K Hecher

Publications (115)407.08 Total impact

• Article: Schmerzen in der laktierenden Brust

  M. Tavares de Sousa, A. Bernhardt, E. Rückert, B. Hüneke, K. Hecher
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  ABSTRACT: Abszesse der laktierenden Brust können als Komplikation im Rahmen einer Mastitis, vor allem bei inadäquater oder verspäteter Therapie, auftreten. Es wird von einer Inzidenz bis zu 20% berichtet. Die ultraschallgesteuerte Punktion hat in der Therapie auch größerer Läsionen einen hohen Stellenwert. Es ist mit einem guten kosmetischen Ergebnis und hoher Akzeptanz im Vergleich zur chirurgischen Intervention zu rechnen. Breast abscesses in lactating women can result as a complication of mastitis, especially if treatment is delayed or inadequate. The reported incidence is up to 20%. Needle aspiration under ultrasound guidance has great value in the treatment of breast abscesses, even in lesions with a large volume. With a good cosmetic outcome, this method is likely to be well accepted as an alternative to surgical treatment.
  Der Gynäkologe 04/2012; 42(8):633-635.
• Article: Vascular programming in twins: the effects of chorionicity and fetal therapy for twin-to-twin transfusion syndrome.

  H.M. Gardiner, A. Barlas, H. Matsui, A. Diemert, M.J.O. Taylor, J. Preece, F. Gordon, S.E. Greenwald, K Hecher
  Journal of Developmental Origins of Health and Disease 01/2012; 3(3):182 - 189. · 1.56 Impact Factor
• Article: OC15.04: Vascular development and responses in twins: influence of monochorionicity, inter-twin transfusion and fetal therapy.

  H M Gardiner, H Matsui, K Hecher, A Diemert, M Taylor, S Greenwald, A Barlas, J Preece, F Gordon
  Ultrasound in Obstetrics and Gynecology 10/2010; 36(S1):30. · 3.01 Impact Factor
• Article: OP06.02: Development of survival rates after intrauterine laser therapy for severe mid-trimester twin-twin transfusion syndrome: experience with 600 cases.

  W Diehl, A Diemert, P Glosemeyer, K Wegscheider, K Hecher
  Ultrasound in Obstetrics and Gynecology 10/2010; 36(S1):67. · 3.01 Impact Factor
• Article: OP06.04: Fetoscopic entry technique at laser therapy for twin-twin transfusion syndrome affects rates of amniorrhexis and preterm birth before 32 weeks.

  S Petersen, A Diemert, C Pennell, L Lewi, K Hecher, J Stirnemann, J E Dickinson, G Gardener, R Cincotta, Y Ville, J Deprest
  Ultrasound in Obstetrics and Gynecology 10/2010; 36(S1):68. · 3.01 Impact Factor
• Article: OP06.03: The impact of access diameter at fetoscopic laser treatment of twin-twin transfusion syndrome.

  S Petersen, D Anke, K Hecher, G Glenn, R Cincotta, J Deprest
  Ultrasound in Obstetrics and Gynecology 10/2010; 36(S1):68. · 3.01 Impact Factor
• Article: OP24.04: Time-related analysis of ductus venosus flow velocity waveforms in normal singleton pregnancies.

  D Tachibana, K Abe, H Nobeyama, T Sumi, O Ishiko, P Glosemeyer, W Diehl, A Diemert, K Hecher
  Ultrasound in Obstetrics and Gynecology 10/2010; 36(S1):122. · 3.01 Impact Factor
• Article: Growth after intrauterine laser coagulation for twin-twin transfusion syndrome.

  C Maschke, A R Franz, B Ellenrieder, K Hecher, A Diemert, P Bartmann
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  ABSTRACT: The aim of this study was to investigate prenatal and postnatal growth of twins with twin-twin transfusion syndrome (TTTS) after intrauterine laser coagulation. The weight and length of 54 sets of twins with severe TTTS surviving intrauterine laser coagulation at the intervention (median 20+4 weeks), at birth (median 34+3 weeks) and on the occasion of neurodevelopmental follow-up (median age 3 years 10 months) were investigated. All data were converted to Z scores, and groups were compared by two-tailed paired t test. At all time points, donors are significantly lighter than recipients (p<0.001). After laser treatment the weight Z score of donors until birth remains unchanged (p=0.76), whereas recipients lose weight significantly (p<0.01). Postnatally, both donors and recipients show catch-up growth. Intrauterine laser coagulation stops growth acceleration in recipients that leads to a decrease in intertwin discordance. After birth, significant catch-up growth was observed for the donor group (p<0.001).
  Archives of Disease in Childhood - Fetal and Neonatal Edition 03/2010; 95(2):F115-7. · 3.05 Impact Factor
• Article: Severely abnormal flow patterns in the ductus venosus in the presence of otherwise normal fetal Doppler parameters in two cases of severe intrauterine growth restriction.

