Showing papers in "Geburtshilfe Und Frauenheilkunde in 1981"
TL;DR: An ultrasonic examination with the same accuracy as in X-ray is conducted on the posterior vesico-urethral angle using lateral urethro-cystograms and its advantages and disadvantages are discussed.
Abstract: Pre-operative diagnostic procedures in evaluating stress urinary incontinence in women became increasingly important within the last years. In many clinics the measurement of the posterior vesico-urethral angle using lateral urethro-cystograms has become an eminent criterion for the selection of the operative method applied. Until now, this angle could be measured by employing X-ray examination techniques. In this paper, an ultrasonic examination with the same accuracy as in X-ray. The technique of both methods and their advantages and disadvantages are discussed.
23 citations
TL;DR: 19 patients with preterm labour received an oral application of 20-30 mval/d Magnesium in addition to the common Fenoterol-Verapamil tocolysis, which showed the following results: augmentation of the Mg2+ serum level and significant reduction of contraction frequency.
Abstract: 19 patients with preterm labour received an oral application of 20-30 mval/d Magnesium in addition to the common Fenoterol-Verapamil tocolysis. This therapy showed the following results: 1. augmentation of the Mg2+ serum level from 1.48 to 1.7 mval/l, 2. significant reduction of contraction frequency (p less than 0.005), 3. significant reduction of Fenoterol dose (p less than 0.005), 4. in 14 patients it was possible to change from parenteral to oral therapy.
21 citations
19 citations
TL;DR: Because of the low incidence of metastases in the ovaries adnexectomy would not be generally justified, a metastatic spread of the tumour in the same manner as in carcinoma of the endometrium is expected.
Abstract: Formation of metastases in the ovaries in carcinoma of the uterine cervix is a rare occurrence. 749 ovaries were subjected to histological examination in 980 operated patients with squamous cell carcinoma of the cervix. A metastatic carcinoma in the ovary was identified in four patients (0.5%). In three patients, a tumour had formed simultaneously in the corpus uteri. This might point to a metastatic spread of the tumour in the same manner as in carcinoma of the endometrium. In view of the low incidence of metastases in the ovaries adnexectomy would not be generally justified.
18 citations
TL;DR: The overall 5-years survival rate was 30%, although patients with early tumors had 42% survival rate, and the single most important factor affecting survival appeared to be the extent of disease at the time of diagnosis.
Abstract: Thirty-seven cases of primary fallopian tube carcinoma treated at our institution over the years 1946 to 1976 are described. The overall 5-years survival rate was 30%, although patients with early tumors had 42% survival rate. The single most important factor affecting survival appeared to be the extent of disease at the time of diagnosis. Present treatment modalities are discussed, even though the number of tube carcinomas are few, it might be useful to adopt an official classification.
15 citations
TL;DR: The present casuistry study deals with condylomata acuminata-like lesions of the vulva of two sexually mature 20 and 22 years old Turkish sisters, and a 34 year old Yugoslavian women.
Abstract: The present casuistry study deals with condylomata acuminata-like lesions of the vulva of two sexually mature 20 and 22 years old Turkish sisters, and a 34 year old Yugoslavian women. Based on clinical and histological particularities the verruciform structures are interpreted as - atavistic? - malformation without functional significance. Their relation to the papillas of corona glans are proved in detail.
15 citations
TL;DR: There was an evident dose-related inhibition of ovulation or corpus luteum integrity and a regular bleeding pattern was found more often in the lower dose groups, whether a higher dose regimen will lead to a more consistent inhibition of ovarian function.
Abstract: The influence of different dose regimens of the potent LH-RH analogue Buserelin (HOE 766: 400 200 100 mcg/day) on pituitary and ovarian function was investigated in 70 women over a period of 6 months. The histological findings of the endometrial biopsy specimen (n=109) were correlated with the hormonal profiles and the bleeding pattern. There was an evident dose-related inhibition of ovulation or corpus luteum integrity. A regular bleeding pattern was found more often in the lower dose groups. Unopposed estrogen effects recognized by prolonged endometrial stimulation were mainly registered in women with amenorrhea induced by 400 mcg Buserelin. Regression of endometrial stimulation could be observed during the 6-month period of administration. It remains to be investigated whether a higher dose regimen will lead to a more consistent inhibition of ovarian function. (authors modified) (summary in ENG)
13 citations
TL;DR: Diagnostic and therapeutic guidelines have been worked out and conflict-oriented personalities of patients seem to play a major role and by employment of the individually required therapy 90% of the patients with habitual abortions were able to successfully complete a further pregnancy.
