Holger Maul

Holger Maul
Asklepios Klinik Barmbek · Department of Obstetrics and Gynecology

Hon.-Prof. Dr. med. habil. Master of Medical Science

About

242
Publications
24,341
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Introduction
Holger Maul currently works at the Department of Obstetrics and Gynecology, Asklepios Klinik Barmbek. Holger does research in Obstetrics and Gynaecology. Their current project is 'Peripartal Haemorrhage (PPH)', 'Preterm Birth', 'Multiple Pregnancy' and 'Preeclampsia'.

Publications

Publications (242)
Article
The authors hypothesize that particularly severely compromised and asphyctic term infants in need of resuscitation may benefit from delayed umbilical cord clamping (after several minutes). Although evidence is sparse, the underlying pathophysiological mechanisms support this assumption. For this review the authors have analyzed the available resear...
Article
The administration of a single course of corticosteroids before week 34 + 0 of gestation in cases with impending preterm birth is now standard procedure in obstetric care and firmly established in the guidelines of different countries. But despite the apparently convincing data, numerous aspects of this intervention have not yet been properly studi...
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Objectives Current international guidelines recommend tocolytic treatment by at least 48 hours to complete fetal lung maturation and to ensure in-utero transfer to a perinatal center before 34 weeks of gestation in patients with threatened preterm birth. According to the results of former surveys, significant differences between daily clinical prac...
Article
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According to current guidelines, inpatient management until birth is considered standard in pregnant women with preterm premature rupture of membranes (PPROM). With the increasing burden on obstetric departments and the growing importance of satisfaction and right to self-determination in pregnant women, outpatient management in PPROM is a possible...
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Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease specific to pregnancy. The cardinal symptom of pruritus and a concomitant elevated level of bile acids in the serum and/or alanine aminotransferase (ALT) are suggestive for the diagnosis. Overall, the maternal prognosis is good. The fetal outcome depends on the bile acid l...
Article
Intrahepatic cholestasis of pregnancy (ICP) is the most frequent pregnancy-specific liver disease. It is characterized by pruritus and an accompanying elevation of serum bile acid concentrations and/or alanine aminotransferase (ALT), which are the key parameters in the diagnosis. Despite good maternal prognosis, elevated bile acid concentration in...
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Objectives Active and passive exposure to tobacco cigarettes during pregnancy is associated with multiple negative health outcomes for the fetus. In addition, exposure to e-cigarettes has been progressively discussed as a new threat to fetal health. Until now, there has been a lack of studies examining active and passive exposure to tobacco and e-c...
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Introduction E-cigarette use during pregnancy is a risk factor for maternal and fetal health. Early studies on animals showed that in utero exposure to e-cigarettes can have negative health outcomes for the fetus. There has been only limited research into the risk perceptions of e-cigarette use during pregnancy. This study was conducted to comprehe...
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Around 3% of all pregnancies are complicated by preterm prelabor rupture of membranes (PPROM) before 37 + 0 weeks of gestation. Since PPROM is likely to be associated with microbial invasion of the amniotic cavity (MIAC)—either before or secondary to PPROM—the risk of developing intraamniotic inflammation (IAI) is high. IAI is associated with short...
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Background The rate of preterm births in Germany is 8.6%, which is very high compared to other European countries. As preterm birth contributes significantly to perinatal morbidity and mortality rates, the existing prevention strategies need to be optimized and expanded further. About ⅔ of all women with preterm birth have preterm labor or prematur...
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Objectives To evaluate the maternal and perinatal outcomes of pregnancies affected by SARS‐CoV‐2 infection. Methods This was a multinational retrospective cohort study including women with a singleton pregnancy and laboratory‐confirmed SARS‐CoV‐2 infection, conducted in 72 centers in 22 different countries in Europe, the USA, South America, Asia a...
Article
Objective: Cervical funneling is associated with spontaneous preterm birth (sPTB). The aim of this analysis was to assess the relationship between funneling shape and the response to the McDonald cerclage, the Arabin pessary and the early total cervical occlusion (ETCO). Methods: We retrospectively analyzed data of 312 randomly selected singleto...
Article
Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to Apr...
Article
Premature birth makes a substantial contribution to the perinatal morbidity and mortality and is one of the main risk factors for disability-adjusted life years (DALYs). Since 2008 the incidence in Germany has been stable at slightly over 8 %. Germany therefore occupies one of the lowest places in Europe. The condition after premature birth is the...
