Papers by Wolfgang Henrich
Ultrasound in Obstetrics and Gynecology, 2000
Congenital aortic stenosis is a rare cause of congestive heart failure and hydrops fetalis. This ... more Congenital aortic stenosis is a rare cause of congestive heart failure and hydrops fetalis. This report describes a case of prenatally diagnosed critical aortic stenosis and endocardial fibroelastosis leading to a severe hydrops fetalis at 27 weeks of gestation. Successful transplacental digitalization was performed and all signs of hydrops resolved within 2 weeks. The pregnancy continued with normal development of the fetus and birth was induced at 39 weeks of gestation. After an uneventful vaginal birth, the child was transferred for cardiac catheterization, and balloon dilation of the aortic valve was performed successfully. Follow up at the age of 2 years showed only mild left ventricular cardiac hypertrophy, a moderate elevated pressure gradient of 50 mmHg at the aortic valve and mild aortic and mitral regurgitation. No further interventions were necessary at this point.
Journal of Clinical Ultrasound, 2014
Fetal cardiac tumors are a rare finding in prenatal ultrasonography. Most of them are rhabdomyoma... more Fetal cardiac tumors are a rare finding in prenatal ultrasonography. Most of them are rhabdomyoma, which are thought to be pathognomonic for tuberous sclerosis complex. We present an infant with prenatally diagnosed cardiac rhabdomyoma (CR), who was found to suffer from Beckwith-Wiedemann syndrome (BWS). This congenital overgrowth syndrome is characterized by macrosomia, macroglossia, omphalocele, hypoglycemia, and hemihypertrophy. BWS patients have an increased risk for formation of benign and malignant tumors, typically intra-abdominally located, but, to the best of our knowledge, fetal CRs have not been reported before. BWS must be added to the list of differential diagnoses and to the prenatal counseling of the parents in cases of prenatal detection of CR.
Fertility and Sterility, 2012
Objective: To compare maternal characteristics and obstetric outcomes of spontaneously conceived ... more Objective: To compare maternal characteristics and obstetric outcomes of spontaneously conceived (SC) and after-fertility treatment (FT) twins. Design: Retrospective study. Setting: Single tertiary center (university hospital). Patient(s): All twin pregnancies (n ¼ 1,239) delivered R24 weeks of gestation and classified by the mode of conception. Intervention(s): None. Main Outcome Measure(s): Maternal age, prematurity, preterm rupture of membranes (PROM), delivery mode, cervical insufficiency, preeclampsia/HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome, gestational diabetes, and postpartum hemorrhage. Result(s): Of 1,239 mothers evaluated, 34.4% received FT. We observed a continuous 3.2-year mean increase in maternal age over time in the FT population. The FT group had statistically significantly higher rates of women R35 years of age versus the SC group (37.6% vs. 22.9%). Mean maternal age (32.5 vs. 30.1 years) and the rates of cesarean delivery (72.3% vs. 63.9%), dichorionic twin prematurity (67.7% vs. 59.6%), postpartum hemorrhage (9.9% vs. 6%), PROM (2.3% vs. 0.6%), and cervical insufficiency (17.6% vs. 10%) were statistically significantly higher in the FT group. Preeclampsia/HELLP syndrome and gestational diabetes showed no significantly significant difference. Conclusion(s): Mothers of twins after FT were statistically significantly older and had higher rates of prematurity, cesarean delivery, and obstetric morbidity. (Fertil Steril Ò 2012;98:95-101. Ó2012 by American Society for Reproductive Medicine.