Abstract: According to several literature surveys women with three consecutive and clinically ascertained spontaneous abortions appear to have without treatment an abortion risk of 50 to 60 per cent in the course of any further pregnancy. For improving prognostication various conditions leading to habitual abortions have to be clarified before the onset of a new pregnancy. Among our patients corpus luteum dysfunctions (35 per cent) and anomalies of the uterus (17 per cent) showed the highest frequency. Our patients also had an increased frequency of pathological spermiograms. Their influence on the incidence of habitual abortions remains, however, unclear. Infectious diseases and metabolic disorders (5 per cent) as well as chromosomal aberrations (6 per cent) appeared to be less frequent. Controversial views on the consequences of blood group incompatibilities of the spouses continue to exist. Conflict-oriented personalities of patients seem to play a major role. After evaluating the findings in literature pertaining to habitual abortions and on the basis of our own results (110 patients) diagnostic and therapeutic guidelines have been worked out. By employment of the individually required therapy 90 per cent of the patients with habitual abortions were able to successfully complete a further pregnancy.
12 citations
TL;DR: In 59 women who became pregnant with an IUD the position of the device was controlled by ultrasound and in 11 cases the IUD was in correct position.
Abstract: In 59 women who became pregnant with an IUD the position of the device was controlled by ultrasound. Before the 9th week of pregnancy the device was located in 40 women (78.4%) in the cervix or in the isthmic region of the uterus. In 11 cases the IUD was in correct position. 8 women had a pregnancy of more than 9 weeks and were not included in the study as the gestational sac could have influenced the IUD position. The possibility of regular control of the IUD position by ultrasound is discussed in order to reduce the failure rate of this contraceptive method.
10 citations
TL;DR: The study shows that visualization of the extremities regularly succeeds in the mid-trimester, thus extending the scope of prenatal diagnosis and in cases with known predisposition to malformations a regular ultrasonic checkup should be performed.
Abstract: In 251 pregnancies fetal extremities were systematically examined by means of an ultrasound sector scanner between the 12th and 28th week of gestation The procedure is demonstrated by typical pictures The long tubular bones, hands and feet were visualized regularly, and differentiation of radius and ulna or tibia and fibular was possible Studies took between 5 and 25 minutes In all cases the length of the diaphyses was determined, resulting normal growth tables and rate of growth curves Between the 12th and 28th week, the humerus grows from 9 to 51 mm, the radius from 7 to 46 mm, the femur from 10 to 55 mm, and the tibia from 8 to 48 mm Sonographic depiction of fingers and clavicles was also quite successful For best results, examinations were done between the 16th and 20th week In three fetuses later aborted, sonographic and direct (after preparation) measurements of bone length for the diaphysis differed by no more than 4% The study shows that visualization of the extremities regularly succeeds in the mid-trimester A multitude of localized or systemic limb malformations may be recognized In cases with known predisposition to malformations a regular ultrasonic checkup should be performed, thus extending the scope of prenatal diagnosis
10 citations
TL;DR: If the pressure profile was found to be normal 74% of patients felt cured after incontinence-operation and only 48% became continent after colporrhaphy, Marshall-Marchetti-Krantz or sling surgery.
Abstract: In 114 out of 1215 stress-incontinent women the maximal urethral closure pressure was determined. Descensus of urinary bladder and urethra was proved by lateral urethrocystography. In the group of sphincter weakness (Edwards) which was to be found in 46 patients, only 48% became continent after colporrhaphy, Marshall-Marchetti-Krantz or sling surgery. If the pressure profile was found to be normal 74% of our patients felt cured after incontinence-operation. Sphincter weakness determines a failure due to surgery which is statistically of significance (P less than 0,01).
TL;DR: The advantages connected with the alimentation with human milk weigh more than the eventual risk by the contamination, in the opinion of the experts.
Abstract: A survey on the situation concerning the residues on pesticides in human milk in West Germany is given, based on own investigations Nearly the whole pattern of chlororganic pesticides - DDT with its metabolites DDE and DDD, hexachlorobenzene (HCB), the different isomeres (alpha-, beta-, gamma-) of benzenehexachloride (BHC) as well as dieldrin and heptachloroepoxid - together with polychlorinated biphenyls (PCB) coming from the environment - were found in all samples of human milk, though in different concentrations PCB, HCB and beta-BHC had been discovered in human milk only about ten years ago The residues have decreased in the past years The concentrations are still so high that the amounts consumed by the suckling exceed the ADI values for the contaminants in question But in the opinion of the experts the advantages connected with the alimentation with human milk weigh more than the eventual risk by the contamination
TL;DR: In this article, the authors report on 114 terminations of pregnancy during the second and third trimester of pregnancy with a new prostaglandin E2 derivative "Sulprostone".