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Introduction During pregnancy, the motherʼs healthy lifestyle is crucial for the health of the fetus. Potential risk factors for maternal and child health should therefore be identified and reduced as early as possible. The consumption of e-cigarettes represents one of these potential risk factors. Exploring risk perceptions about e-cigarette use d...
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Background: The preterm birth rate in Germany has remained unchanged at 8-9% since 2009. Preterm birth is the most common cause of neonatal morbidity and mortality. In the absence of a causal treatment, it is important to lower the risk of preterm birth by preventive measures in prenatal outpatient care. Methods: This review is based on pertinen...
Article
Aims: This is an official guideline of the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (ÖGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The aim of this guideline is to improve the prediction, prevention and management of preterm birth based on evidence obtained from rece...
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This position paper describes clinically important, practical aspects of cervical pessary treatment. Transvaginal ultrasound is standard for the assessment of cervical length and selection of patients who may benefit from pessary treatment. Similar to other treatment modalities, the clinical use and placement of pessaries requires regular training....
Article
Zusammenfassung Ziel Offizielle Leitlinie der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG), der Österreichischen Gesellschaft für Gynäkologie und Geburtshilfe (ÖGGG) und der Schweizerischen Gesellschaft für Gynäkologie und Geburtshilfe (SGGG). Ziel der Leitlinie ist es, die Prädiktion, die Prävention und das Management der Frühgeb...
Article
The transcription factor B Cell CLL/Lymphoma 11B (BCL11B) is indispensable for T lineage development of lymphoid progenitors. Here we show that chimeric antigen receptor (CAR) expression early in ex vivo generated lymphoid progenitors suppressed BCL11B, leading to suppression of T cell-associated gene expression and acquisition of natural killer (N...
Article
Objective: Previous studies have shown that e-cigarettes are perceived as being less harmful than tobacco cigarettes by pregnant women and might be used to quit smoking during pregnancy. Our aim was to further explore and characterise perceived threats, benefits and barriers of e-cigarette use during pregnancy. Methods: Our STudy on E-cigarettes...
Article
Aims This is an official guideline of the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (ÖGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The aim of this guideline is to improve the prediction, prevention and management of preterm birth based on evidence obtained from recent...
Article
Aims This is an official guideline of the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (ÖGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The aim of this guideline is to improve the prediction, prevention and management of preterm birth based on evidence obtained from recent...
Article
Background Cervical cancer is mostly diagnosed in women of reproductive age. For this reason a fertility-preserving approach is often desired by the patient. In this review the various surgical options are presented. The obstetric and oncological risks associated with these procedures are discussed in detail. Material and methods Recommendations a...
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Purposeβ2-sympathomimetics are used in obstetrics as tocolytic agents, despite a remarkable profile of side effects. Recently, the β2-sympathomimetic tocolytic drug hexoprenaline was identified as an independent risk factor for the development of infantile hemangioma (IH) in preterm infants. The aim of this study was to evaluate whether this observ...
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ABSTR AC T Preterm birth is one of the major global health problems and part of the Millennium Development goals because of the associated high number of perinatal or neonatal mortality and long-term risks of neurodevelopmental and metabolic diseases. Transvaginal sonography has meanwhile been established as a screening tool for spontaneous preterm...
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Auf dem 38. Jahreskongress der Society of Maternal and Fetal Medicine (SMFM) Anfang Februar in Dallas stellten die Arbeitsgruppen um Vinh Dang und Ben Mol (1) die Daten aus der ersten prospektiv randomisierten Studie über den Head-to-Head Vergleich von Arabin-Pessar und vaginalem Progesteron zur Prävention der Frühgeburt bei Zwillingsschwangerschaf...
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Purpose This is an official interdisciplinary guideline, published and coordinated by the German Society of Gynaecology and Obstetrics (DGGG), the Austrian Society of Gynaecology and Obstetrics (OEGGG) and the Swiss Society of Gynaecology and Obstetrics (SGGG). The guideline was developed for use in German-speaking countries and is backed by the Ge...
Chapter
Weltweit kommen ca. 15 Mio. Kinder vor Abschluss der 37. Schwangerschaftswoche zur Welt und 2,8 Mio. vor Abschluss der 32. Schwangerschaftswoche. Frühgeburten stellen eine der Hauptursachen der neonatalen (35% ≙ 2,8 Mio. Kinder/Jahr) und kindlichen Mortalität (17% ≙ 6,2 Mio. Kinder/Jahr) dar. Frühgeburten sind verantwortlich für 25–50% schwerer neu...
