Diagnosis of intrauterine fetal growth retardation by prolongation of dehydroepiandrosterone sulfate (DHAS) half-life after DHAS loading.

In the last trimester of pregnancy, a correlation was established between the serum dehydroepiandrosterone sulfate (DHAS) half-life of the mother (n = 40) after DHAS loading (50 mg i.v.) and the birth weight percentile of the newborn. The DHAS half-life in pregnancies with normal fetal growth (greater than 10th percentile) was found to be 3.76 +/- 0.91 h (mean +/- SD) (n = 29) and in pregnancies with small-for-date babies (less than 10th percentile) was assessed to be 6.03 +/- 0.63 h (mean +/- SD) (n = 10) (P less than 0.001). Retrospective diagnosis of an intrauterine fetal growth retardation or normal fetal growth was based on a DHAS halflife threshold of 4.7 h. Retarded fetal growth was detected in all cases (10/10) by prolonged DHAS half-life (greater than r.7 h). Regular fetal growth was diagnosed in 90% of the cases (27/30) by a DHAS half-life of less than 4.7 h. In two out of these 30 pregnancies, an unexpected prolongation of DHAS half-life (greater than 4.7 h) led to the false diagnosis of poor fetal growth. In one patient, no DHAS half-life could be calculated due to a parabolic decline of the DHAS concentration curve. Indications for the DHAS test are diagnosis of an ultrasonographically symmetric intrauterine fetal growth retardation (biparietal and thoracic diameters) in cases with an indefinite gestational age. Furthermore, consistently low urinary excretion was clarified with particular respect to cases of placental sulphatase deficiency.

[Clinical problems in extreme fetal retardation]. / Beitrag zur klinischen Problematik der extremen fetalen somatischen Retardierung

Three cases of extreme fetal somatic retardation are reported. Fetal retardation is the consequence of chronic placental insufficiency and is affected with a high lethality. It is necessary to recognize suspicious cases by anamnesis and clinical findings; a method of differential diagnostic procedure is described. After demonstrating the placental insufficiency and sufficient fetal maturity the indication for finishing pregnancy is given even though the fetus is extremely small.

[The induction of abortion and the priming of the cervix with prostaglandin F2 alpha and prostaglandin E2 by intra-amniotic, extra-amniotic and intra-cervical application (author's transl)]. / Abortinduktion und "Priming" mit Prostaglandin-F2alpha und Prostaglandin-E2--Vergleich der intraamnialen, der extraamnialen und intrazervikalen Applikation.

PIP: More than 130 terminations of pregnancy in the 2nd and 3rd trimesters are reported. In 100 cases, the results of priming prior to therapeutic abortion in the 1st trimester of pregnancy are available. Compared are application for induction of abortion by the extraamniotic, the intraamniotic, and the intracervical route. The results with PGF2alpha and PGE2 gel intracervically are reported. The shortest interval between induction of abortion and abortion was 15 hours with regular application of PGE2 gel into the cervical canal. The failure rate was reduced to 5% with regular applications. The failure rate with irregular application was 22%. With the intraamniotic administration of PGF2alpha, the most severe side effects such as shock symptoms or bronchospasm were noticed. Gastrointestinal side effects such as diarrhea were only noticed with the administration of PGF2alpha. Following a single intracervical application, the so-called priming dose, 67-69% of the cases reached a sufficient dilatation of the cervix up to Hagar number 8. In 16-19% of the cases with the application of PGE2, a spontaneous abortion was achieved with a single dose. Side effects such as marked uterine cramps, nausea, and vomiting were noticed in less than 30% of the cases receiving a priming dose. Our results suggest that a regular and short term application of PG is necessary for the induction of abortion. Relatively short intervals between induction of abortion and abortion and a low failure rate of induction of abortion can thus be achieved. The intracervical application of PGE2 gel or PGF2alpha gel results in sufficient and gentle dilatation of the cervix for a suction curettage in the 1st trimester of pregnancy in about 70% of the cases. The priming dose is recommended for primigravidas or cases with rigid cervix. (author's)^ieng

[Controlled modification of fetal lung-maturity using dexamethasone]. / Die kontrollierte Beeinflussung der fetalen Lungenreifung mit Dexamethason

A report is given on the induction of the fetal lung-maturity by administering glucocorticoide dexamethazone to the mother. The lecithin-level and the L/S ratio are established in amniotic fluid before and after tthe treatment. Before the 32. week of gestation no influence of the phospholipidlevel was evident. After the 32. week and after treatment the physiological increase is deeper. Propositions of treatment for premature and induced premature delivery are given corresponding to the results.

[Pregnancy in adolescents]. / Zur Schwangerschaft bei Adoleszenten.

PIP: 122 primiparae, 14-16 years of age, were compared to a control group of 200 primiparae, 20-24 years of age. The adolescents comprised .56% of the women who gave birth in the Halle city hospital between 1962 and 1970. 169 of the adolescents were 16 years old. 15.5% were not in school and unemployed, and 28% worked at menial jobs. 48.3% of the adolescents had to be treated for some illness during pregnancy, compared to 37.5% of the control group. There was a relatively high frequency of EPH-gestoses among both groups, due to the fact that all were primiparae. Premature birth occurred more often among the adolescents. A review of induced abortions performed between 1965 and 1970 revealed only a small number of adolescent abortions.^ieng