Abstract: Report on 114 terminations of pregnancy during the second and third trimester of pregnancy with a new prostaglandin E2 derivative "Sulprostone". In 84 cases legal therapeutic abortions were induced. In 30 women an abnormal pregnancy was terminated. "Sulprostone: is a prostaglandin with selective activity in the uterus. It can be administered parenterally or locally. 48 women received intravenous sulprostone, 35 patients had extraamniotic injections and 31 patients had extra-amniotic injections following an intramuscular injection for priming of the cervix the night before. In 103 women the pregnancy was terminated within the first 24 hours after the administration of sulprostone (90.3%). 8 patients (7.0 %) had a cervical dilatation over 2 cm. In 3 women no effect was noted. In 1 patient the prostaglandin application was stopped because of severe vomiting. The mean administration abortion interval was 12 hours and 54 minutes following extra amniotic application and 10 hours and 30 minutes with extra amniotic application and following intramuscular priming. In 5 patients the abortion was completed after the priming administration. More than 90% of the patient's required analgesia. There were 32.4% side effects of mild character. The results and the methods are described and compared to other methods.
TL;DR: Methods and Results of human in vitro fertilisation at the 2nd Department of Obstetrics and Gynaecology, University of Vienna are reported and possible reasons for failures in fertilisation and cleavage as well as possibilities for improving the rate of reimplantation are discussed.
Abstract: Methods and Results of human in vitro fertilisation at the 2nd Department of Obstetrics and Gynaecology, University of Vienna are reported. Applying preparations of media and culture techniques according to Edwards et al. no satisfactory results could be achieved: only 3 out of 11 preovulatory oocytes were fertilised, no cleavages occurred. Using modified Ham's F 10 medium according to Lopata et al. fertilisation could be observed in 60% as well as regular cleavages in 40%. 5 Embryotransfers have been performed in the 8 cell or in the 16 cell stage respectively. No implantation occurred in 4 of these, in one case evidence for a transient implantation could be proved by an increased activity of SP1 and HCG beta. In this case obviously postimplantation death occurred resulting in a bleeding 16 days after oocyte recovery. Possible reasons for failures in fertilisation and cleavage as well as possibilities for improving the rate of reimplantation are discussed.
TL;DR: The data show clearly that the addition of the function Urethral length and the maximum urethral closure pressure is an useful parameter to calculate the risk of recurrence of stress incontinence even prior to its surgical treatment.
Abstract: Anamnestic findings and urodynamic parameters of 377 patients suffering from urinary stress incontinence were evaluated before and one year after several incontinence operations (anterior colporrhaphy, colposuspension according to a modified Marshall-Marchetti-Krantz procedure and vesico-urethral suspension according to Pereyra). Two groups were formed: group I including 246 women who experienced successful operation and group II consisting of 131 patients suffering from recurrent stress incontinence. Mean age, -parity and -body-weight did not influence the result of surgical treatment. However, there was a statistical significant difference between both groups concerning the functional urethral length (alpha U-test = 0.00118) and the maximum urethral closure pressure (alpha much less than 0.001). By the addition of the preoperatively measured functional urethral length and the maximum urethral closure pressure a new parameter was determined by which group I and group II could be separated clearly. The difference was statistical significant (alpha much less than 0.001). According to these data the risk of recurrence could be evaluated preoperatively: the cure rate below the 25th percentile (0-56) of this new parameter was 49%, in between the 25th and the 50th percentile (57-70) the cure rate was 60%, in between the 50th and 75th percentile (71-84) 75% and above the 75th percentile (x greater than 84) 79%. Our data show clearly that the addition of the function urethral length and the maximum urethral closure pressure is an useful parameter to calculate the risk of recurrence of stress incontinence even prior to its surgical treatment.
TL;DR: In 37 pregnancy women preterm labour was inhibited with intravenous administration of ASA and a non-dose-dependent prolongation ( by 30% or normal) of bleeding time was found and in the fetus respectively the newborn an affection by this ASA treatment could be excluded.
