalen Intervention an inzwischen sechs Standorten in Deutschland. Fur die Zukunft bleibt zu fordern, dass die Forschungsaktivitaten eingebettet in ein klinisches Fach wie die Frauenheilkunde mehr Akzeptanz und finanzielle Forderung erfahren.
- Published
- 2001
42. Die Wechseljahre der Frau - Kenntnisse und Meinungen deutscher und türkischstämmiger Frauen im Vergleich
- Author
-
Th. Borde, Matthias David, and H. Kentenich
- Subjects
Cultural influence ,Turkish ,business.industry ,media_common.quotation_subject ,Normal phase ,Immigration ,Obstetrics and Gynecology ,medicine.disease ,language.human_language ,German ,Menopause ,language ,medicine ,business ,Demography ,media_common - Abstract
320 German and 262 Turkish immigrant patients of the gynaecological units of the Virchow Women's Clinic in Berlin were questioned, to compare their knowledge and opinion on menopause and possible cultural influence factors. The results showed that 70% of the migrant vs. 90% of the German women regarded menopause as a normal phase in a women's life and more Turkish than German women (35% vs. 7%) associated complaints with menopause. However the immigrant women knew noticeably less about health risks related to menopause (10% vs. 50%).
- Published
- 2001
43. Cesarean section on request and vaginal childbirth: psychological aspects
- Author
-
P. Rott, F. Siedentopf, H. Kentenich, and Beate Schücking
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,Obstetrics and Gynecology ,Medicine ,business - Abstract
In den letzten Jahren geht die Tendenz in der Geburtshilfe hin zum “Kaiserschnitt auf Verlangen”. Bei der Tatsache, dass einige in diese Richtung weisenden Arbeiten auf so fruchtbaren Boden fielen, spielen eine Vielzahl von Grunden (z. T. auch unbewusste) eine Rolle. Diese sind zum einen in der verstandlichen Angst der Frau vor der schmerzhaften Geburt und einem daraus resultierenden Kontrollverlust begrundet, kommen aber zum anderen auch den Bedurfnissen von uns Medizinern entgegen, die wir 1. mit der Sectio den scheinbar ungefahrlicheren und forensisch sichereren Weg gehen konnen und 2. eine gewisse Erleichterung durch aktives Vorgehen erhalten. Es erscheint daher notwendig, auch die aus psychologischer Sicht relevanten Hintergrunde eines solchen Vorgehens zu beleuchten, um eine freie und evidenzbasierte Grundlage fur die Entscheidung zur Sectio zu finden, da insbesondere aufgrund der wissenschaftlich-medizinischen Daten der Kaiserschnitt auf Wunsch kein vertretbares Routinevorgehen sein sollte. Es ist daher unerlasslich, jedes Begehren nach der Wunschsectio individuell zu prufen und daraus die gemeinsame Entscheidung zu treffen. Eine generelle Empfehlung fur oder gegen den Kaiserschnitt auf Wunsch erscheint nicht sinnvoll.
- Published
- 2000
44. Psychosomatik in der Reproduktionsmedizin
- Author
-
H. Kentenich, C. Bindt, H. Felder, K. Henning, Elmar Brähler, S. Bettge, S. Goldschmidt, E. Ittner, E. Yüksel, K. Ningel, H. Stammer, Bernhard Strauß, D. Gagel, Tewes Wischmann, and Rolf Verres
- Subjects
Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,0302 clinical medicine ,business.industry ,Obstetrics and Gynecology ,Medicine ,business ,030217 neurology & neurosurgery - Published
