With sadness we have to accept that a very special mentor, colleague and friend, who
had dedicated his professional life to the development of new concepts in pre-and
perinatal medicine has passed away on 22nd of April 2013 while staying at home with
his family.
In his lifetime he has realized many goals for the improvement of maternal-fetal medicine
and all his dreams in his private life. His humorous charm and competence made him
to be loved by patients, colleagues, residents and students – whereby his striking
characteristics were modesty, diligence and creativity in patient care, science and
teaching. Without losing his gentleness he was fulfilled with dedication and tenacity.
With this silent perseverance he has improved human, technical and organisational
perinatal care in Berlin and Germany more from the background than on stage. On top
of all, he was a pioneer of early prenatal ultrasound.
The family of Hartmut Hoffbauer derived from Silesia. His father Franz Joseph was
a music teacher and even a conductor, choir leader, composer and piano teacher. He
married one of his students Wanda Grünpeter who then converted from the Jewish to
the catholic confession. Since his father accepted for some time a position near Kleve
at the Dutch border Hartmut Hoffbauer was born on the 22nd of October 1914 in the
lower Rhine region. When Hartmut was 2 years young, his family returned to Silesia
where he grew up in Oppeln and visited the humanistic gymnasium until 1933.
He studied medicine in Breslau, whereby during his studies he had to serve in the
Wehrmacht where he achieved the title as a medical officer. In between he even studied
in Vienna but returned to Breslau where he passed his final exams. Since his mother
was of Jewish origin he did not receive a final degree (Approbation) and even considered
to immigrate to Brasilia. Unexpectedly, he was allowed to start to work in surgery
and anaesthesiology-between 1940 and 1945 in the catholic Hedwigs Hospital in Berlin-Charlottenburg.
Only after the war he could enter the specialty of his dreams: Women’s’ Health.
He started at the University Hospital in the Street of Artillery (today Tucholsky
Street) under the leadership of Prof. Stoeckel. His thesis which he finished in 1949
had the title “Cardiac Diseases During Pregnancy”, which is still a hot topic and
subject of meetings nowadays.
In the same year he married his wife Jutta, who supported him throughout his life.
Together they had six children.
After the retirement of Prof. Stoeckel Hartmut Hoffbauer was offered the position
of a senior consultant at the Hospital Friedrichshain in the former East Berlin under
the guidance of Prof. Willibald Pschyrembel all together from 1950–1961 while he already
lived in the former West Berlin. Retrospectively he regarded these years as the happiest
period of his professional life.
At that time, Rhesus disease was still frequent since general diagnosis and prevention
had not yet been introduced. This motivated Hartmut Hoffbauer to install in Friedrichshain
(at the first hospital in Germany) a laboratory for blood group and antibody detection
already in 1950, and to reflect about this still fatal disease. In 1954, he even performed
as far as we know the first amniocentesis in Germany in order to improve the diagnosis
and therapy of hemolytic disease of the newborn. This was still criticized at that
time by the obstetric establishment.
He also introduced a “frog laboratory”. Frogs were used within the 1950ies until the
1960ies as pregnancy test by observing either male or female reactions after the injection
of the urine containing human gonadotropin.
With the construction of the Berlin wall Prof. Pschyrembel and Hoffbauer had to decide
whether to continue to work and to live in East Berlin, which was offered to them
by the East Berlin officials. But they both refused and thus a fruitful period was
interrupted.
After an interval of a year at a West Berlin health office he was engaged by Prof.
Lax at the Hospital Charlottenburg of the Free University for Women’s’ Disease “Pulsstraße”
as the Head of Obstetrics where he stayed from 1962 until his retirement in 1980.
In 1965, he finished his “Habilitation” with the topic: „Über die Bedeutung unbekannter
hämolysierender und nicht-hämosysierender Faktoren für die Blutgruppen-unverträgliche
Schwangerschaft“ and thus he received the degree of a University teacher.
