[Intraamniotic amino acid infusions in chronic placental insufficiency]. / Intraamniale Aminosäureinfusionen bei chronischer Plazentainsuffizienz.

12 pregnant women in the gestational weeks 33 to 39 who had symptoms of chronic placental insufficiency received 22 intraamniotic amino acids infusions. 250 ml of a 5 per cent solution of L-amino-acids was infused within 12 hours. During these infusions nearly 80 per cent of the amino acids (according to alpha-amino-nitrogen) were eliminated from the amniotic fluid in 24 hours. The highest elimination rate with 83.4 per cent has been found in cases with intrauterine growth retardation. The smallest rise of urea-nitrogen-level after intraamniotic amino acid infusion has been observed in cases with intrauterine growth retardation and in the second or third infusion. The decrease of amniotic fluid protein content after infusion was on the average about 30 per cent. The interpretation of these results is difficult, because so far not exist examinations of the gastrointestinal resorption and metabolism of amino acids and amniotic fluid proteins by the human fetus. According to our experiences it is possible to supply fetus with severe intrauterine growth retardation with vital substrates on paraplacental way. But the postnatal treatment of the small for dates babies is more effective.

[Postnatal monitoring of the newborn infant using cardiotachography. 1. Normal cardiotachogram in the newborn]. / Die postnatale Uberwachung des Neugeborenen durch Kardiotachoraphie. I. Das normale Kardiotachogramm des Neugeborenen.

Cardiotachograms in a group of 30 vigorous newborns have permitted the study of the typical signs of the regulatory mechanism of neonatal circulation during the first minutes of life. Immediately after birth neonatal heart rate rise to a peak heart rate of 177 bpm at the age of two minutes. Thereupon neonatal heart rate falls gradually and reaches a stabil level in the 13. minute after delivery. In the phase of gradually fall in neonatal heart rate many brief episodes of cardiac deceleration ("spikes") were observed.

[Postnatal monitoring of the newborn infant with cardiotachography. II. Significance of cardiotachography for diagnosis of existing conditions in the newborn infant]. / Die postnatale Uberwachung des Neugeborenen durch Kardiotachographie. II. Wertigkeit der Kardiotachographie für die aktuelle Zustandsdiagnostik des Neugeborenen.

Eighty-five cardiotachograms of newborns aged between 34 and 42 weeks of gestation were studied. Fifty newborns were delivered spontaneously. In seventeen cases caesarean sections were used and in eighteen cases vacuum extractions. Cardiotachograms were recorded continuously throughout the immediate postnatal period until the stabilisation of the heart rate. Cardiotachograms were divided into three typical groups based on their cours of heart rate and fluctuation. The relation between these groups and the methods and duration of delivery and the condition of newborns were discussed. We found a correlation between the pathological cardiotachograms (tachycardiac and bradycardiac type of cardiotachogram) and long expulsion time, existent history of intrauterine disorder and low Apgar score. No relationship could be established between pathological cardiotachograms and the method of delivery.

[Results of delivery in umbilical cord prolapse at the University-Gynecological Clinic Rostock in the years 1958 to 1973]. / Ergebnisse der Geburtsleitung beim Nabelschnurvorfall an der Universitäts-Frauenklinik Rostock in den Jahren 1958 bis 1973

Basing on a 16-year-analysis recommendations are given for the definitive management of delivery in cases of umbilical cord prolapsus in dependence of the cervical dilatation and the position of the fetus. The indication for cesarean section is to pronounce generously and inhibition of labour by tocolytical drugs is to demand.

[Clinical experience obtained from antepartal CTG evaluation according to Fischer, Hammacher, Hodr, and Kubli. Second communication: Hammacher score (author's transl)]. / Klinische Erfahrungen mit den antepartalen CTG-Auswerteverfahren nach Fischer, Hammacher, Hodr und Kubli. II. Mitteilung: Hammacher-Score.

One antepartal cardiotocogram each was taken from 1,239 pregnant women and evaluated by means of theCGT score, as proposed by Hammacher and co-workers. Inconspicuous cardiotocograms were recorded from 1,090 patients (88.0 per cent), while 124 (10.0 per cent) were suspicious, 20 (1.6 per cent) prepathological, and five (0.4 per cent) pathological. Forecasts of newborns' conditions were correct in 994 cases (80.4 per cent), erroneously positive in 140 cases (11.3 per cent), and erroneously negative in 103 cases (8.3 per cent).

[Clinical experience from antenatal CTG evaluation techniques according to Fischer, Hammacher, Hodr, and Kubi. Third communication: Score according to Hodr (author's transl)]. / Klinische Erfahrungen mit dem antenatalen CTG-Auswertungsverfahren nach Fischer, Hammacher, Hodr und Kubli III. Mitteilung: Score nach Hodr.