  A Diemert, K Hecher
  Ultrasound in Obstetrics and Gynecology 10/2009; 34(5):605-7. · 3.01 Impact Factor
• Article: OP09.07: TTTS1 protocol: a cluster randomized controlled trial comparing a conservative management and primary laser surgery in stage 1 TTTS.

  J Stirnemann, J C Thalabard, K Nicolaides, K Hecher, E Lopriore, D Oepkes, J Deprest, E Gratacos, M Kilby, Y Ville
  Ultrasound in Obstetrics and Gynecology 10/2009; 34(S1):90. · 3.01 Impact Factor
• Article: OP03.07: In-vivo MRI measurement of fetal blood oxygen saturation in cardiac ventricles of fetal sheep: a feasibility study.

  U Wedegärtner, J Yamamura, M Frisch, G Adam, W Diehl, K Hecher
  Ultrasound in Obstetrics and Gynecology 10/2009; 34(S1):70-71. · 3.01 Impact Factor
• Article: OC24.09: Relationship between head circumference and neurodevelopmental outcome of 160 children after twin-twin transfusion syndrome (TTTS).

  C Maschke, B Ellenrieder, K Hecher, P Bartmann
  Ultrasound in Obstetrics and Gynecology 10/2009; 34(S1):47-48. · 3.01 Impact Factor
• Article: OC24.08: Childhood growth after intrauterine laser coagulation for twin-twin transfusion syndrome (TTTS).

  C Prinz, C Maschke, P Graeve, K Hecher, P Bartmann
  Ultrasound in Obstetrics and Gynecology 10/2009; 34(S1):47. · 3.01 Impact Factor
• Article: OC22.08: New indices for the analysis of ductus venosus flow velocity waveforms: preliminary study in twin-to-twin transfusion syndrome treated with laser coagulation.

  D Tachibana, P Glosemeyer, W Diehl, A Diemert, K Hecher
  Ultrasound in Obstetrics and Gynecology 10/2009; 34(S1):42. · 3.01 Impact Factor
• Article: OC14.05: Fetal cardiac MR imaging with cardiac triggering in the sheep fetus: preliminary results.

  U Wedegärtner, J Yamamura, M Frisch, G Adam, W Diehl, K Hecher
  Ultrasound in Obstetrics and Gynecology 10/2009; 34(S1):27. · 3.01 Impact Factor
• Article: OP22.07: Lung function at school age of 60 children after intrauterine laser therapy for twin-twin transfusion syndrome (TTTS).

  C Maschke, C Prinz, P Graeve, K Hecher, P Bartmann
  Ultrasound in Obstetrics and Gynecology 10/2009; 34(S1):133-134. · 3.01 Impact Factor
• Article: P18.16: Chorioangioma, non-immunologic hydrops foetalis (NIHF), Mirror-syndrome and post partum cardiomyopathy-a case report.

  B G Hollwitz, P Glosemeyer, W Diehl, T Somville, M Tavares de Sousa, K Hecher
  Ultrasound in Obstetrics and Gynecology 10/2009; 34(S1):251. · 3.01 Impact Factor
• Article: Laser therapy of twin-to-twin transfusion syndrome in triplet pregnancies.

  A Diemert, W Diehl, A Huber, P Glosemeyer, K Hecher
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  ABSTRACT: Laser coagulation of placental anastomoses in twin pregnancies complicated by severe twin-to-twin transfusion syndrome (TTTS) has been shown to be superior to serial amniodrainage, and has emerged as the standard therapy for this condition. We report the outcome of triplet pregnancies treated with laser therapy for severe TTTS. From a database containing information on all multiple pregnancies referred to our center we identified 20 triplet pregnancies with severe TTTS. Sixteen of them were dichorionic, four monochorionic and all cases were triamniotic. Perinatal outcome was obtained in all cases. Fetoscopy was performed in 18 out of 20 cases at a median gestational age of 19.7 (range, 17.0-23.3) weeks. Delivery occurred at a median of 31.9 (range, 24.7-36.4) weeks with an overall fetal survival rate of 65%, at least one surviving fetus in 83% of cases and all three fetuses surviving in 39%. Laser coagulation is an effective treatment for severe TTTS in triplets. However, survival rates are lower than in twin pregnancies.
  Ultrasound in Obstetrics and Gynecology 09/2009; 35(1):71-4. · 3.01 Impact Factor
• Article: Umbilical venous volume flow in twin-twin transfusion syndrome.