Abstract: In 37 pregnancy women preterm labour was inhibited with intravenous administration of ASA. 20 patients (Group I) had a combined treatment of ASA and Fenoterol. 7 pregnant women (Group II) without successful labour inhibition under Fenoterol were treated with ASA subsequently. In a third group of 10 women we administered ASA alone. The treatment was considered as successful if signs of preterm labour stopped and pregnancy maintained for 7 days or more. In the first group 16, in the second group all patients had been treated successfully. In group III we succeeded in labour inhibiting for more than 7 days in 6 cases. An initial loading dose of 5.5 to 7.0 mn/min ASA had been infused for 24 hours. If preterm labour was stopped, the dosage had been reduced. In all patients dose related but reversible symptoms of vertigo, tinnitus, headache and hyperventilation were seen. Furthermore we found a non-dose-dependent prolongation ( by 30% or normal) of bleeding time. In the fetus respectively the newborn an affection by this ASA treatment could be excluded. We propose inhibition of preterm labour by i.v. ASA administration in all pregnant women if beta-mimetic drugs are not successful or an intolerance is diagnosed. Contraindications for ASA therapy are mentioned.
TL;DR: Based on investigations, a typical type of troubles after radical abdominal hysterectomies, which partly depends on lesions of the autonomous nerval system of the lower urinary tract is indicated.
Abstract: 1972 to 1977 141 patients at the university department of gynecology and obstetrics in Innsbruck had radical abdominal hysterectomies according to Latzko because of carcinoma of the cervix uteri state I-IIa. 111 (78.8%) patients without recurrence of carcinoma were investigated without recurrence of carcinoma were investigated in the period of 2 to 36 months after operation in a modern urodynamic testing unit to state functional troubles of the lower urinary tract. We judged the sensibility of the bladder, the incidence of urinary incontinence, residual urine determinations and the frequency of infections of the lower urinary tract after radical hysterectomies. In particular we were interested in the urodynamic investigation (spontaneous flow rate and uroflow-metrie after bladder filling, liquid cystometry and simultaneous measurement of the pressure in the rectum for a faithful expression of the detrusor pressure). Based on these investigations we could indicate a typical type of troubles after radical abdominal hysterectomies, which partly depends on lesions of the autonomous nerval system of the lower urinary tract. 89.5% of all these patients within the first year after operation could not feel any desire to void although the bladder was full. Longer than one year after operation we could find the same symptom in 45.5%--recovery in part seems to be possible. Moreover we could find unnoticed urinary loss, residual urine and infections of the lower urinary tract (24.7%) in higher incidence compared with a control group. Because of our investigation we could work out advice for prevention and therapy of functional troubles of the lower urinary tract after radical abdominal hysterectomy.
TL;DR: Urodynamic studies and physical measurements showed the pivotal importance of the levator ani muscle for the maintenance of continence.
Abstract: A method for the operative treatment of stress incontinence in the female is described. The anatomical importance of the levator sling behind the urethra is stressed. The pubococcygeal muscles which have been lateralized by trauma are prepared. The levator ani muscle with its fascia is mobilized and the two muscle components of the perineal muscles are joined in the midline. The muscular adaptation starts behind the symphysis and is carried on dorsally as far as necessary. In this way a strong sub-urethral and subvesical muscular plate is created. In 673 patients who were treated by this method recurrence was rare. A concomitant six weeks. Urodynamic studies and physical measurements showed the pivotal importance of the levator ani muscle for the maintenance of continence.
TL;DR: In this article, the technique and results of 50 laparoscopies performed on sterility patients to obtain mature oocytes from Graafian follicles to carry out in vitro fertilization, are reported.
Abstract: Technique and results of 50 laparoscopies performed on sterility patients to obtain mature oocytes from Graafian follicles to carry out in vitro fertilisation, are reported. In 32% of all laparoscopies and in 52% of all punctured follicles a mature oocyte could be obtained. Different diameters of puncture needles as well as different suction intensities are compared. It is mentioned that through increasing experience and improved technique the exact time for the intervention has been correctly determined in 92%. The recovery-rate for oocytes also could be increased to 58%. A further improvement in this important initial step to a successful in vitro fertilisation program is feasible.
TL;DR: In 15 patients with multiple sclerosis about half of the patients showed decreased gonadotropin and estrogen values in the urine, and a control examination of these findings in 19 additional patients showed normal plasma FSH and LH values.