Evaluation on the basis of Hodr's CTG score was undertaken of 1,239 antepartum cardiotocograms obtained from 1,239 pregnant women. Inconspicuous cardiotocograms were obtained from 1,114 patients, that is 89.9 per cent, while dubious or prepathological findings were recorded from 123 women (nine per cent) and clearly pathological cardiotocographic findings from two. Predictions were correct in 1,019 cases (82.4 per cent), falsely positive in 147 cases (11.8 per cent), and falsely negative in 71 cases (5.7 per cent).

[Clinical experience obtained from use of antepartum CTG-evaluation technique, according to Fischer, Hammacher, Hodr, and Kubli. Fourth communication: score according to Kubli (author's transl)]. / Klinische Erfahrungen mit den antepartelen CTG-Auswerteverfahren nach Fischer, Hammacher, Hodr und Kubli. IV. Mitteilung: score nauch Kubli.

A total of 1,239 antepartum cardiotocograms, obtained from the same number of pregnant women, was evaluated on the basis of the CTG score proposed by Kubli. The cardiotocograms were unconspicuous, that is non-contributory, in the context of 752 patients (60.7 per cent), while 400 (32.3 per cent) gave rise to suspicion, and 87 (7.0 per cent) were pathological. Predictions were correct in 736 cases (59.5 per cent), falsely positive in 91 cases (7.4 per cent), and falsely negative in 410 cases (33.1 per cent).

[Clinical experience obtained from antepartal CTG evaluation according to Fischer, Hammacher, Hodr and Kubli. First communication: Fischer score (author's transl)]. / Klinische Erfahrungen mit den antepartalen CTG-Auswerteverfahren nach Fischer, Hammacher, Hodr und Kubli. I. Mitteilung: Fischer-Score.

The score proposed by Fischer and co-workers was used in evaluating 1,239 antepartal cardiotocograms which had been recorded from the same number of pregnant women. The cardiotocograms of 966 patients (78.0 per cent) were without pathological findings (between eight and ten scores on the condition index), while prepathological suspicion was recordable from 141 (11.4 per cent) (between five and seven scores), and pathological conditions from 132 (10.7 per cent) (between four and zero scores). Conditions of the newborn were correctly predicted in 913 cases (73.8 per cent), erroneously positive in 120 cases (9.7 per cent), and erroneously negative in 204 cases (16.5 per cent).

[Clinical experience with Hammacher's "CTG score"]. / Klinische Erfahrungen mit dem "CTG-Score" nach Hammacher.

The cardiotocograms of 340 pregnant women which are recorded ante partum and intra partum were analysed by the score of Hammacher. This score is representative for the intra partum period. We found a direct relation between variations of CTG and the Apgar-score of newborn. In the ante partum period only in pathological score this correlation can be observed.

[Cardiovascular effect of solcoseryl with low molecular dextran in normal late pregnancy]. / Die kardiovaskuläre Wirkung von Solcoseryl mit niedermolekularem Dextran in der normalen Spätschwangerschaft.

By means of quantitative sphygmometry and the unbloody recording of arterial blood pressure the hemodynamic effect of an infusion of Solcoseryl in combination with low molecular dextrane on the maternal cardiovascular system in 9 normotensive healthy late pregnant women is examined. Solcoseryl causes no improvement of the cardiovascular effects known for low molecular dextrane.

[Localisation of placenta by liquid crystal thermography (author's transl)]. / Plazentalokalisation mittels flüssiger Kristalle.

The efficiency of liquid crystals in placenta localisation was checked by comparison of thermographic results with those obtained from using the ultrasonic B-scan method. Ther results obtained from the two techniques were in fair agreement in 93 of 106 cases or 87.7 per cent. The highest amount of agreement was recorded from the group with anterior-wall placenta. For placenta localisation the sensitivity of liquid crystal thermography was found to be inferior to that of the ultrasonic B-scan method.

[Amniocentesis with free needle guidance following pinpointing using ultrasonic compound scan]. / Amniozentese mit freier Nadelführung nach Ultrasehall-Compoundscan-Zielermittlung.

There is reported about 106 amniocenteses between 28th and 40th week of pregnancy after previous investigation and marking of the point of puncture on the abdomen of the pregnant woman by means of investigation the point with ultrasonic compoundscan. The angle of puncture method is found out and the maximum and minimum infiltration intensity. Complications have not been observed. That technique makes possible a high security for puncture and excellent puncture results.

[Ehlers-Danlos syndrome and pregnancy]. / Ehlers-Danlos-Syndrom und Schwangerschaft]

The clinical aspects of pregnancy, parturition and childbed in a young primigravida, who had the Ehlers-Danlos syndrome, are reported. The whole course was without complications, contrary to other bibliographies. A survey of the family gave no evidence, that the characteristic was familial. Possibilities of danger are showed.