During his activities at Friedrichshain he had already met Prof. Liley who was invited
by Willibald Pschyrembel to report on his findings on intrauterine therapy of Rhesus
disease. Only now, in 1966, he performed the first intrauterine (intraperitoneal)
transfusion under radiological control with contrast medium which was replaced by
ultrasound controlled transfusions in the later 1970ies. In patients with extreme
high antibody concentration Hoffbauer even used plasmapheresis combined with intrauterine
blood transfusions.
Hoffbauer also worked on coagulation disorders during pregnancy and was one of the
first who started to applicate low dose heparin to prevent intrauterine growth retardation
with the idea that this might prevent placental thrombosis. And he worked on prenatal
infections using amniocentesis to diagnose toxoplasma infection within the amniotic
fluid.
One of his great contributions was to early recognize the enormous potential of the
use of ultrasound for the diagnosis of early pregnancy, multiple pregnancy, placental
localization, fetal growth and malformations and to systematically investigate the
clinical implications. The Siemens Vidoson was one of the newer achievements in 1968
and ultrasound early became part of the routine pregnancy controls at the University
Hospital Charlottenburg. Luckily, The first author could personally work with him
during this fascinating period –still as a student- and got the chance to establish
growth charts for multiple fetal characteristics including bones of all extremities.
In addition, we could correlate the results in growth retardation and macrosomic fetuses
for fetal weight estimation.
After his retirement in 1980 Hartmut Hoffbauer opened a private policlinic in central
West Berlin, which was primarily located in the Uhlandstrasse and later at the Kurfürstendamm.
At the beginning, his wife even helped him with the organisation and bureaucracy,
which was not his strength. He also attracted gifted younger co-workers and subsequently
also geneticists were included. This specified prenatal policlinic has grown to a
wellrenown Berlin institution with recognized clinical and scientific output whereby
Hartmut Hoffbauer even was a co-author with the first paper from this place. Here
he continued to work until 2000 until the age of 85 years. Here he also celebrated
his 80th birthday whereby Prof. Saling was one of his guests ([Fig. 1]).
Fig. 1 Prof. Hartmut Hoffbauer (right) at his 80th birthday in 1994 visited by Prof. Erich
Saling (left)
Prof. Hoffbauer received quite some honors. In 1988 he became –together with Prof.
G. Martius – honourable member of the Berlin Society of Obstetrics and Gynecology.
During the World Congress of Perinatal Medicine in Berlin in 2009, he received form
the former president of the Wold Society of Perinatal Medicine, Prof. Chervenak, –together
with Prof. Chaoui- the first Clara Angela Sculpture Price for his combined efforts
for creativity and humanity in our field ([Fig. 2]).
Fig. 2 Prof. Hartmut Hoffbauer at the age of 95 (second from left) together with his granddaughter
(left) receiving the Clara Angela Price by Prof. Frank Chervenak (second from right)
during the World Congress of Perinatal Medicine in Berlin.
Looking back to the life of Hartmut Hoffbauer and the start of own efforts in this
field thanks to him we have to confess that it is difficult to decide what was more
important to fascinate a young student to start with clinical scientific work and
not to give up until a project was finished: Whether is was the humanity of Hartmut
Hoffbauer whom we did not want to disappoint when he asked us to work hard and to
help him with congress contributions yet allowing freedom and confidence be part of
the cooperation or whether it was the fascinating topic of early fetal development.
But a great mentor is not characterized by fame or vanity but his capacity to induce
joy and scientific curiosity and preciseness all in favour of the maternal and fetal
patient whereby career thinking and top-down hierarchy of medical structures are no
topics.
We thank Prof. R. Becker, Prof. M. David, Prof. J.W.Dudenhausen, Prof. A.Ebert and
Dr. H. Hardt for helpful information.
Prof. Dr. Birgit Arabin, Prof. Dr. Eberhard Merz im Namen der DEGUM, Sektion Geburtsmedizin
2013
