Christoph Berg

• Prof. Dr. med.
• University of Cologne

Since the first intrauterine interventions were carried out in the 1970 s under what today would be considered basic conditions, the range of prenatal interventions has steadily expanded, as has the frequency with which these interventions are carried out at specialized centers. Although most of these procedures are minimally invasive, they are inv...

Objective To investigate the ongoing parvovirus B19 (B19V) outbreak among pregnant women in Germany and its connection to the coronavirus disease 2019 (COVID‐19) pandemic. Methods This retrospective cohort study analyzed anonymous data regarding serologically confirmed B19V infections during pregnancy between January 2014 and April 2024 across 13...

Aims This study aimed to evaluate the Oxygen Saturation Index (OSI) as a noninvasive measure for early postnatal management and outcome prediction in neonates with congenital diaphragmatic hernia (CDH). Additionally, the study analyzed the correlation and predictive ability of OSI, Oxygenation Index (OI), Horovitz Index (HI), and partial pressure o...

Introduction As a widely accessible, cost-effective, and safe imaging tool, obstetric and gynecologic (OB/GYN) ultrasound (ULS) plays a vital role in diagnostics and patient care. With its growing relevance, the demand for comprehensive education in this field increases. The objective of this work was to outline the current state of OB/GYN ULS educ...

This report describes the ingestion of a dislodged Somatex Intrauterine Stent by the fetus. At 35 weeks one shunt was visualized in the fetal stomach, suggesting that the fetus had swallowed it. The shunt kept its position in the stomach until the last follow up scan at 37 weeks. At 38 weeks the patient went into spontaneous labor and vaginally del...

Purpose Intrauterine vesicoamniotic shunting (VAS) was shown to affect survival of male fetuses with megacystis in suspected lower urinary tract obstruction (LUTO). Data on postnatal management are largely lacking. We aim to describe the pathologies diagnosed in children born after vesicoamniotic shunt placement in early pregnancy for megacystis....

Objective: In our center, we observed an increased frequency of right aortic arch (RAA) with an agenesis of the ductus arteriosus (ADA) in prenatally diagnosed tetralogy of Fallot (ToF) and its variations. This study aimed to determine whether there is an association of RAA and ADA in fetuses with ToF. Distribution of genetic anomalies and impact...

Introduction Prenatal lower urinary tract obstruction (LUTO) is a rare and challenging condition with potential severe morbidity and mortality. Prenatal shunting methods, specifically vesicoamniotic shunting (VAS) and fetal cystoscopy, aim to manage this condition. However, comprehensive education and training are hindered by the rarity of LUTO. To...

Objectives: Twins resulting from a complicated monochorionic (MC) twin pregnancy are at risk for postnatal evolution of pulmonary hypertension (PH) and cardiac dysfunction (CD). Both pathologies are important contributors to short- and long-term morbidity in these infants. The aim of the present retrospective single-center cohort study was to evalu...

Background Critical aortic stenosis (AS) in fetuses may progress to hypoplastic left heart syndrome (HLHS) with need for postnatal single ventricular (SV) palliation. Fetal aortic valvuloplasty (FAV) is performed to achieve postnatal biventricular (BV) circulation. However, the impact of FAV on fetal myocardial function is difficult to measure. Pre...

Aims Current treatment guidelines recommend immediate postnatal intubation in all neonates with congenital diaphragmatic hernia (CDH). This study aimed to investigate the feasibility and outcomes of a spontaneous breathing approach (SBA) versus immediate intubation in neonates with prenatally diagnosed very mild CDH. Methods A retrospective study...

Background: Cordocentesis is used in clinical situations in which lower-risk diagnostic procedures do not deliver the desired results. The aim of this study was to evaluate the risk for procedure-related complications and fetal loss in correlation to maternal risk factors. Methods: This is a multicenter retrospective study investigating the complic...

Introduction: Intrauterine vesicoamniotic shunting (VAS) using a Somatex® shunt was shown to significantly affect survival of male fetuses with megacystis in suspected lower urinary tract obstruction (LUTO) [Figure 1]. Data on postnatal surgical management and complications are largely lacking. Objective: To describe the postnatal management of...

