[Eye diseases and control of labor. Studies of changes in the eye in labor exemplified by subconjunctival hemorrhage (hyposphagmas)]. / Augenerkrankungen und Geburtsleitung. Untersuchungen über Vorgänge am Auge unter der Geburt am Beispiel von subkonjunktivalen Blutungen (Hyposphagmen).

The possible significance of subconjunctival bleedings (hyposphagmas) as a symptom for other pathological changes of the eye was studied in a group of 354 postpartum patients. They were found in 10.5% of the cases. A relatively higher frequency occurred in primiparas. No other maternal factors than parity were detected as of statistically significant influence. A slightly higher percentage in mothers with large newborn (above average cranial circumference) indicates a relationship to the necessary bearing-down effort. In a second study, 49 postpartum women with subconjunctival bleeding were examined by an ophthalmologist. Neither any intraocular or retrobulbar bleeding nor any other grievous damage to the eye were found. In accordance with the literature we recommend, that highly myopic pregnant women (even with a previous history of retinal detachment, but ophthalmologically sufficiently treated) should undergo induced delivery. However, the approach to pregnant women with retinal detachment occurring and treated during pregnancy, or to glaucoma-patients with risk to a small remaining visual field, should be more careful. In those cases, a vaginal operative delivery procedure (forceps, vacuum-extraction) is recommended. Nevertheless, one should consider individual wishes of the mother, when striving to diminish the risk to the foetus. The same applies to irrational fears related to previously damaged (and possibly only functional) eye.

[Immuno-elimination and clearance of Rh-positive erythrocytes in Rh-negative volunteers following administration of anti-D-immunoglobulin]. / Immunelimination und Abbau Rh-positiver Erythrozyten in Rh-negativen Versuchspersonen nach Gabe von Anti-D-Immunglobulin.

The prophylactic treatment of Rhesus-negative women to prevent Rhesus-sensitization has been accepted worldwide, although the working mechanism of the anti-D-immunoglobulin is still unknown. We have used Cr-51-labelled red blood cells to investigate the immune clearance of the cells in Rhesus-negative volunteers following injection of anti-D. Intravenous application of anti-D-immunoglobulin resulted in an accelerated elimination of the Rhesus-positive erythrocytes from the peripheral blood in contrast to the intramuscular treatment with the same dosage. But we had not been able to investigate whether the intravenous route might result in a more effective prophylaxis. In result of the application of IgG-anti-D sequestration can be observed in the spleen. This organ seems to be of great importance for the working mechanism of the anti-D-immunoglobulin. On the other hand splenectomized patients showed reduced clearance rates. In these cases the liver may be involved in the elimination of the red blood cells. F(ab')2-fragments, which cannot pass the placental barrier, seemed to be ineffective with respects to immunosuppression. As patients showing the Du-variant can be sensitized against -- D -- they also should receive anti-D-immunoglobulin for prophylaxis.

[Particularly small foetus papyraceus after full pregnancy period (author's transl)]. / Besonders kleiner Fetus Papyraceus bei ausgetragener Schwangerschaft.

This is a report on an extremely small fetus papyraceus coinciding with an uncomplicated pregnancy, delivery and post-partum period of a healthy newborn; the blighted twin fetus was found quite unexpectedly after a careful inspection of the placenta and fetal membranes. Because of the possible complications following retention of blighted fetuses in utero it seems wise to us to put great emphasis on tedious examination of the afterbirth especially in all those uniparous women, in whom a multiple pregnancy had been suspected in earlier stages of gestation.

[On the clinical significance of sequential scintigraphic examinations of the uteroplacental perfusion (author's transl)]. / Zur klinischen Bedeutung sequenzszintigraphischer Untersuchungen der utero-plazentaren Perfusion.

The utero-placental perfusion was examined by means of the method of Hünermann (1972) in a group of 74 patients with toxemia of pregnancy, diabetes mellitus, or intrauterine growth retardation. The perfusion measurements were categorized and evaluated according to the clinical findings. The correlation between single values deriving from the time-activity curves and their clinical predictive value was ascertained. A strong correlation between the parameters and the clinical findings resulted when several criteria were considered simultaneously. Among the single values resulting from the perfusion curves, the Tmax (placenta) and Tmax (uterus) (time of activity maximum) as well as the quotient of both revealed the highest significance. Pathological time-activity-curves were found in 16 of 19 patients with moderate and severe intrauterine growth retardation, and in all patients with moderate and severe toxemia, or diabetes mellitus. The limited clinical value of the used method is discussed.

[The hidden intrauterine device]. / Das okkulte Intrauterinpessar.

The hidden intrauterine device (IUD) may result because of disapperance of the tails into the uterus, unobserved loss of the device and perforation. The localization can be estimated by sonography, x-ray and probing of the uterine cavity. In most of the cases the device can be removed without hospitalization, surgical procedures are rarely neccessary. If pregnancy did occur the hidden intrauterine device cannot be removed without termination of the pregnancy in most cases.

[Intrauterine devices for contraception? Results of an inquiry conducted in the BRD in 1976]. / Intrauterinpessare zur Kontrazeption? Ergebnisse einer Umfrage inder BRD im Jahre 1976.

The results of the 1098 responses to a questionnaire show a remarkable increase in the use of intra-uterine devices (IUD) as a method of contraception (especially in the last 3 years) in the FRG too. The main reasons for the insertion of IUD were specified as "incompatibility" with the pill or "weariness induced through constant use of the pill". IUD are also used by nulliparae. At the moment T-shaped models containing copper are most popular. The majority of insertions are performed without general anaesthesia. The optimal length of time for wearing an IUD is considered to be 2 years or more. The foremost reasons for removal of IUD are bleeding or pain. Failures (pregnancies) however, are rather frequently recorded. Most gynecologists remove the IUD if pregnancy has occurred and in this case only few of them try to maintain the pregnancy on the patients request. In 1976, the majority of gynecologists attended patients composed of 40 : 1 users of the pill : users of IUD. Numerically speaking therefore, IUD are the method which actually takes second place. In our opinion however, if attention is paid to indications and contra-indications and to the necessity for intensive education of the patient, IUD are a real alternative to the pill and to the increasing use of any type of female sterilization.

Antibody formation by human tonsil cells in vitro.

The ability of human tonsil lymphocytes to give an anti-SRBC response in conventional cultures and in microcultures was studied. It was found that about two-thirds of tonsils responded with a significant number of plaque-forming cells (PFC), and that in some instances the response could be augmented if allogeneic tonsil cell (irradiated or intact) were added. Moreover, tonsil lymphocytes which failed to give a response on their own often responded upon addition of an appropriate number of allogeneic tonsil cells. The response was remarkably improved if allogeneic tonsil supernatant or conditioned medium were added. An anti-SRBC response was also obtained if SRBC was omitted from the cultures. The frequency of anti-SRBC specific B cells was estimated as 1/60000 (f = 1-7 X 10(-5)).