- 2000
45. Psychosomatik und Reproduktionsmedizin – eine gute Ehe ?
- Author
-
H. Kentenich
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,Obstetrics and Gynecology ,business - Published
- 1999
46. Perinatal outcome in hospital and birth center obstetric care
- Author
-
H. Kraker Von Schwarzenfeld, H. Kentenich, M. David, and J.A.S Dimer
- Subjects
Episiotomy ,Pediatrics ,medicine.medical_specialty ,medicine.medical_treatment ,Psychological intervention ,Perinatal risk ,Perinatal outcome ,Birthing Centers ,Obstetric care ,Pregnancy ,Germany ,medicine ,Humans ,Maternal Health Services ,Fetal Death ,Risk criteria ,Quality of Health Care ,Retrospective Studies ,Obstetrics ,business.industry ,Perinatal mortality ,Delivery Rooms ,Incidence (epidemiology) ,Infant, Newborn ,Pregnancy Outcome ,Obstetrics and Gynecology ,General Medicine ,Female ,business - Abstract
Objective: Our purpose was to compare birth complications and fetal outcome in hospitals and birth centers. Method: We retrospectively compared all 801 deliveries between 1992 and 1994 from two free-standing birth centers against 3271 hospital deliveries in Berlin. The hospital collective was selected according to the same risk criteria of the birth centers. Results: The birth center group had significantly fewer medical interventions, with a similar cesarean section rate (3.0% vs. 4.6%, P=0.057) and occurrence of severe perineal lesions. The episiotomy rate was significantly higher (P
- Published
- 1999
47. Unterschiedliche Inanspruchnahme einer gynäkologischen Notfallambulanz durch deutsche Patientinnen und Migrantinnen
- Author
-
G. M. Pette, H. Kentenich, and M. David
- Subjects
Pediatrics ,medicine.medical_specialty ,Evening ,business.industry ,Significant difference ,Obstetrics and Gynecology ,Emergency department ,language.human_language ,German ,Health history ,Maternity and Midwifery ,Female patient ,medicine ,language ,Medical diagnosis ,business ,Psychosomatic disease - Abstract
Background: Analyse of factors referring to ethnical origin that indicate unequal approach as well as different care conditions for foreign-born female patients compared to German female patients in hospital. Study design and methods: A retrospective, cross-sectional study was based on the examination of 258 German and 311 non-German female patients in the Emergency Department of Gynaecology of a Berlin hospital affording maximum care. Statistical evaluation of data was performed, the data having been selected according to defined criteria (p
- Published
- 1998
48. Geburtshausentbindung - eine sichere Alternative zur Klinikgeburt?
- Author
-
H. Kraker Von Schwarzenfeld, M. David, and H. Kentenich
- Subjects
Episiotomy ,medicine.medical_specialty ,education.field_of_study ,Pediatrics ,Obstetrics ,business.industry ,Mortality rate ,Incidence (epidemiology) ,medicine.medical_treatment ,Population ,Obstetrics and Gynecology ,Blood loss ,Statistical significance ,Maternity and Midwifery ,medicine ,Observational study ,Apgar score ,education ,business - Abstract
Purpose: Are there differences in the type and frequency of maternal and newborn complications in deliveries at a birth center in comparison to those in hospitals? Is the incidence of operative deliveries, of birth canal injuries, or increased sub partum blood loss dependent on the site of delivery? Do newborn and maternal morbidity and mortality rates differ between collectives from hospital deliveries and birth center deliveries. Method and maternal: In the course of a non-randomized observational study, perinatal data from all 801 deliveries from two birth centers in Berlin were retrospectively recorded from the period August 1,1992 to July 31,1994.These data were evaluated and were compared to a collective selected (on the basis of the birth centers' risk criteria) from 14,367 hospital deliveries from the years 1993 and 1994 (Chi 2 -Test, significance level of p
- Published
- 1998
49. Die Wunschsektio - medizinische und psychosomatische Problematik
- Author
-
P. Rott, Beate Schücking, H. Kentenich, and F. Siedentopf
- Subjects
Pediatrics ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Section (typography) ,MEDLINE ,Obstetrics and Gynecology ,Psychosomatic medicine ,medicine.disease ,Scientific evidence ,medicine ,Caesarean section ,Medical emergency ,business ,Elective caesarean ,Psychosocial ,reproductive and urinary physiology ,health care economics and organizations - Abstract
Caesarean section on request of the mother turned out lately to be very actual in obstetrical discussions. To come to rational decisions the scientific results of several medical disciplines should be taken into consideration. There is no scientific evidence for benefits of such elective c-section in paediatrics and psychosocial medicine. The obstetricians view shows both benefits and disadvantages, the later overweighing the first. In the light of these data, elective caesarean without other indication but the mothers request does not show to be an acceptable routine procedure.
- Published
- 2001
50. Chronische Unterbauchschmerzen unter Berücksichtigung psychosomatischer und kulturspezifischer Überlegungen - Darstellung des 'Göbek Düsmesi' (= Nabelfalls) anhand einer Kasuistik - Chronic Pelvic Pain and a Fallen Navel': The Importance of Psychosomatic and Cultural Aspects When Evaluating Pelvic Pain
- Author
-
F. Siedentopf, E. Yüksel, and H. Kentenich
- Subjects
Gynecology ,medicine.medical_specialty ,Housewife ,business.industry ,General surgery ,Pelvic pain ,Navel ,Obstetrics and Gynecology ,Familiar environment ,medicine.anatomical_structure ,Sterilization (medicine) ,Maternity and Midwifery ,medicine ,medicine.symptom ,business - Abstract
We describe a 42-year-old Turkish woman admitted to the hospital for tubal sterilization. The patient also reported chronic pelvic pain. She had been treated in Turkey for a fallen navel. According to the patient her navel, considered the bodys epicenter, had slipped and thus caused pelvic pain, Evaluation showed a woman in conflict between the roles of a traditional Turkish housewife and a modern European woman. Returning to her familiar environment gave her her center back. This case suggests that subjective or cultural assumptions should be taken into account when evaluating chronic pelvic pain and planning an integrated therapeutic approach.
- Published
- 2000
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