[COVID-19 and pregnancy]. / COVID-19 und Schwangerschaft: Fallserie mit der Komorbidität Diabetes aus der Registerstudie "Covid-19 Related Obstetric and Neonatal Outcome Study" (CRONOS).

From March 3 to October 13, 2020, 27 cases with diabetes comorbidity have been recorded in the CRONOS registry (Covid-19 Related Obstetric and Neonatal Outcome Study in Germany) among 262 registered women with SARS-CoV­2 infection during their pregnancy. Of those, 21 presented with gestational diabetes, 5 with type 2 diabetes and 1 with type 1 diabetes. About half of the women were asymptomatic and were diagnosed via general screening at hospital admission. The most common symptoms were nasal congestion, cough, tiredness, malaise and changes in smell and taste. The majority of pregnant women showed a mild to moderate course, three women were admitted to the intensive care unit and none required invasive ventilation. In the type 2 diabetes group, there were two cases with late fetal death (37 and 40 weeks of gestation) and one with a malformation, an association with diabetes being most likely. Pregnant women with diabetes mellitus represent a special subgroup; 1 in 10 women in this small cohort required intensive care monitoring due to COVID-19. In addition, this case series underscores the need for unrestricted access to pregnancy care, especially in times of pandemic, for optimal perinatal outcome.

Multiple Gestation as a Risk Factor for SARS-CoV-2-Associated Adverse Maternal Outcome: Data From the COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS).

Introduction: Studies have shown that pregnant women with COVID-19 have a higher risk of intensive care unit admission and invasive mechanical ventilation support than non-pregnant women. Pregnancy-associated physiological changes in respiratory function may contribute to the elevated risk. Alteration in lung volumes and capacities are attributed to the mechanical impediment caused by the growing fetus. Multiple pregnancies may therefore compromise functional lung capacity earlier than singleton pregnancies and contribute to severe respiratory symptoms of COVID-19. Materials and Methods: A total of 5514 women with a symptomatic SARS-CoV-2 infection during pregnancy registered in the COVID-19 Related Obstetric and Neonatal Outcome Study were included. The COVID-19-related adverse maternal outcomes were compared in 165 multiple versus 5349 singleton pregnancies. Combined adverse maternal outcome was defined as presence of COVID-19-related hospitalization and/or pneumonia and/or oxygen administration and/or transfer to ICU and/or death. Multivariate logistic regression was used to estimate the odds ratios and 95% confidence intervals were calculated. Results: The frequency of dyspnea, likelihood of developing dyspnea in a defined pregnancy week and duration of the symptomatic phase of the COVID-19 infection did not differ between the two groups. On average, COVID-19-related combined adverse outcome occurred earlier during pregnancy in women expecting more than one child than in singleton pregnancies. The overall incidence of singular and combined COVID-19-associated adverse maternal outcomes was not significantly different between groups. However, regression analysis revealed that multiple gestation, preconceptional BMI > 30 kg/m 2 and gestational age correlated significantly with an increased risk of combined adverse maternal outcome. Conversely, maternal age and medically assisted reproduction were not significant risk factors for combined adverse maternal outcome. Conclusion: Our data show that multiple gestation alone is a risk factor for COVID-19-associated combined adverse maternal outcome. Moreover, severe courses of COVID-19 in women expecting more than one child are observed earlier in pregnancy than in singleton pregnancies.

Correction: Multiple Gestation as a Risk Factor for SARS-CoV-2-Associated Adverse Maternal Outcome: Data From the COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS).

[This corrects the article DOI: 10.1055/a-2196-6224.].

Subthreshold depression in Parkinson's disease.

BACKGROUND: Quality of life in Parkinson patients with subthreshold depression could be improved if the prevalence and symptom profile were better understood. METHODS: Our study used standard DSM-IV and Judd criteria as well as motor, depression, and quality-of-life scales to investigate a sample of 110 nondemented Parkinson patients. This led to formation of nondepressed (48.2%), subthreshold depressed (25.5%), and depressed (26.4%) groups. RESULTS: Quality of life was seen to be significantly lower in subthreshold depressed patients than in the nondepressed, and there were differences in the frequency of depressive symptoms that partially overlapped with nonmotor symptoms of vegetative origin in Parkinson's disease (appetite, sleep disorders). Key measures of depression (diminished interest/pleasure) were more frequent in the depressed group compared with the subthreshold depressed, although the motor functions of these 2 groups did not differ significantly. CONCLUSIONS: The Beck Depression Inventory score ranging from 9 to 15 points differentiates subthreshold depressed from nondepressed and depressed patients best.

Bladder endometriosis: possibility of treatment by laparoscopy.

BACKGROUND AND OBJECTIVES: Genital endometriosis is still an unclear enigma of the female. It occurs in approximately 20% to 35% of all women of reproductive age. The urinary tract is seldom affected. METHODS: We report on a patient with bladder endometriosis with recurrent heavy pain at menstruation within the framework of 5 similar cases. RESULTS: A combined vaginal and laparoscopic treatment with excision of the lesion reaching into the dome of the bladder and vaginal wall was performed. The bladder opening was sutured in 2 layers. CONCLUSION: Laparoscopic treatment of bladder endometriosis requires a combined surgical treatment by a gynecologist and urologist or an experienced laparoscopist.