Geburtshilfe und Frauenheilkunde, 1993
Prof. DT. W. ü chtenegger) 2 Institut Iür med. Mikro biologie und lnfeküonstmmunologte {Leiter: P... more Prof. DT. W. ü chtenegger) 2 Institut Iür med. Mikro biologie und lnfeküonstmmunologte {Leiter: Prof. Dr. H. Hahn) Unive rsitä ts klinikum RudolCVirchow der Freien Unive rsitä t Berlin Zus a mmenfassung In eine r pr osp ektiven Studi e wurde das bakteri ologische Keimspektrum des Uterus inne rhalb der ers ten 3 Tage post partum analysiert. Bei 80 asymptomatischen Wöchn eri nnen (70 x Z. n. Spontangeburt und 10x Z. n. vag ina l-ope rative r Entbindung) wurden von der Ektozervix und aus dem Cavum uteri Keimabst rich e entnom men. Letzte res gelang mit Hilfe eines Endometriumkath eters mit Führungshüls e. 47 von 70 Wöchnerin nen nach Spontangeb urt und 1 von 10 Patienti nne n na ch vaginal-operativer Entbind ung. wiesen bei der gez ielten Entnahme aus dem Uteruskavum keine bakteri elle Besi ed elun g auf. Nach pr än ataler pr oph ylaktischer Antibiotikagabe konnte signifika nt seltener ein Keimnachweis erbracht werden (p < 0.05). Bei Wöchn erinnen mit Z. n. Zervixpri ming mit PGE2 und Fetalblutana lysen sub partu wurden hingegen signifikant häufiger in tra uteri ne Keim e na chg ewiese n (p < 0.0 5). Im Gege nsatz zum Kavum ab strich waren sä mtliche ektozervi-kaIen Abstriche pos itiv. In 13 von 23 der Fälle mit positivem intra uterinem Keimnac hweis wu rde ein Unterschied im Keims pektrum zum pa ra llel abgenommenen Zervixa bstrich gefund en. Weitere geburtshifiiche Faktoren wiesen eine n Einfluß auf die Keimbesiedelung auf. Die Abstrich entnahme er folgte in allen Fällen komplikationslos und es wu rd en kein e Infektionen im weiteren Woch enbettverlauf beobachet. Einle itu ng Über die uterine Keimb esiedelung post pa rtum gibt es in der Literatur nur wen ige Angab en. Standard lehrbücher der Geburtsh ilfe und EinzeIpublikation en berichten da rüberhi na us wide rs prü chlich über die physio logische Mikrobiologie des Uteru s im Wochenbett. Nach Michel (1986) begin nt die ba kteri elle Besi edelung des Uterus unmittelbar nach der Geburt. Kais er und Marti us (1988) bes chreiben. daß der Uter us späteste ns 24 Stunden na ch der Geburt eine Keimbes iedelu ng aufweist. Knärr u. Mita rb. (198 2) geb en an. da ß a b dem 3. postpartalen Tag das Cavum uteri mit Mikroorg an ism en der Vagina lflora besiedelt ist. In einer Arbeit von Esc he nbac h u.
Anticancer research
Since the anti-HER2 monoclonal antibody trastuzumab made its triumphant advance into breast cance... more Since the anti-HER2 monoclonal antibody trastuzumab made its triumphant advance into breast cancer therapy, new selective agents, including pan-HER inhibitors are entering clinical practice. This study investigates the expression of the four HER-family members, HER1-4, in 48 primary breast carcinomas (PBC) and corresponding distant metastases (CDM) by immunohistochemistry and fluorescence in situ hybridisation. Concordance rate between PBC and CDM was 79% for HERI and HER2, 67% for HER3 and 56% or HER4. Expression of HER1-3 was associated with poor prognosis compared to HER-negative disease (p = 0.036). HER4 overexpression was associated with a better outcome (p = 0.003). Though most tumours demonstrate a stable HER expression pattern, both loss and acquisition of HER receptor overexpression can occur during metastasis. HER4 overexpression predicts prolonged survival compared to receptor negative disease, while the opposite is true for HER1-3. Consequences for modem antibody therapy...
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, Jan 31, 2015
To determine the effects of betamethasone on fetal growth and neonatal outcomes. A retrospective ... more To determine the effects of betamethasone on fetal growth and neonatal outcomes. A retrospective cohort study was performed of deliveries that occurred at Charité University Hospital Berlin, Germany, between January 1996 and December 2008. The betamethasone group included women with preterm labor and symptomatic contractions, cervical insufficiency, preterm premature rupture of membranes, or vaginal bleeding. Women in the control group were matched for gestational age at time of delivery and had not received betamethasone. Fetal growth changes and neonatal anthropometry were compared. Among 1799 newborns in the betamethasone group and 42 240 in the control group, betamethasone was associated with significantly lower birth weight (154g lower on average) after adjusting for confounders (e.g. hypertension, smoking, and maternal weight), sex, and gestational age at delivery (P<0.05). The higher the dose, the greater the difference in mean birth weight versus controls in births before...
Journal of perinatal medicine, Jan 18, 2014
Background: The long-term outcomes of antenatal glucocorticoids (GCs) vary between reports, and h... more Background: The long-term outcomes of antenatal glucocorticoids (GCs) vary between reports, and have generated controversy in terms of repeated and single-course events, causing irreversible effects on endocrine set points. Aim: This study aimed to assess the effects of alternative therapeutic agents other than synthetic glucocorticoid GC administration for fetal lung maturation. Methods: A review of literature from PubMed, EMBASE, Cochrane Library, and Google Scholar was conducted to assess the use of alternative therapies to synthetic GCs using recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). End points included the rates of respiratory distress syndrome (RDS), mRNA expression for pneumocyte type II, concentration of surfactant proteins in alveolar lavage, morphological differences, histological proof of lung maturation, and angiogenesis or quantification of the surfactant pool. Results: In all 41 studies examined, we fo...
