[Follow-up of the lateral ventricles and their development in congenital hydrocephalus using sonograms. II]. / Die Verlaufsbeobachtung der Lateralventrikel und deren Entwicklung bis zum Hydrocephalus congenitus im Sonogramm. II. Mitteilung.

Ultrasonographic observations of the development of the hydrocephalic lateral ventricles during the fetal period. Twenty-three pregnant women having a fetus with brain defects were followed up. Twenty had sonographically identified hydrocephalus and 3 others had a fetus with either porencephalia, cystencephalus or monstrous defect of the brain. The use of a ventricular model (see 1st communication) permitted an observation of the development of the volume of the lateral ventricles, the brain diameter and an estimation of the prognosis. Accompanying defects (e.g. spina bifida in 56% of cases) were noted. Detailed case studies, measurements, clinical observation of the course, combinations of defects, and special diagnostic measures were compared with postpartum conditions.

[Sonographic demonstration of intrafetal cysts and their differential diagnosis]. / Sonographische Darstellung intrafetaler Zysten und deren Differentialdiagnose.

By high dissolvent power ultrasound equipments it is possible to perceive intrafetal malformations of organs in the second trimester of pregnancy already. Cystic abdominal tumours differential diagnostically are scarcely to be identified by ultrasound only. Their origin mostly is the urogenital system. Even monstrous findings don't allow a prognose of the further development. Additional procedure, e.g. puncture of the cysts by ultrasound sight are necessary for diagnose.

[A non-invasive stress test for fetal movement stimulation]. / Ein nicht invasiver Stresstest zur fetalen Bewegungsstimulation.

A method for foetal stimulation is required for both interpretation of external CTG and assessment of foetal mobility status. All methods so far described in the literature proved to be impracticable for their invasive nature or for insufficient controllability. An approximately unitised level of stimulation is necessary for proper assessment of mobility standards, and this has been achieved by means of sound stimulation. The latter is based on a body sound transmitter coupled to a sinus generator. Sensitivity of the method is 90 per cent. Preliminary comparison between quantity of movement and birth weight of examined foetuses has provided some clues to the effect that the responsiveness to external stimuli of newborns with low birth weight had been comparatively low, which was reflected in less movement activity.

[Development of the fetal lateral ventricles and their sonographic identification during pregnancy. I]. / Die Entwicklung der fetalen Lateralventrikel und ihre Identifizierung im Laufe der Schwangerschaft durch Sonographie--I. Mitteilung.

A prerequisite for the ultrasonographic prenatal diagnosis of hydrocephalus is knowledge of the normal shape and position of the foetal lateral ventricles as well as of the range of variability between normal and pathological development. A model of the lateral ventricles of an 38-weeks old foetus was constructed. It was then tested by ultrasonographic examination in 6 transverse sections on foetuses having a biparietal diameter of 90-95 mm. In this way three ventricular parameters could be established for normal as well as for hydrocephalic development during foetal life.

[Fetal movement patterns in the external cardiotocography and their interpretation by simultaneous ultrasound observation]. / Fetale Bewegungsmuster im externen CTG und deren Deutung durch simultane Ultraschallbeobachtung.

Analysing cardiotocographs not only fetal heart frequency and uterine contractions but also fetal movements have to be considered. Based on this knowledge 96 cardiotocographs are estimated with simultaneous observation by ultrasound. It seems to be possible to conclude from the tocograph pattern to the type of movements.

[Outline for the control of the course of fetal growth]. / Schema zur Verlaufskontrolle des fetalen Wachstums

In a synoptic schema are presented the percentiles curves of the biparietal diameter, the sum of the sagittal and transversal thoracic diameter and the fetal weight (Lubchenco modif.). To attain the percentiles curves of the ultrasonic parameters we applied 5400 mensurations of the biparietal diameter and 1300 mensurations of the thorax. In the diagram are published the percentiles P 10, P 25, P 50, P 75, P 90. It is possible to diagnose a divergence between the cephalic and thoracic growth (dystrophia, hypertrophia) and estimate the gestation weeks.

[Experiences with continuous fetal measurements during pregnancy]. / Erfahrungen mit der Verlaufsbeobachtung fetaler Messwerte.

Experiences by continuous ultrasonic measurements during pregnancy. The authors have published earlier a diagram for use to evaluate the fetal development. The aptitude in practice has been proved.--To evaluate normal fetal growth the percentiles curves of Lubchenco are less suitable than of the GDR. But also the last show the normal weight 100 to 150 g to small during the 30th to 36th gestation week in comparison to the calculated fetal weight of normal pregnancies. The intrauterine retardation and hypertrophy can well be diagnosed if the beginning of the measures occurs at the end of the first trimenon of the pregnancy. But it is necessary to know the possibilities of apparent "abnormalities" in normal pregnancy, as ceccation of the fetal growth for 3 or 4 weeks, the late flattening of the biparietal diameter in breech presentation etc.--Our effort to simulatae the fetal growth in intrauterine retardation by using beta-stimulating sympathicomimetics, was without of success.