Objective: to assess the course and outcome of fetuses affected by primary cardiomyopathy (CM). Methods: Retrospective study of 21 cases with prenatal diagnosis of a primary CM in one tertiary center over a period of 20 years. Charts were reviewed for echocardiographic findings, pregnancy outcome, and postnatal course. The utility of prenatal ev...

Introduction Pulmonary hypertension (PH) is one of the major contributing factors to the high morbidity and mortality in neonates with congenital diaphragmatic hernia (CDH). The severity and duration of postnatal PH are an established risk factor for patient outcome; however, the early postnatal dynamics of PH have not been investigated. This study...

Objective Restrictive foramen ovale (FO) in dextro-transposition of the great arteries (d-TGA) with intact ventricular septum may lead to severe life-threatening hypoxia within the first hours of life, making urgent balloon atrial septostomy (BAS) inevitable. Reliable prenatal prediction of restrictive FO is crucial in these cases. However, current...

Purpose In adults and fetuses, N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a marker of cardiac failure and myocardial remodelling. We examined the effect of anemia and intrauterine transfusion (IUT) on NT-proBNP concentrations in fetuses with anemia and established gestational age-dependent reference values of a control group. Methods...

Objectives To assess the spectrum of underlying pathologies, the intrauterine course and postnatal outcome of 46 fetuses with megacystis that underwent intrauterine vesico-amniotic shunting (VAS) with the Somatex® shunt in a single center. Methods Retrospective analysis of 46 fetuses with megacystis that underwent VAS either up to 14 + 0 weeks (ea...

Introduction: Twin anemia-polycythemia sequence (TAPS) is a complication in monochorionic-diamniotic (MCDA) twin pregnancies. This study analyzes whether the prenatal diagnosis using delta middle cerebral artery-peak systolic velocity (MCA-PSV) > 0.5 multiples of the median (MoM) (delta group) detects more TAPS cases than the guideline-based diagn...

Purpose In adults and fetuses, N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a marker of cardiac failure and myocardial remodelling. We examined the effect of anemia and intrauterine transfusion (IUT) on NT-proBNP concentrations in fetuses with anemia and established gestational age-dependent reference values of a control group. Methods...

Die moderne Pränataldiagnostik ermöglicht die vorgeburtliche Erkennung fetaler Anomalien, bei welchen es trotz nachgeburtlicher Behandlung zum Versterben oder zu schwerwiegender Beeinträchtigung des betroffenen Kindes kommen kann. Als Alternative zum rein konservativen Vorgehen bzw. zum Schwangerschaftsabbruch in solchen Fällen, kann unter gewissen...

Purpose Report on the diagnosis of prenatally detected fetal kidneys with bilateral polycystic appearance in a single center between 1999 and 2020 with special focus on renal morphology and biometry, amniotic fluid and extrarenal findings and proposal for an diagnostic algorithm. Methods Retrospective observational study including pregnancies with...

Purpose Evaluating procedure-related complications and perinatal outcomes after intrauterine transfusion (IUT) before or after 20⁺⁰ weeks of gestation in fetuses with severe anemia due to intrauterine human parvovirus B19 infection. Methods A retrospective study investigating fetuses requiring IUT for fetal Parvo B19 infection in two tertiary refe...

Amniotic fluid (AF) is the first fluid to enter the gastrointestinal tract. Preterm birth is leading to a sudden interruption of AF swallowing. Understanding the composition of amniotic fluid is crucial to implement strategies preventing intestinal injury in preterm infants. We hypothesized that the fetal gastrointestinal tract (GIT) is exposed to...

Purpose To assess the spectrum of associated cardiac anomalies, the intrauterine course, and postnatal outcome of fetuses with double inlet ventricle (DIV). Methods Retrospective analysis of prenatal ultrasound of 35 patients with DIV diagnosed between 2003 and 2021 in two tertiary referral centers in Germany. All fetuses underwent fetal echocardio...

Background The carbohydrate antigen 125 (CA125) was proven as a robust biomarker for risk stratification in adults with heart failure. This is the first study analyzing CA125 in a cohort of infants with congenital diaphragmatic hernia (CDH). Methods Sixty-eight infants with CDH, treated at the University Children’s Hospital Bonn (Germany), between...