  S Gungor, P Glosemeyer, A Huber, K Hecher, A A Baschat
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  ABSTRACT: To examine umbilical venous volume flow (UVF) dynamics by twin status and disease severity in untreated twin-twin transfusion syndrome (TTTS). In 70 cases of untreated TTTS, absolute UVF, UVF corrected for estimated fetal weight (UVF/kg), intertwin difference (DeltaUVF/kg) and recipient to donor ratio (R/D-UVF/kg) were calculated. Parameters for UVF were compared with respect to twin status and disease severity (early, Quintero Stages I and II; advanced, Stages III and IV). UVF/kg was higher in recipients than in donors and decreased with advancing stage in both twins (in recipients, 183.9 mL/kg/min vs. 145.6 mL/kg/min, P = 0.043; in donors, 137.5 mL/kg/min vs. 122.5 mL/kg/min, P = 0.033). Linear regression analysis demonstrated that the overall best correlation coefficient for DeltaUVF/kg was obtained for the Doppler pulsatility index of the umbilical artery (t = - 4.536, P < 0.001). In advanced stage, absolute and weight-corrected UVF were lower overall, while significant differences in intertwin volume flows persisted. The lowest flows were observed in hydropic recipients (median, 67.0 (range, 55.2-122.0) mL/kg/min vs. 180.8 (range, 59.1-565.4) mL/kg/min; P = 0.001). In TTTS, UVF is significantly higher in recipients than in donors. With progression to advanced stage UVF/kg decreases in both twins as the magnitude of UVF that can be accommodated by the recipient declines. Further study of these dynamics in combination with cardiac performance parameters is warranted to refine diagnostic and prognostic assessment.
  Ultrasound in Obstetrics and Gynecology 10/2008; 32(6):800-6. · 3.01 Impact Factor
• Article: Monochorialität: Risiken und intrauterine Therapie

  K. Hecher, A. Diemert, W. Diehl, L. Lewi
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  ABSTRACT: Monochoriale Gemini stellen aufgrund der plazentaren Gefäßanastomosen eine besondere Risikokonstellation dar. Dieser Überblick befasst sich mit den verschiedenen Möglichkeiten der Gefäßarchitektur monochorialer Plazenten und deren Folgen, sowohl für den natürlichen Verlauf als auch im Hinblick auf eine minimal invasive intrauterine Therapie. Bei ungleicher Aufteilung der Plazenta liegen meist viele, häufig auch arterioarterielle Anastomosen vor. Diese Konstellation führt typischerweise zu einer frühen Wachstumsdiskrepanz, dabei profitiert der kleinere Zwilling von der Monochorialität. Bei einer später eintretenden Wachstumsdiskrepanz sind die plazentaren Anteile ausgeglichener, und es finden sich nur wenige Anastomosen. Insgesamt ist das Risiko für das Auftreten eines ausgeprägten Zwillingstransfusionssyndroms etwa 10%, für die Entstehung einer selektiven intrauterinen Wachstumsretardierung 14%. Die fetoskopische Laserkoagulation der plazentaren Anastomosen beim Zwillingstransfusionssyndrom ist allen anderen therapeutischen Optionen eindeutig überlegen. Bei selektiver Wachstumsretardierung sollte unter engmaschigem fetalem Monitoring ein möglichst hohes Gestationsalter bei Entbindung angestrebt werden. Die Koagulation der Nabelschnur bei schweren Komplikationen eines Zwillings führt zu Überlebensraten der Ko-Zwillinge von über 80%. Monochorionic twin pregnancies are at increased risk for certain complications owing to placental vascular anastomoses. This review describes the various types of angioarchitecture of monochorionic placentas and their consequences for the natural history of these pregnancies as well as for intrauterine invasive procedures. In cases of unequal placental sharing, many anastomoses exist and usually include large arterio-arterial anastomoses. This is typical for early-onset discordant growth, and the smaller twin may benefit from monochorionicity. In cases of late-onset discordant growth, the placentas are usually equally shared, and there are fewer and smaller anastomoses. Severe midtrimester twin-to-twin transfusion syndrome occurs in about 10% of monochorionic pregnancies, and severe discordant growth without transfusion syndrome occurs in 14%. Fetoscopic laser coagulation of placental vascular anastomoses in twin-to-twin transfusion syndrome results in significantly improved outcomes compared with other therapeutic interventions such as serial amniodrainage. In cases of selective intrauterine growth restriction, the optimal time for elective preterm delivery should be based on the results of intensive fetal monitoring. Cord coagulation of a twin with severe complications leads to survival rates of more than 80% for co-twins.
  Der Gynäkologe 09/2008; 41(10):781-789.