Abstract: In 15 patients with multiple sclerosis about half of the patients showed decreased gonadotropin and estrogen values in the urine. A control examination of these findings in 19 additional patients showed normal plasma FSH and LH values. Except for one slightly elevated value the prolactin levels were normal in this group.
TL;DR: Criteria which are essential for sexual development were examined on the basis of interviews conducted with 57 married couples who had remained without children without wanting to be childless, the reasons for their sterility being different in each case.
Abstract: Criteria which are essential for sexual development were examined on the basis of interviews conducted with 57 married couples who had remained without children without wanting to be childless, the reasons for their sterility being different in each case. It appears that both the experience of the first cohabitation and of the first orgasm, as well as the number of sexual partners before marriage are in some way connected with subsequent infertility. We also attempted to examine marital sexual relations in a kind of stock-taking operation. The cumulative occurrence of disturbances of intimate life was confirmed by this study, especially the reduced sexual satisfaction which depends on the cause of sterility. It also appears that changes in libido and feeling are influence by fertility; however, relative increases in such changes seem to indicate psychosexual disturbances of maturity in some of the partners, from which it would be possible to derive causal connections with infertility and therapeutic approaches.
TL;DR: A significant correlation between the CT-finding of an intracranial haemorrhage and the neurological observations was found, whereas there was no relation to the mode of delivery.
Abstract: The cranial computer-tomography is a new non-invasive method for the diagnosis of perinatal intracranial haemorrhage. Among 80 neonates, who were examined by CT after delivery at term between the 3rd and 5th day of life, there were 43 newborns without any neurological symptom. These were examined voluntarily with the permission of their parents. A significant correlation between the CT-finding of an intracranial haemorrhage and the neurological observations was found, whereas there was no relation to the mode of delivery. Parity, birth weight, Apgar-score, cord blood-pH did not correspond to the CT-findings. An extremely short duration of the second stage of labor in spontaneous delivery seems to increase the risk of perinatal intracranial haemorrhage.
TL;DR: The correlation between the ultrasound results of length version and flexion of the uterus and complaints and side effects like bleeding and pain are discussed especially if the IUD is not in the correct position.
Abstract: The correct position of an IUD in the uterine cavity is essential for the effectiveness of the method. Ultrasound examination of the thickness of the anterior and posterior wall of the uterus were carried out and their relation to a correct position of the IUD calculated. It was found that the position of the IUD is correct, if the distance between fundus and the cranial end of the IUD does not exceed the thickness of the uterine wall by more than one-third; i. e. in all 4/3 of the thickness. The correlation between the ultrasound results of length, version and flexion of the uterus and complaints and side-effects like bleeding and pain are discussed, especially if the IUD is not in correct position.
TL;DR: The article describes the case of a young woman with genital malformation combined with ovarial endometriosis, known as Mayer-Rokitansky-Küster syndrome with congenital aplasia of the vagina and a rudimentary uterus bicornis solidus.
Abstract: The article deals with the various theories, hypotheses, localisations and experiments in connection with the genesis of uterine and extrauterine endometriosis. It is explained that there is not just one single valid cause; rather, it will be necessary to resort to various theories, depending on the localisation of the endometrial heterotopia. The article describes the case of a young woman with genital malformation combined with ovarial endometriosis. This malformation syndrome is known as Mayer-Rokitansky-Kuster syndrome with congenital aplasia of the vagina and a rudimentary uterus bicornis solidus. Since such uteri do not contain any endometrium which is capable of functioning, this would exclude any canalicular, haematogenic, lymphogenic, embolic, metastatic or homotransplantational cause of endometriosis. In fact, ovarial endometrial tissue heterotopia is due to pluropotentiality of the coelomic epithelium and is produced by indentation of cortical epithelium and segmentation.
TL;DR: The authors were able to show in a small comparative series that grouped calcifications can be detected even without previous information of their presence.
Abstract: Sonography can yield indirect visualization only of microcalcifications in the female breast. In order to obtain an image of the echo pattern of the grouped microcalcifications, it is essential that the device employed possesses suitable dynamic characteristics, and it is also necessary to employ the technique of additive tomography. The investigator must familiarize himself with the proper interpretation of reflex patterns. Microcalcifications cannot be detected via sonography with the same degree of accuracy as with the help of mammography. However, sonographic detection is easier if the microcalcifications are more closely grouped. Nevertheless, the authors were able to show in a small comparative series that grouped calcifications can be detected even without previous information of their presence.