Objective: To assess the course and outcome of fetal aortic valvuloplasty (FAV) in fetuses with severe aortic stenosis (SAS) in a single center. Methods: All fetuses with a prenatal diagnosis of SAS with subsequent FAV were retrospectively collected in one tertiary center for fetal medicine over a period of 10 years. In the study, period fetuses...

Background: Assessment of pulmonary hypertension (PH) is essential in neonates with congenital diaphragmatic hernia (CDH). Echocardiography is widely established to quantify PH severity, but currently used parameters have inherent limitations. The aim of our study was to investigate the prognostic utility of the index of the pulmonary artery accel...

Purpose Aorto-left ventricular tunnel (ALVT) is an extremely rare, albeit prenatally detectable, extracardiac channel that connects the ascending aorta to the cavity of the left ventricle. Materials and Methods All ALVTs diagnosed prenatally (2006–2020) in five tertiary referral centers were retrospectively assessed for prenatal ultrasound findings...

(1) Background: The aim of this study was to compare perinatal outcomes and complication rates of vesicoamniotic shunting (VAS) before 17 + 0 weeks in isolated LUTO (lower urinary tract obstruction) with the Somatex® intrauterine shunt vs. the Harrison fetal bladder shunt. (2) Methods: This is a retrospective cohort study in two tertiary fetal medi...

(1) Background: Severe fetal hydrothorax can be treated by intrauterine thoracoamniotic shunting (TAS). The aim of this study was to assess perinatal outcome and complication rates of TAS with a novel Somatex intrauterine shunt. (2) Methods: This is a single-center retrospective study of all fetuses with hydrothorax treated with TAS using a Somatex...

Scimitar syndrome is a rare disease characterized by hypoplasia of the right lung and partial anomalous pulmonary venous drainage to the inferior vena cava. All cases with a prenatal diagnosis of scimitar syndrome with or without associated malformations in an 18-year period (2000–2018) in two large tertiary referral centers (University of Bonn and...

Objectives: To review the outcome of complicated monochorionic pregnancies after fetoscopic selective feticide with bipolar cord coagulation in an experienced German center. Methods: All cases that underwent selective feticide using fetoscopic bipolar umbilical cord occlusion (and simultaneous dissection in monoamniotics) at the University of Bo...

( N Engl J Med . 2021;385:119–129) Congenital diaphragmatic hernia (CDH) can lead to pulmonary hypoplasia and is associated with serious neonatal complications and death. In infants with severe left diaphragmatic hernia, fetoscopic endoluminal tracheal occlusion (FETO) has been associated with greater survival rates but also higher rates of prematu...

( Engl J Med . 2021;385:107–118) Congenital diaphragmatic hernia (CDH) can lead to serious lifelong complications, but may be treated if diagnosed before birth. In fetoscopic endoluminal tracheal occlusion (FETO), a balloon is inserted into the fetal trachea in utero to stimulate fetal lung growth and is removed prior to birth. One study of 210 fet...

Objective The purpose of this study was to explore the outcome in fetuses with prenatal diagnosis of absent pulmonary valve syndrome (APVS) on ultrasound imaging. Methods A manual web scraping technique was utilized, where MEDLINE and EMBASE were searched along the combination with other relevant medical subject headings such as “absent pulmonary...

To assess the spectrum of different etiologies, the intrauterine course, outcome and possible prognostic markers in prenatally detected fetal growth restriction (FGR) combined with polyhydramnios. Retrospective study of 153 cases with FGR combined with Polyhydramnios diagnosed by prenatal ultrasound over a period of 17 years. Charts were reviewed f...

Fetal cardial interventions (FCI) are performed in utero with the aim of improving the postnatal prognosis of a small number of distinct cardiac anomalies or, more rarely, preventing intrauterine fetal demise. The three main indications include aortic stenosis with evolving hypoplastic left heart syndrome (eHLHS), hypoplastic left heart syndrome (H...

Introduction: The aim of this study is to evaluate the outcome of pregnancies complicated by monochorionic monoamniotic twin reversed arterial perfusion sequence (MOMA TRAP) diagnosed in the first trimester. Methods: All patients diagnosed with MOMA TRAP sequence <14.0 weeks of gestation in a 10-year study period were retrospectively analyzed fo...