[The roll-over test in clinical use and its significance in the early detection of hypertensive gestosis]. / Der Lagerungstest (roll-over-test) in der klinischen Anwendung und seine Bedeutung bei der Früherkennung der H-Gestose.

The roll-over-test introduced 1974 by Gant and coworkers was said to open new possibilities for prediction of gestational hypertension. The convincing results of these authors could not be reached by other study groups. The test was done in 115 pregnant women, mainly primigravidae, in the 28th gestational week. Based on our results we cannot recommended clinical use of the roll-over-test.

[Possibilities and limitations of ultrasonic diagnosis in the prenatal recognition of abnormalities]. / Möglichkeiten und Grenzen der Ultraschalldiagnostik bei der antenatalen Erkennung von Missbildugen1

This paper explains the momentary situation of diseasediagnostic with ultrasonic (B-scan). Possibilities and limits of this methods are shown. Some rare symptoms fetal-disease are explained and we discuss the possibility, to recognize diseases of skeleton and central nervous system better than before.

[Exacerbation of chronic postpartum inflammation of the ileosacral joint]. / Exazerbation einer chronischen Entzündung des Ileosakralgelenks post partum.

Reported in this paper is the case of a secundigravida, 27 years of age, with postpartum pelvic complication, following spontaneous childbirth. The patient had a record of previous damage to the left side of her ileosacral joint.--This case of leftside inflammation of the ileosacral joint with severe dystasia and gait disorders following parturition is described, with the view to telling gynaecologists and obstetricians that what is called "sacralgia" in conjunction with childbirth deserves careful analysis.

[Value of ultrasonic fetometry for fetal monitoring in diabetes mellitus]. / Die Wertigkeit der Ultraschallfetometrie zur Beurteilung des Schwangerschaftsverlaufes bei Diabetes mellitus.

Evaluation of ultrasonic fetometry in diabetic pregnancy. In 51 cases we have carried out 134 ultrasonic investigations. The diabetes we classified to the score of White A--F. To evaluate the increase in fetal weight and the maturity in a qualified sense, we measured the biparietal diameter, the transversal and the sagital diameter of the thorax and the trunk length. The findings were registered into diagrams of our percentiles of development.--The fetopathia diabetica will be diagnosed right, if it is joint with fetal hypertrophy. The beginning of the macrosomia of the fetus is possible to recognize from the 32th week of gestation.

[Validity of the modern fetal monitoring methods in the decision of emergency obstetric operations]. / Die Aussagekraft der modernen fetalen Uberwachungsmethoden bei der Entscheidung zu dringlichen geburtshilflichen Operationen

The validity of the modern methods of fetal monitoring to decide for the indication of urgent obstetric operations. The reliability of the modern supervision of the fetus is studied in cases of doubtful fetal heart action. Up to the present day we have no method for the exact estimation of the degree of a damage to the fetus. In such a precarious situation we should use all available methods for the diagnosis of the fetal condition, because the results of only one of the methods offer insufficient evidence. By means of the literature the alterations in the ECG of the dying fetus are interpreted in comparison to artefacts. In cases of doubtful fetal heart action we recommend in addition to the clinical findings to record the fetal ECG, to controll the actual fetal pH and attempt an investigation by ultrasonic.

[The current importance of ultrasonics in the diagnostic progressive program in prenatal care]. / Die derzeitige Bedeutung von Ultraschallbefunden im diagnostischen Stufenprogramm der Schwangerenbetreuung

In the University-Clinic of Obstetrics and Gynecology (Charite) of Berlin we carried out about 20,000 examinations with the method of ultrasound. In the presented paper we want to put a declaration about the survey of this method in the system of diagnosis during pregnancy. Our experiences led to the same conclusions like published in international journals. The following parameters have been successful in clinical practice: biparietal diameter, position of the fetus, localisation of placenta, diagnosis of heart-beat and other. We concentrated our investigations to the calculation of actual fetal weight in utero. For this aim we established formulas; thus we are able to calculate the weight with the aid of 4 parameters of ultrasound. The evaluation of 621 cases has shown the deviation of the calculated weight compared with the real birth weight is without problems in the group of big babies. For the group of premature deliveries it is nessecery to carry out tocolysis until a calculated weight of 2500 g. In all the babies, calculated in this largeness everyways the real birth weight has been more than 2000 g.

Problems in using linear ultrasound parameters for the determination of fetal weight.

We have developed three formulas for the calculation of fetal weight by means of ultrasound which have proved clinically useful (Formula I for normal size fetuses, Formula II for very small fetuses, and Formula III as a control). From 621 controlled calculations of the fetal weight and the general experience from our ultrasound clinic (over 20,000 examinations) we discuss the inherent problems. We used the Vidoson apparatus manufactured by Siemens (West Germany) which is a rapid imaging B-scan. We have learned from many years of studying means of calculating fetal weight that a regression equation from linear fetal measurements can be used: namely the biparietelllll skull diameter, the sagittal and the transverse thoracic diameter and the length of the trunk (Tab. I)...