Chapter
Bei einer Chorioamnionitis kommt es zu einer Infektion von Fruchtwasser, Eihäuten, Plazenta und/oder Dezidua. Die Infektion verläuft manifest oder subklinisch. Die Chorioamnionitis ist eine der Hauptursachen für peripartal auftretendes Fieber. Die Diagnose kann letztlich nur nachträglich durch histologische Sicherung erfolgen. Die Chorioamnionitis...
Article
Background: Transplantation of hematopoietic stem cells (HSCs) from peripheral blood (PB) or cord blood (CB) is well established. HSCs from CB are associated with a lower risk of graft-versus-host disease (GVHD), but antigen-independent expanded CB- and PB-derived T cells can induce GVHD in allo-HSC recipients. CB-derived cells might be more suita...
Chapter
Das Frühgeburtsrisiko ist bei Mehrlingen gegenüber Einlingen erhöht. Die Vorhersage einer Frühgeburt bei einer Mehrlingsschwangerschaft ist kaum möglich. Bekannte Maßnahmen zur Prävention oder Hemmung der Wehentätigkeit wie z.B. Progesteron, Bettruhe, Cerclage und tokolytische Therapie reduzieren die Frühgeburtenrate bei Mehrlingsschwangerschaften...
Article
Frühchen, die vor der 30. Schwangerschaftswoche zur Welt kommen, sind in besonderem Maße von perinatalen Hirnschäden betroffen. Viele dieser Kinder sind schwerbehindert. Dies gilt es zu vermeiden.
Article
Worldwide, post-partum haemorrhage (PHH) remains one of the leading causes for maternal mortality. The German Society of Gynaecology and Obstetrics, the German Midwifes' Society, the German Society of Thrombosis and Haemostasis and the German Society of Anaesthesiology and Intensive Care updated the former guideline. The resulting recommendations a...
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Retroviral engineering of hematopoietic stem cell-derived precursor T cells (preTs) opens the possibility of targeted T cell transfer across HLA-barriers. Alpharetroviral vectors exhibit a more neutral integration pattern thereby reducing the risk of insertional mutagenesis. Cord blood-derived CD34+ cells were transduced and differentiated into pre...
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Laparoscopy-related tumor implantations of gynecological malignancies into the subcutaneous tissue are rarely diagnosed. We report an interesting case of a 46-year-old female who presented with an abdominal subcutaneous metastasis of a borderline ovarian tumor. The patient received a laparoscopic unilateral adnexectomy for a solid-cystic tumor of t...
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Objective: In March 2012, a universal screening for gestational diabetes mellitus (GDM) was implemented in Germany. Despite international recommendations, a two-step approach was introduced [step 1: 50-g glucose challenge test (GCT); if GCT is suspicious, step 2 follows: 75-g oral glucose tolerance test with (OGTT)]. This qualitative study aimed a...
Article
to explore pregnant women׳s experiences with the recently implemented screening for gestational diabetes mellitus (GDM). qualitative study. Rhine-Neckar Metropolitan region, Germany. 20 pregnant women aged 27-41 years (mean: 32.6 years) who were at least in gestational week 29, i.e., those who should have already been screened for GDM. semi-structu...
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Emergency cervical cerclage is one of the treatment options for the reduction of preterm birth. The aim of this study is to assess neonatal outcome after cerclage with special focus on adverse effects in very low birth weight infants. Retrospective cohort study. Classification of cerclages in history-indicated (HIC, n = 38), ultrasound-indicated (U...
Article
Hintergrund: Die Prävention und Behandlung der Frühgeburt gehört auch heute noch zu den ungelösten Problemen der Geburtshilfe. Progesteron entfaltet eine Vielzahl von Wirkungen auf Myometrium und Zervix, u. a. eine Hemmung der Myometriumkontraktion und eine zervixstabilisierende Wirkung durch Inhibition proinflammatorischer Zytokine und konsekutiv...
Article
Background: In March 2012, the screening for gestational diabetes was included as a 2-step screening into the German maternity directive. However, up to now it is unclear what resident gynaecologists, who are affected directly by this change in the maternity directive, think about the inclusion of the screening and the kind of screening introduced....
