“Congratulations! You’re expecting!” We will be happy to advise you.
We are thrilled for you and look forward to supporting you throughout your pregnancy. Together, we can discuss all of the issues around care for mother and baby. Our practice specialises in caring for mothers-to-be in keeping with the German Maternity Guidelines and in comprehensive prenatal diagnostics. To protect the unborn child and the mother-to-be, legislators in Germany have provided for a series of regular examinations.

Under the German Maternity Guidelines, the following examinations are offered to all pregnant women; the costs are covered by statutory health insurers.

• Weight
• Blood pressure
• Blood tests
• Cervical examination and testing of vaginal pH
• Urine tests
• Testing urine for chlamydia
• Vaginal smear test
• Oral glucose tolerance test 50g
• Oral glucose tolerance test 75g when 50g screening is positive
• Three scheduled ultrasound scans around the 10^th, 20^th and 30^th weeks

Additionally, we offer a wide range of prenatal test which are not currently paid for by the statutory health insurers, but are still very useful as they provide you and your baby with a high level of safety.

These include:

• Toxoplasmosis screening
• Cytomegalovirus screening
• Screening for fifth disease
• Listeria screening
• Food supplements
• Streptococcus swabs
• 75g glucose tolerance test (diagnostic test to rule out gestational diabetes)
• Additional, optional ultrasound scans (see: prenatal diagnostics)

We are happy to arrange a one-to-one consultation to explain the points above in greater detail.

Prenatal diagnostics are a cornerstone of modern prenatal care, which I have been closely involved with for many years. These scans and examinations are very comprehensive. In addition to high-end, specialised equipment, they demand a great deal of experience and special training. Regular participation in congresses in Germany and abroad ensures that my knowledge and skills stay right up-to-date.

• First trimester screening (nuchal translucency scan)
  The first trimester screening is a well-established, non-invasive scan during early pregnancy, used to assess individual risk of chromosomal abnormalities in the unborn fetus.

  If conditions are good when this scan is carried out, it provides information on how your child is developing.

• Organ scan (high resolution ultrasound) 20-23 weeks
  With a further, high resolution ultrasound scan, which is usually carried out between the 20th and 23rd week of pregnancy, it is possible to check for a great number of developmental abnormalities and organ defects, some of which cannot be detected during early pregnancy. This ultrasound scan is far more comprehensive than that provided for in the German Maternity Guidelines during this period. In addition to specialised, high-end equipment, it is essential that the medical specialist have a great deal of experience.

  This detailed diagnostic scan includes an assessment of how the foetus is developing given the stage in pregnancy, the morphology of the individual organs, an assessment of the baby’s heart including the large blood vessels, the morphology and position of the placenta and the amount of amniotic fluid.

• NIPT (non-invasive prenatal test)
  This test involves extracting the unborn child’s genetic material (DNA) from the mother’s blood. This supplements the non-invasive test procedure. All that is necessary is a blood sample from the mother-to-be.

  The majority of trisomy 13, 18 and 21 cases can be detected by the NIPT, as well as anomalies affecting sex chromosomes (as found for example in cases of Turner Syndrome).

• Fetal Doppler ultrasound
  With fetal Doppler ultrasound, it is possible to carry out an especially detailed scan of your fetals blood circulation, showing the direction and speed of the circulating blood. This scan plays an important role in prenatal diagnostics for:

  • Possible developmental abnormalities
  • Possible preeclampsia
  • Suspected heart defects
  • Abnormal fetal heartbeat (CTG)
  • Gestational diabetes (maternal diabetes during pregnancy)

  With the aid of a Doppler ultrasound, information can be garnered on the blood supply to the fetus, as well as heart and circulatory function, so that risks can be recognised early on and appropriate treatment begun.

  Fetal echocardiography is a special type of Doppler ultrasound, which enables congenital heart defects to be diagnosed. In order to carry out a fetal echocardiography, the medical specialist needs to be highly qualified, experienced and have access to high resolution ultrasound equipment.

• 3D-/4D ultrasound
  3D ultrasound enables you to see a three-dimensional picture of your baby. If the child’s movements are also recorded, this is referred to as a 4D ultrasound. This technology allows the child’s movements to be shown in real-time, in almost photographic quality. The emotional connection with the child can be strengthened through the three dimensionality of the picture, contributing to the parent-child bonding process. Additionally, 3D ultrasound broadens the options for diagnostics and medical treatment.

  The best time for this scan is between the 26^th and 30^th week of pregnancy. However, whether clear photos can be obtained depends a great deal on the position of the child, the amount of amniotic fluid and visual and sonographic conditions.

  Public health insurers do not cover the costs of a 3D ultrasound.

• Preeclampsia
  Preeclampsia can arise during the second half of pregnancy. This is a very serious complication. The symptoms are high blood pressure in the mother, as well as increased levels of proteins being excreted by the kidneys, causing water retention (oedema).