[Amniofetography in antenatal diagnosis of fetal abnormalities]. / Die Amniofetographie in der antenatalen Diagnostik fetaler Missbildugen

The authors report the application of the amniofetography in the field of the antenatal diagnostic of fetale deformities. All pregnant women were investigated by Ultrasonic-B-scan. In cases of unambiguous hydramnios and in cases of pathological findings or findings which are not clear in Ultrasonic-B-scan an amniofetography was made. This method was carried out in 14 patients between the 28th and 37th week of pregnancy. It was found changes in 8 cases which in control of pregnancy and delivery were important.

[The normal fetal intestinal tract in correlation to gestational age. An amniofetography study]. / Der normale fetale Intestinaltrakt in Abhängigkeit vom Gestationsalter. Eine amniofetographische Studie.

Amniofetography represents an adequate method to study prenatally the fetal gastrointestinal tract in utero. In 108 pregnancies without fetal intestinal anomalies, the course of intestinal growth with regard to the lumen of certain parts of intestine has been analyzed. The results agree with those of other authors using sonography to study the intrauterine development of fetal intestinal tract. The demonstrated kinetics of contrast media passage through the gastrointestinal tract, following its intra-amnion application, contribute the knowledge of normal fetal physiology.

[Indications and characteristics in the diagnosis of tumors using ultrasonography in gynecology]. / Indikacije i osobenosti dijagnostike tumora pomocu ultrasonografije u ginekologiji.

The use of sonography in gynecology, including the examination of the small pelvis and the breast, adds a further dimension to this diagnostic method. Along with the diagnosis of tumours, an important role is played also by functional diagnosis which covers almost all fields of gynecology (urology, sterility). The range of the possible use of sonography and indications are presented. Ultrasonography has an additional role in the exploration of the small pelvis, but it can also replace classical diagnostic procedures and radiological examinations. In view of its advantages and possibilities, this method (real time scan technique) should find a wide use in gynecology.

[Indications and methods for kidney sonography and isotope renography in pregnancy]. / Zur Indikation und Methodik der Nephrosonographie und Isotopennephrographie in der Schwangerschaft.

Ultrasonographic determination of the renal parenchyma/pyelon index (PPI) and semi-quantitative ING evaluation with complementary consideration of the passage value, following re-positioning, were applied to 114 pregnant women, among them 57 without and another 57 with diseases, as well as to twelve puerperae and 14 gynaecological patients (control group) for the purpose of objectivating urinary stasis in pregnancy. No significant differences were found to exist with regard to PPI and ING parameters in normal early pregnancy between the pregnant probands, on the one hand, and the non-pregnant control group, on the other. However, a significant delay occurred to the activity maximum on the right side in the second trimenon and also on the left side in the third trimenon, yet, without ultrasonographically recordable adequate enlargement of the renal pelvis. Additional delays in maximum activity and half-life of curve decline as well as drop in PPI parameters were recorded (but not statistically secured), primarily on the right side, from pathologically affected pregnant patients (acute pyelonephritis, asymptomatic bacteriuria, gestosis). Pyelon enlargement (PPI decline) in pathologically affected pregnant patients differed from that in clinically intact patients in the third trimenon only in cases of acute pyelonephritis (22 patients). A correlation was established between PPI decline and ING passage data above 70 per cent in 50 per cent of these cases.(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical problems of premature labor. 2. Therapy of threatening and actual premature labor]. / Die klinische Problematik der Frühgeburt. 2. Therapie der drohenden und der in Gang gekommenen Frühgeburt

The therapy of imminent prematurity needs specific treatment of the respective illness. Moreover there are three fundamental measures: 1. To appease the patients and to applicate sedatives. 2. To carry out tokolysis with medicamentes. 3. To carry out cerclage operation in order to close the uterine mouth. These possibilities must be combined in various ways dependent from the success in every individual case. These measures also are suit in prophylaxis, for example in disorders of former pregnancies. All schemes of therapy adapted to the individual case. The dosis must be determined from the effect of therapy. A particular view point must be the hospitalisation between 28. and 32. week of pregnancy in cases of twins or placenta previa. Also in cases of early rupture of amnion prolongation of pregnancy must be aspired.

[Diagnosis of follicle maturation and ovulation following hormonal stimulation using ultrasonography]. / Diagnostik der Follikelreifung und der Ovulation nach hormoneller Stimulation durch die Ultrasonographie.

10 patients with normal cyclus, 22 patients with FSH/HCG stimulated cyclus and 15 patients previous to laparoscopic puncture underwent ultrasound examination of follicle growth. The results were good reproducible. Ultrasonic examination of growing follicle should be done established continuously in cases of hormonal stimulation before laparoscopical puncture with regard to extracorporal fertilisation.