Purpose: The onset of the COVID-19 pandemic posed an eminent challenge for medical teachers worldwide. Face-to-face lectures and seminars were no longer possible, and alternatives had to be found. E-learning concepts quickly emerged as the only practicable solutions and also offered the opportunity to evaluate whether traditional face-to-face lectures could be translated into an online format, independent of the COVID-19 pandemic. Methods: We offered an e-learning program consisting of lecture notes, screencasts with audio narration, and online webinars that covered topics normally taught in traditional lectures and seminars. To evaluate the learning behavior and quality of our e-learning program, we drafted a questionnaire that students completed at the end of the 2020 summer semester that had been designed to enable a comparative analysis of the different e-learning modules. Results: Voluntary participation in the online courses was high. Survey analysis revealed high satisfaction with and a distinctive preference for the format, even under regular, COVID-19-independent conditions. In general, a positive appraisal of e-learning—especially as a substitute for regular lectures—was found. Students also reported higher studying efficiency. Exam results were equal to those of previous semesters. Conclusion: Both acceptance of and satisfaction with our e-learning modules were high, and students displayed increased demand for this kind of e-learning format. We, therefore, conclude that e-learning offerings could serve as reasonable, efficient, student-orientated substitutes for certain medical courses, especially lectures. These curricular adaptations would correlate with the high digitalization seen in students’ everyday lives. This correlation may also hold true independent of the ongoing COVID-19 pandemic.

Obese women are at high risk of developing pre-eclampsia (PE). As an altered angiogenic profile is characteristic for PE, measurement of soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PIGF) ratio in the maternal serum can be helpful for PE diagnosis, as well as for adverse perinatal outcome (APO) prediction. There is growing evidence that obesity might influence the level of sFlt-1/PIGF and, therefore, the aim of the study was the evaluation of sFlt-1/PIGF as an APO predictor in obese women with PE. Pre-eclamptic women who had an sFlt-1/PIGF measurement at the time of diagnosis were retrospectively included. Women were classified according to their pre-pregnancy body mass index (BMI) as normal weight (BMI < 25 kg/m²), overweight (BMI > 25–29.9 kg/m²) or obese (BMI ≥ 30 kg/m²). APO was defined as the occurrence of one of the following outcomes: Small for gestational age, defined as a birthweight < 3rd centile, neonatal mortality, neonatal seizures, admission to neonatal unit required (NICU) or respiratory support. A total of 141 women were included. Of them, 28 (20%) patients were obese. ROC (receiver operating characteristic) analysis revealed a high predictive value for sFlt-1/PIGF and APO across the whole study cohort (AUC = 0.880, 95% CI: 0.826–0.936; p < 0.001). However, the subgroup of obese women showed a significantly lower level of sFlt-1 and, therefore, the performance of sFlt-1/PIGF as APO predictor was poorer compared to normal or overweight PE women (AUC = 0.754, 95% CI: 0.552–0.956, p = 0.025). In contrast to normal or overweight women, a ratio of sFlt-1/PIGF < 38 could not rule out APO in women with obesity.

The aim of this study was to evaluate the association between cerebroplacental ratio (CPR), mean uterine artery (mUtA) Doppler and adverse perinatal outcome (APO) and their predictive performance in fetuses with birth weight (BW) <3rd centile (very small for gestational age, VSGA) in comparison with fetuses with BW 3rd–10th centile (small for gestational age, SGA). This was a retrospective cohort study including singleton pregnancies delivered at term (37 + 0–41 + 6) in a single tertiary referral center over a six-year period. APO was defined as a composite of cesarean section for intrapartum fetal compromise (IFC), umbilical artery pH < 7.20, and admission to the neonatal intensive care unit for >24 h. The characteristics of the study population according to BW (VSGA and SGA) as well as the presence of composite APO were assessed. The prognostic performance of CPR and mUtA-PI was evaluated using receiver operating characteristic (ROC) analysis. In total, 203 pregnancies were included. Of these, 55 (27%) had CPR 95th centile, 65 (32%) VSGA fetuses, and 93 (46%) composite APO. VSGA showed a non-significantly higher rate of composite APO in comparison to SGA (52% vs. 43%; p = 0.202). The composite APO rate was significantly higher in SGA with CPR <10th centile (36% vs. 13%; p = 0.001), while in VSGA with CPR 95th centile. The ROC analysis showed a significantly predictive value of CPR for composite APO in SGA only (AUC 0.612; p = 0.025). A low CPR was associated with composite APO in SGA fetuses. VSGA fetuses were more frequently affected by composite APO regardless of Doppler values. The predictive performance of CPR and uterine artery Doppler was poor.