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 2002
... A, Transvaginal real-time gray scale sonograms showing an anechoic lesion (arrow) in the myom... more ... A, Transvaginal real-time gray scale sonograms showing an anechoic lesion (arrow) in the myometrium of the lower segment of the posterior uterine wall, sagittal view. The right oblique section shows the pseudoaneurysm that originates from the uterine artery. ...
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 2002
To evaluate the possible advantages, applications, and usefulness of real-time transabdominal and... more To evaluate the possible advantages, applications, and usefulness of real-time transabdominal and transvaginal extended field-of-view sonography combined with power Doppler sonography in gynecology. A series of 63 gynecologic patients, referred for preoperative sonographic examination and for whom the examiner thought that extended field-of-view sonography might be helpful in imaging pathologic findings, were selected. Patients were examined with conventional vaginal and abdominal B-mode sonography, extended field-of-view sonography, and power Doppler extended field-of-view sonography. A sonographic system with 3.5- to 7-MHz transducers was used to study and document pathologic findings. Extended field-of-view sonography provided a superior overview of pathologic findings and topography by creating a single image showing the relationship to reference structures. The combination of power Doppler extended field-of-view sonography provided additional information on the perfusion patter...
Reproductive sciences (Thousand Oaks, Calif.), 2015
Glucocorticoid treatment given in late pregnancy in sheep resulted in altered placental developme... more Glucocorticoid treatment given in late pregnancy in sheep resulted in altered placental development and function. An imbalance of placental survival and apoptotic factors resulting in an increased rate of apoptosis may be involved. We have now investigated the effects of dexamethasone (DEX) in early pregnancy on binucleate cells (BNCs), placental apoptosis, and fetal sex as a determinant of these responses. Pregnant ewes carrying singleton fetuses (n = 105) were randomized to control (n = 56, 2 mL saline/ewe) or DEX treatment (n = 49, intramuscular injections of 0.14 mg/kg ewe weight per 12 hours over 48 hours) at 40 to 41 days of gestation (dG). Placentomes were collected at 50, 100, 125, and 140 dG. At 100 dG, DEX in females reduced BNC numbers, placental antiapoptotic (proliferating cell nuclear antigen), and increased proapoptotic factors (Bax, p53), associated with a temporarily decrease in fetal growth. At 125 dG, BNC numbers and apoptotic markers were restored to normal. In m...
Journal of Clinical Ultrasound, 2003
We report the case of a 27-year-old pregnant woman in whom isolated mild fetal cardiomegaly, diag... more We report the case of a 27-year-old pregnant woman in whom isolated mild fetal cardiomegaly, diagnosed prenatally on sonographic examination at 22 weeks&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; menstrual age, was the first sign of development of an arteriovenous malformation of the vein of Galen. The arteriovenous malformation was visualized on sonographic examination at 29 weeks&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; menstrual age; prenatal MRI at 32 weeks confirmed the diagnosis. At 34 weeks&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; menstrual age, repeat sonographic examination demonstrated polyhydramnios, cardiomegaly, and generalized hydrops with ascites and pleural effusion. After vaginal delivery, the male neonate died of respiratory distress. We present the findings of prenatal gray-scale, color Doppler, and power Doppler sonography; MRI; and postmortem examination.
Fetal Diagnosis and Therapy, 2010
Mirror syndrome, also referred to as Ballantyne&amp;amp;amp;amp;amp;amp;amp;amp;#39;s syndrom... more Mirror syndrome, also referred to as Ballantyne&amp;amp;amp;amp;amp;amp;amp;amp;#39;s syndrome, is normally defined as the development of maternal edema in association with fetal hydrops. The incidence of mirror syndrome is low and few cases have been published. We describe a case report in association with fetal Ebstein anomaly and provide a systematic review on the fetal associated conditions, maternal presentation and perinatal outcome reported for mirror syndrome. A PubMed database search was done until December 2008 (English, French or German) without any restriction of publication date or journal, using the following key words: Ballantyne syndrome, Mirror syndrome, Triple edema, Pseudotoxemia, Maternal hydrops syndrome, Pregnancy toxemia, Acute second trimester gestosis, and Early onset preeclampsia. Reported cases were considered eligible when fetal associated conditions, maternal symptoms and fetal outcome were clearly described. Among 151 publications a total of 56 reported cases satisfying all inclusion criteria were identified. Mirror syndrome was associated with rhesus isoimmunization (29%), twin-twin transfusion syndrome (18%), viral infection (16%) and fetal malformations, fetal or placental tumors (37.5%). Gestational age at diagnosis ranged from 22.5 to 27.8 weeks of gestation. Maternal key signs were edema (80-100%), hypertension (57-78%) and proteinuria (20-56%). The overall rate of intrauterine death was 56%. Severe maternal complications including pulmonary edema occurred in 21.4%. Maternal symptoms disappeared 4.8-13.5 days after delivery. Mirror syndrome is associated with a substantial increase in fetal mortality and maternal morbidity.