Purpose To assess the spectrum of associated anomalies, the intrauterine course, postnatal outcome and management of fetuses with truncus arteriosus communis (TAC) Methods All cases of TAC diagnosed prenatally over a period of 8 years were retrospectively collected in two tertiary referral centers. All additional prenatal findings were assessed an...

(Abstracted from N Engl J Med 2021;385:107–118) Congenital diaphragmatic hernia (CDH) occurs in approximately 1 in 4000 births, and 85% of these cases have the defect on the left side. The condition is associated with neonatal death due to respiratory failure and pulmonary hypertension.

Zielsetzung Ziel dieser Studie war es, das Outcome bei Feten mit pränataler Diagnose eines fehlenden Pulmonalklappensyndroms (APVS) im Ultraschall zu untersuchen. Methoden Es wurde eine manuelle Web-Scraping-Technik verwendet, bei der MEDLINE und EMBASE in Kombination mit anderen relevanten medizinischen Fachbegriffen wie „absent pulmonary valve s...

Background Two randomized controlled trials compared the neonatal and infant outcomes after fetoscopic endoluminal tracheal occlusion (FETO) with expectant prenatal management in fetuses with moderate and severe isolated congenital diaphragmatic hernia (CDH), respectively. FETO was carried out at 27⁺⁰ to 29⁺⁶ weeks’ gestation (referred to as “early...

Purpose To assess the spectrum of associated anomalies, the intrauterine course, postnatal outcome and management of fetuses with truncus arteriosus communis (TAC) Methods All cases of TAC diagnosed prenatally over a period of 8 years were retrospectively collected in two tertiary referral centers. All additional prenatal findings were assessed an...

Objectives Prenatal prediction of postnatal univentricular versus biventricular circulation in patients with borderline left ventricle (bLV) remains challenging. This study investigated prenatal fetal echocardiographic parameters and postnatal outcome of patients with a prenatally diagnosed bLV. Methods We report a retrospective study of bLV patien...

Purpose To evaluate the outcome of first trimester intervention by intrafetal laser (IFL) in pregnancies complicated by twin reversed arterial perfusion (TRAP). Materials and Methods For a 10-year study period, all patients with TRAP diagnosed < 14.0 weeks of gestation were retrospectively analyzed for intrauterine course and outcome. Monoamniotic...

Background Observational studies have shown that fetoscopic endoluminal tracheal occlusion (FETO) has been associated with increased survival among infants with severe pulmonary hypoplasia due to isolated congenital diaphragmatic hernia on the left side, but data from randomized trials are lacking. Methods In this open-label trial conducted at cen...

Background Fetoscopic endoluminal tracheal occlusion (FETO) has been associated with increased postnatal survival among infants with severe pulmonary hypoplasia due to isolated congenital diaphragmatic hernia on the left side, but data are lacking to inform its effects in infants with moderate disease. Methods In this open-label trial conducted at...

Purpose To analyze anatomic features and associated malformations in 37 prenatally detected cases of congenitally corrected transposition of the great arteries (ccTGA) and to evaluate the prenatal course, neonatal outcome and mid-term follow-up. Methods Retrospective analysis of prenatal ultrasound of 37 patients with ccTGA in two tertiary centers...

Zusammenfassung Die Mortalität von Patienten mit isoliert auftretenden angeborenen Zwerchfellhernien liegt in spezialisierten Zentren bei 20–40%. Wesentliche, das Outcome beeinflussende Faktoren, sind die bestehende Lungenhypoplasie, eine daraus resultierende pulmonale Hypertonie, sowie das Vorliegen weiterer Fehlbildungen. Begleitfehlbildungen wie...

Purpose: To assess the spectrum of different etiologies, the intrauterine course, outcome and possible prognostic markers in prenatally detected fetal growth restriction (FGR) combined with polyhydramnios. Methods: Retrospective study of 153 cases with FGR combined with Polyhydramnios diagnosed by prenatal ultrasound over a period of 17 years. Char...