  This can reduce the circulation of blood to the placenta, leading to the fetus not receiving everything they need. Early preeclampsia arises before the 34^th week; late preeclampsia presents after the 34^th week.

  The early form of preeclampsia is very serious and presents an acute risk to mother and child. If, thanks to screening, an increased risk of preeclampsia is recognised at an early stage, then the expectant mother can be monitored more closely. This screening takes place between the 11^th and 14^th weeks of pregnancy, via an additional measurement of the expectant mother’s blood pressure, a special ultrasound scan of the blood vessels in the womb (Aa. uterinae) and by testing for two kinds of proteins in the mother’s blood – pregnancy-associated plasma protein A (pregnancy-associated plasma protein A) and PlGF (placental growth factor).

  If the tests find that there is an increased risk, 100mg of aspirin can be prescribed as a preventative measure well before the 16^th week; this prevents over 50% of preeclampsia cases. This screening is carried out at the same time as the first semester screening, meaning that you can choose to have both scans carried out during the same consultation.

  Diagnosis of preeclampsia mainly depends on clinical signs. Two markers: sFlt-1 (soluble fms-like-tyrosine kinase-1) and PlGF (placental growth factor) can confirm a suspected case of acute preeclampsia or risk of preeclampsia. Recognising preeclampsia at an early stage enables appropriate action to be taken to care for both mother and child.

We are very much looking forward to meeting you. We will be happy to answer all of your questions about changes to your body during puberty, contraception, love and menstrual problems. Gynaecologists are the right people to ask about all these issues, since you get the right answers from someone you can trust.

You can come to your first consultation on your own, or with your best friend, sister, mother or boyfriend. Doctors have an obligation to keep everything you tell them secret; we take this very seriously, so everything we talk about will be kept absolutely confidential. At our consultation you can ask questions about anything which is troubling you.

We are looking forward to welcoming you to our clinic.

Regular screening enables potentially cancerous changes to the female genitalia to be recognised at an early stage; from the 50^th year of life, the rectum should also be checked. Cancer prevention involves not only a detailed consultation, but the following tests:

• Cervical cell smears
• Blood pressure monitoring
• Clinical examination of the inner genitals
• From the end of the 30^th year of life: clinical examination of the breast, as well as examination of the skin
• From the end of the 50^th year of life: additional digital examination of the rectum, along with regular testing of stool for the presence of occult blood (blood not visible to the eye)
• From the end of the 55^th year of life: information on colonoscopy for early diagnosis of colon cancer

Other tests and examinations for preventative purposes are not paid for under public health insurance schemes. These include:

• Breast ultrasound
• Ultrasound scan of the womb and ovaries
• Immunological stool testing
• Bladder cancer screening test
• Thin film cytology

We are happy to advise you about these tests and examinations.

For patients in remission following gynaecologic cancer, we offer advice and further support based on the most up-to-date scientific knowledge. The aim is to screen for the return of cancer following successful treatment, so that it can be detected early and the necessary diagnostic and therapeutic action can be taken quickly. This can be achieved by carrying out regular follow-up texts and examinations for the type of cancer in question, as recommend in the German Cancer Society guidelines.

Furthermore, any side-effects from drugs administered during follow-up treatment for cancer can be monitored. Together we can treat or relieve such side effects.

The menopause is the years between the 50^th and 55^th year of life. This period of hormonal changes is a normal, natural biological process. How women feel during this time varies a great deal. As long as there are no serious problems, then there is no need for treatment. Many women have no or hardly any problems. I will put my knowledge at your disposal at this time, so that we can address any symptoms together and relieve them with an individualised approach, based on the latest scientific evidence.

A further service available at our practice is travel medicine consultation before you take a long-haul trip. When planning a carefree holiday or a successful business trip, it is important to take into account the local circumstances in the country you are visiting. I will be happy to give you information about your country of destination, in a one-to-one consultation.

During a travel medicine consultation, you will receive guidance on any necessary vaccinations, based on your destination, age, whether you are pregnant and any previous illnesses.

The costs for all vaccinations which have been recommended by STIKO (the German Standing Commission on Immunisation) are covered by statutory health insurance schemes. Any other vaccinations need to be paid for privately. That said, statutory insurers will cover a share of the costs (it is necessary to pay up front and then request a refund).

Contraceptive needs depend on the individual woman’s circumstances; your decision will be based on personal needs, previous illnesses and how reliable your choice of contraception needs to be. This means that detailed advice is important to help you make the right decision. Together, we can choose a suitable method, which will meet your individual wishes and foster your sense of well-being.

Below, you will find an overview of the most common contraceptive methods:

• The pill or minipill
• Intravaginal rings
• Intrauterine device (IUD) with progestogen
• Copper IUD
• Contraceptive patch
• Contraceptive injection
• Contraceptive implant
• The rhythm method
• Barrier methods
• Chemical contraceptives
• Sterilisation for women/men