Epilepsy Research, 2009
Purpose: To prospectively analyse the pharmacokinetics of lamotrigine (LTG) during pregnancy and ... more Purpose: To prospectively analyse the pharmacokinetics of lamotrigine (LTG) during pregnancy and lactation in a consecutive series of epileptic pregnant women. Methods: Nine women on LTG-monotherapy were studied during pregnancy, delivery and lactation, until a mean of 3 weeks postpartum. Maternal blood samples were available from all trimesters as well as umbilical cord blood samples of the newborn 24 and/or 48 h postpartum. In 4 cases we additionally determined the LTG-concentration in breast milk. Results: The median LTG-clearance was elevated by 197% during the first trimester, 236% and 248% during the second and third trimester respectively. A maximum of 264% was reached at delivery. An average LTG-dose increase by 250% had to be undertaken in order to obtain therapeutic serum levels. In puerperium LTG-clearance decreased again to reach the initial concentrations approximately at the third week postpartum. The median LTGconcentration ratio of the umbilical cord blood to maternal serum was 1.01 (range: 0.56-1.42), while the median LTG-concentration ratio of breast milk to maternal serum was 0.59 (range: 0.35-0.86).
American Journal of Obstetrics and Gynecology, 2001
American Journal of Obstetrics and Gynecology, 2012
OBJECTIVE: Knowledge about the mechanism of labor is based on assumptions and radiographic studie... more OBJECTIVE: Knowledge about the mechanism of labor is based on assumptions and radiographic studies performed decades ago. The goal of this study was to describe the relationship between the fetus and the pelvis as the fetus travels through the birth canal, using an open magnetic resonance imaging (MRI) scanner.
American Journal of Obstetrics and Gynecology, 2012
OBJECTIVE: During labor, transperineal sonography is increasingly used to evaluate fetal head des... more OBJECTIVE: During labor, transperineal sonography is increasingly used to evaluate fetal head descent. The aim of this study was to compare the angle of progression assessed by open magnetic resonance imaging (MRI) vs transperineal ultrasound.
Natural processes do not always function perfectly. In breastfeeding, problems are encountered in... more Natural processes do not always function perfectly. In breastfeeding, problems are encountered in up to 80% of mother-infant dyads. Altogether, in Western societies, the difficulties reduce the breastfeeding rate within the first months drastically. To deal with the problems of breastfeeding efficiently requires a profound understanding of its physiology, as well as of its psychological and social determinants. This review focuses on the current knowledge of breastfeeding physiology, only touching the psychosocial factors, which are included in the promotion strategies. Subsequently, it scrutinizes definitions, incidences, prevention, and treatment of breastfeeding problems faced most frequently by nursing mothers and their consultants. Not all measures used in counseling mothers and not all treatments for the most common medical problems withstand a careful evaluation on the basis of current scientific data. However, applying proven prevention strategies will significantly improve the well being of mothers and their infants, and may contribute to an affective attitude that increases the success, frequency, and duration of breastfeeding.
Journal of Clinical Ultrasound, 2014
Fetal cardiac tumors are a rare finding in prenatal ultrasonography. Most of them are rhabdomyoma... more Fetal cardiac tumors are a rare finding in prenatal ultrasonography. Most of them are rhabdomyoma, which are thought to be pathognomonic for tuberous sclerosis complex. We present an infant with prenatally diagnosed cardiac rhabdomyoma (CR), who was found to suffer from Beckwith-Wiedemann syndrome (BWS). This congenital overgrowth syndrome is characterized by macrosomia, macroglossia, omphalocele, hypoglycemia, and hemihypertrophy. BWS patients have an increased risk for formation of benign and malignant tumors, typically intra-abdominally located, but, to the best of our knowledge, fetal CRs have not been reported before. BWS must be added to the list of differential diagnoses and to the prenatal counseling of the parents in cases of prenatal detection of CR.
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Papers by Wolfgang Henrich