Prenatal detection of an isolated congenital coronary artery fistula (ICCAF) requires an examination of the affected fetal hemodynamic situation by the fistula. Early pediatric cardiological presentation is needed, since prenatal changes may have relevant postpartal consequences. Prenatal detection of an ICCAF requires an examination of the affecte...

Purpose: To assess the spectrum of associated anomalies, the intrauterine course, postnatal outcome and management of fetuses with truncus arteriosus communis (TAC) Methods: All cases of TAC diagnosed prenatally over a period of 8 years were retrospectively collected in two tertiary referral centers. All additional prenatal findings were assessed a...

Objective: In this study we set out to examine the efficacy of the hyperimmunoglobulin (HIG treatment in women with a recent primary CMV infection up to 14 weeks' gestation. Methods: Ongoing observational study at the prenatal medicine departments of Tuebingen, Bonn, Cologne and Erlangen, Germany as well as the laboratory Prof. Gisela Enders and...

Objective: Evaluation of course and outcome of pregnancies with prenatally diagnosed fetal teratomas of various locations in a single center between 2002 and 2019. Methods: Retrospective observational single-center study including prenatally suspected or diagnosed fetal teratomas. Focus was put on ultrasound findings during pregnancy. Complicati...

PurposeThe objective was to evaluate the feasibility of vesicoamniotic shunting (VAS) in the first trimester with the Somatex® intrauterine shunt and report on complications and neonatal outcome.Methods Retrospective cohort study of all VAS before 14 weeks at two tertiary fetal medicine centres from 2015 to 2018 using a Somatex® intrauterine shunt....

Background Severity of lung hypoplasia, pulmonary hypertension (PH) and cardiac dysfunction are major contributors to mortality in congenital diaphragmatic hernia (CDH). Therefore, early assessment and management is important to improve outcome. NT-proBNP is an established cardiac biomarker with only limited data for early postnatal risk assessment...

Die Reduktion von Mehrlingen (MFPR) hat sich im Kontext der assistierten Reproduktion entwickelt, um insbesondere das Risiko der Frühgeburt und der damit verbundenen perinatalen Morbidität und Mortalität zu senken. Der Eingriff ist mit medizinischen, psychosozialen und ethischen Problemen behaftet und sollte daher nur nach umfangreicher Aufklärung...

Purpose The objective of this study was to identify possible implications and risk factors in monochorionic (MC) twin pregnancies having a bipartite placenta. Materials Between 2014 and 2019 data on such pregnancies was prospectively collected and retrospectively analyzed. Monochorionicity was confirmed either by the presence of a T-sign, one chor...

Objective: To assess the intrauterine course and outcome of fetal cardiac intervention (FCI) in fetuses with critical aortic stenosis (CAS), severe mitral regurgitation (MR), severe left atrial dilatation (LAD), and restrictive foramen ovale (RFO) or intact atrial septum. Methods: All fetuses with a prenatal diagnosis of CAS, severe MR, severe L...

Background The mortality of neonates with congenital diaphragmatic hernia (CDH) ranges between 20 and 40% even in specialized high-volume centers. The Score for Neonatal Acute Physiology-II (SNAP-II Score) could facilitate the decision about supportive therapies in CDH newborns. Methods The SNAP-II score consists of the variables arterial blood pre...

Purpose: To assess the intrauterine course, the outcome, and to establish a new prenatal echocardiographic scoring system to predict biventricular (BV) versus univentricular (UV) outcome of fetuses with severe pulmonary stenosis or atresia with intact ventricular septum (PSAIVS). Methods: All cases of PSAIVS diagnosed prenatally over a period of...

Purpose Isolated classic bladder exstrophy (CBE) is the most common variant of the bladder-exstrophy–epispadias complex (BEEC). The BEEC represents a spectrum ranging from isolated epispadias over CBE to the most severe form, cloacal exstrophy. We report on a series of 12 cases with CBE diagnosed prenatally and illustrate the spectrum of prenatal u...

Congenital lower urinary-tract obstruction (LUTO)is caused by anatomical blockage of the bladder outflow tract or by functional impairment of urinary voiding. About three out of 10,000 pregnancies are affected. Although several monogenic causes of functional obstruction have been defined, it is unknown whether congenital LUTO caused by anatomical b...