Conference Paper
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Objective Celox gauze (7.5 cm wide, 3 m long) is covered with chitosan, a hemostatic agent derived from chitin. The objective of our analysis was to compare a 26 mth period before and a 38 mth period after the introduction of Celox in the treatment of PPH and to evaluate the numbers of postpartum hysterectomies (ppHE). Study Design Women sufferi...
Article
Objective: The aim of this study is to present the current state of neuroprotection for prematurely born infants.
Article
Hintergrund Übelkeit und Erbrechen sind häufig beobachtete Symptome in der (Früh-)Schwangerschaft, und Studien belegen, dass nichtpharmakologische Therapieansätze für Hyperemesis regelmäßig von Schwangeren nachgefragt und von Hebammen wie Ärzten empfohlen werden. Ziel Ziel des Beitrags war es, mögliche alternative bzw. komplementäre Behandlung...
Article
Ziel: Neonatales Outcome nach Anlage einer Cerclage lasst sich durch unterschiedliche Indiaktionsstellung und Schwangerschaftsverlaufe retrospektiv kaum vergleichen. Das Ziel dieser Studie ist die differenzierte Darstellung des Einflusses einer Cerclage auf das neonatale Outcome an Hand von Schwangerschaftswochen- (SSW) und Geburtsgewicht- (GG) kor...
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Objective: To describe the use of gauze covered with chitosan, a potent hemostatic agent derived from chitin, in the treatment of postpartum hemorrhage (PPH). Study design: Patients suffering from postpartum hemorrhage were treated by uterine packing with chitosan-covered gauze, either through the hysterotomy in case of cesarean delivery or tran...
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One of the first steps in optimizing future prevention and appropriately allocating resources to future diagnosis and treatment of Gestational diabetes (GDM) is to quantify its burden. The aim of this study was therefore to conduct a systematic review of current international literature on the prevalence of GDM with a focus on advanced economies. B...
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Cheap and simple interventions that are intended to minimize postpartum hemorrhage are of major public health concern. We report a case of postpartum hemorrhage in which conservative interventions had failed. The use of a chitosan-covered gauze that originally was developed for combat trauma allowed us to achieve hemostasis, and a seemingly inevita...
Article
Gestational diabetes and preeclampsia are leading causes of complications during pregnancy. The aims of this study were to quantify the probability that both diseases occur together, to evaluate commonality of risk factor profiles, and to clarify the connection between gestational diabetes and preeclampsia in combination with the maternal body mass...
Article
The purpose of this study was to determine whether optical methods can estimate cervix function during pregnancy and whether progestins modify this process. Photos of the external cervix of timed-pregnant rats were taken every other day from day 13 until postpartum day 5 after daily treatments with vehicle (controls) or progestin treatments (proges...
Article
We investigated risk factors and neonatal outcomes of preeclampsia. We analyzed data of the German Perinatal Quality Registry 2006 that contains the complete national birth cohort of 668,085 newborn infants and 647,392 mothers from 917 German obstetric clinics. The prevalence of preeclampsia in 2006 was at 2.31%. Higher maternal age, gestational di...
Article
Over the last few decades a large number of studies have investigated mental illness during pregnancy detecting a considerable prevalence of antenatal depression at a level of approximately 10%. Whilst much attention has been paid to the subject in the Anglo-American and Scandinavian world the issue has scarcely been studied in Germany. At present...
Article
Zusammenfassung Eine Vielzahl von Studien hat sich in den vergangenen Jahrzehnten mit psychischen Störungen während der Schwangerschaft beschäftigt und eine nicht zu vernachlässigende Prävalenz präpartaler Depressionen festgestellt, welche bei rund 10% liegt. Im Gegensatz zum angloamerikanischen und skandinavischen Raum ist das Thema in Deutschland...
Article
Objective: This study aimed to identify risk factors for gestational diabetes mellitus (GDM) and assess the effects of GDM on the risk of adverse pregnancy outcomes. Material and methods: This was a cross-sectional study using data from the German Perinatal Quality Registry, which is a complete national registry containing information on all hos...
Article
interleukin (IL)-24 and -29 are novel cytokines, produced by immune cells in response to microbial antigens. The functions of these cytokines in the reproductive system are unknown. We examined the expression pattern of IL-24 and IL-29 in human fetal membranes from preterm and term births and in in vitro in response to microbial antigens. fetal mem...