Vaginal Birth at Term – Part 1. Guideline of the DGGG, OEGGG and SGGG (S3-Level, AWMF Registry No. 015/083, December 2020)

Abstract

Purpose This guideline aims to summarize the current state of knowledge about vaginal birth at term. The guideline focuses on definitions of the physiological stages of labor as well as differentiating between various pathological developments and conditions. It also assesses the need for intervention and the options to avoid interventions. This first part presents recommendations and statements about patient information and counselling, general patient care, monitoring of patients, pain management and quality control measures for vaginal birth. Methods The German recommendations largely reproduce the recommendations of the National Institute for Health and Care Excellence (NICE) CG 190 guideline “Intrapartum care for healthy women and babies”. Other international guidelines were also consulted in specific cases when compiling this guideline. In addition, a systematic search and analysis of the literature was carried out using PICO questions, if this was considered necessary, and other systematic reviews and individual studies were taken into account. For easier comprehension, the assessment tools of the Scottish Intercollegiate Guidelines Network (SIGN) were used to evaluate the quality of the additionally consulted studies. Otherwise, the GRADE system was used for the NICE guideline and the evidence reports of the IQWiG were used to evaluate the quality of the evidence. Recommendations Recommendations and statements were formulated based on identified evidence and/or a structured consensus.

SARS-CoV-2 in Pregnancy, Birth and Puerperium. Guideline of the DGGG and DGPM (S2k-Level, AWMF Registry Number 015/092, March 2022)

“…Monitoring the pregnancy and the fetus of mothers with (acute) SARS-CoV-2 infection is done in accordance with general guidelines and medical guidelines and is based on the respective week of gestation 43 , 44 , 45 , 46 , 47 , 48 . Setting up outpatient infection clinics in doctorʼs offices may make it easier to implement guideline recommendations 49 .…”

“…Die Überwachung der Schwangerschaft und des Ungeborenen von Müttern mit (akuter) SARS-CoV-2-Infektion folgt den allgemeinen Richtlinien und Leitlinien abhängig von der jeweiligen Schwangerschaftswoche 43 , 44 , 45 , 46 , 47 , 48 . Die Einrichtung von Infektsprechstunden kann hierbei die Umsetzung in der Arztpraxis erleichtern 49 .…”

Possible Rates of Detection of Neonatal Sepsis Pathogens in the Context of Microbiological Diagnostics in Mothers – Real World Data

“…Einige Autoren empfehlen eine generelle mikrobiologische Diagnostik in Risikosituationen wie zum Beispiel dem frühen vorzeitigen Blasensprung und bei vorzeitiger Wehentätigkeit [14]. In den deutschen Leitlinien "Vaginale Geburt am Termin -S3-Leitlinie" und "Prävention und Therapie der Frühgeburt -S2k-Leitlinie" ist diese Diagnostik nicht grundsätzlich empfohlen [21,22,23,24,25], jedoch ist dies weitgehend klinische Praxis in Deutschland. In anderen Leitlinien wird eine mikrobiologische Diagnostik bei der Mutter nicht erwähnt bzw.…”

Fetal Assessment in Pregnancy (Indication and Methodology for Fetal Monitoring in a Low-risk Population). Guideline of the DGGG, DEGUM, OEGGG and SGGG (S3-Level, AWMF Registry No. 015/089, February 2023)

“…Tab. 8 CTG -Beurteilung nach dem FIGO-Score (aus der S3-Leitlinie Vaginale Geburt am Termin[18]). Dezelerationen gelten als repetitiv, wenn sie mit > 50 % der Kontraktionen auftreten.…”