[Cardiotocogram findings in antenatal monitoring of fetal hematoblastosis and during intrauterine intrafetal transfusion]. / Kardiotokogrammbefunde bei antenataler Uberwachung des Morbus haemolyticus fetalis und während der intrauterinen intrafetalen Transfusion

34 falls with Morbus haemolyticus fetalis were controled from the 30. to 40. week of pregnancy by cardiotocography. The order of the severity of fetal erythroblastosis and certain types of oscillation devoted: In slight cases of Morbus haemolyticus fetalis preponderated (Hb greater than 15 g%) a undulating curve of oscillation (80%). Middlesevere cases (Hb 9-15 g%) showed in 57.2% an undulating and in 42.8% a saltatoring types of oscillation. In cases of severe fetal anemia (Hb less than 9 g%) we found at 64.2% a silent to narrowed undulating and at 21.4% saltatoring types of oscillations. A normal type of oscillation we not observed in this group. The various degrees of a chronical fetal hypoxia caused by an anemia and a placental dysfunction have been discussed as a reason for the typical CTG-curves. At hydrops fetus et placentae are bearing silent and sinusoid heart frequency curve and the CTG-sign late deceleration. A fetal intrauterine transfusion seems not very successfully, at this findings. During the intrauterine transfusion were established in all cases to a restriction of fluctuation at simultaneous increase of frequency.

[The value of radioimmunological HPL determinations for the evaluation of intrauterine fetal growth during late pregnancy]. / Wert von radioimmunologischen Serum-HPL-Bestimmungen fur die Beurteilung des intrauterinen fetalen Wachstums in der Spatschwangerschaft

In 24 high-risk pregnancies correlation between maternal level of HPL in serum and the weight of the newborn is examinated. Retarded fetal growth was assumed of the weight of the newborn was found below the 5. percentil. Results of statistical sensitivity and specificity of radiommunoassay of HPL are given for this question.

[Cardiovascular effect of fenoterol (Partusisten)]. / Kardiovaskuläre Wirkung von Fenoterol (Partusisten).

8 normotensive late pregnant women in the early latent phase of premature labor were examined before, during and after the intravenous pump infusion of fenoterol (Partusisten) with the method of quantitative sphygmometry, the bloodless graphic registration of the arterial blood pressure and the direct electronic timing of pulse wave velocity. Dose levels of fenoterol were 3 microgram/min and 6 microgram/min. During the administration of fenoterol systolic blood pressure increases insignificantly, but mean and diastolic pressure decrease distinctly with broadening of amplitude. Stroke volume, cardiac output, work and power of the heart increase significantly. The fall of the total peripheral resistance is much more pronounciated than the decrease of blood pressure. Therefore the hemodynamic mode of action of fenoterol is a favourable one in regard to the perfusion of peripheral tissues. The effects on the cardiovascular system in a dose level usual for tocolysis are smaller than those of nylidrin.

[Bacteriological studies of the human amniotic fluid in repeated amniocenteses]. / Bakteriologische Untersuchungen des menschlichen Fruchtwassers bei wiederholten Amniozentesen.

The amniocentesis to gain increasing importance ought to be examined whether an alteration of the bacterial flora of the amniotic fluid was caused by repeated amniocentesis. 128 samples of amniotic fluid selected by abdominal amniocentesis were placed in microbiological cultures. Bacteria was isolated in 30 cases, originated predominantly by pollution. Under the circumstance of strong sterile conditions the amniocentesis proven even when repeated a diagnostical way of procedure which does not represent any danger to mother nor child.

[Effect of the protein-free calf-blood-extract (Solcoseryl) on the excretion of estrogens in chronic placental insufficiency]. / Einfluss eines proteinfreien Kälberblutextraktes (Solcoseryl) auf die Ostrogenausscheidung bei chronischer Plazentainsuffizienz

In a double blind study the action of Solcoseryl was tested in 31 patients during late pregnancy with chronic placental insufficiency. Under treatment with Solcoseryl a significant increase in urinary estrogen excretion occurred in relation to the placebo-group.

[Influence of long-term beta adrenergic therapy on the HPL blood level and the total excretion of estrogens]. / Einfluss der Beta-Adrenergika-Langzeittherapie auf den HPL-Blutspiegel und die Gesamt-Ostrogenausscheidung.

Pregnant women with imminent miscarriage were treated with Partusisten and/or Dilatol for tocolysis beginning in the 29. week of pregnancy. During treatment the mean urinary excretion of total oestrogens (n = 35; p less than 0,01 in 36th week of pregnancy and later) and the mean plasma level of HPL increased (n = 8; p less than 0,01 in 33., 34. and 35. week of pregnancy). These changes have to be concidered in judging the fetoplacental unit or the function of placenta.