Induction of labour (IOL) is commonly performed by administration of prostaglandin E (PGE). As pro-inflammatory agents, a known side-effect of PGE is maternal fever. This is problematic as it potentially mimics chorioamnionitis and may lead to unnecessary interventions such as administration of antibiotics or cesarean section. The aim of the study was therefore to investigate the effect of PGE on pregnancy outcomes. Retrospective single-centre cohort study with inclusion of women ≥ 37 weeks of gestation who underwent IOL with PGE and subsequently developed PROM (Group 1) or women who presented with spontaneous PROM without contractions (Group 2). At the time of PROM, CRP and white blood count (WBC) were assessed. We compared rates of maternal fever, Triple I, mode of delivery, and administration of antibiotics between Group 1 and Group 2. A total of n = 850 women were included (Group 1: 200, Group 2: 650). CRP levels were higher in patients with more prolonged PGE administration (< 12 hours: 0.3 mg/dL vs. > 48 hours: 1.4 mg/dL, p = 0.002; r = 0.309; p < 0.001). WBCs were also higher after PGE administration (11.1 × 10⁹/L vs. 9.5 × 10⁹/L, p < 0.001). The logistic regression model revealed an association between IOL with PGE and antibiotics during labour. However, the rates of maternal fever and suspected Triple I did not differ significantly between the two groups, nor did the mode of delivery. IOL with PGE increases maternal serum levels of CRP (time-dependently), as well as WBC. This might lead to overtreatment with antibiotics during labour. However, the diagnosis of maternal fever or rates of suspected Triple I were not affected in our cohort. Die Geburtseinleitung am Termin erfolgt häufig mittels Prostaglandin E (PGE). Ob aufgrund deren proinflammatorischer Wirkung mütterliche oder kindliche Nebenwirkungen wie erhöhte Infektparameter oder Fieber auftreten, wurde bisher nicht systematisch untersucht. Fieber unter Geburt ist aber auch das Leitsymptom einer Chorioamnionitis, weshalb die Geburtseinleitung mit PGE unnötige geburtshilfliche Interventionen wie die Gabe von Antibiotika nach sich ziehen könnte. Ziel dieser Studie war es daher, die Auswirkung einer Geburtseinleitung mit PGE auf maternale Infektparameter sowie den weiteren Geburtsverlauf zu untersuchen. Es handelt sich um eine retrospektive, monozentrische Kohortenstudie. Eingeschlossen wurden Frauen ≥ 37. SSW, die mit PGE eingeleitet wurden und unter Einleitung einen vorzeitigen Blasensprung entwickelten (Gruppe 1), und Frauen, die sich mit einem spontanen vorzeitigen Blasensprung vorstellten (Gruppe 2). Alle Frauen erhielten zum Zeitpunkt des Blasensprungs eine Blutentnahme mit Bestimmung der Infektparameter (CRP und Leukozyten). Es wurde die Häufigkeit von maternalem Fieber, Triple I, Entbindungsmodus und Antibiotikatherapie in beiden Gruppen verglichen. Insgesamt wurden 850 Frauen eingeschlossen (Gruppe 1: n = 200, Gruppe 2: n = 650). Frauen mit vorangegangener PGE-Gabe hatten signifikant höhere CRP-Werte als Frauen mit vorzeitigem Blasensprung ohne PGE-Gabe, wobei die CRP-Werte umso höher waren, je länger PGE verabreicht wurde (< 12 h: 0,3 mg/dl vs. > 48 h: 1,4 mg/dl, p = 0,002; r = 0,309; p < 0,001). Auch die Leukozyten waren nach der PGE-Gabe erhöht (11,1 × 10⁹/l vs. 9,5 × 10⁹/l, p < 0,001). Die logistische Regressionsanalyse ergab, dass Gruppe 1 häufiger eine Therapie mit Antibiotika erhielt, obwohl sich die Raten von maternalem Fieber oder die Verdachtsdiagnose eines Triple I nicht unterschieden. Die Einleitung hatte keinen Einfluss auf den Geburtsmodus. Die Einleitung mit PGE führt zu einer Erhöhung der maternalen Infektparameter (Leukozyten und CRP), was eine Übertherapie mit Antibiotika wahrscheinlicher macht. In der untersuchten Kohorte war kein Unterschied bezüglich des Geburtsmodus oder der Rate an maternalem Fieber zu beobachten. Received: 16 August 2025 Accepted after revision: 02 December 2025 Article published online: 10 February 2026 © 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany