Alteration of homocysteine catabolism in pre-eclampsia, HELLP syndrome and placental insufficiency.

Hyperhomocysteinemia is a risk factor in obstetrical complications such as pre-eclampsia, 'hemolysis, elevated liver enzymes, low platelet' (HELLP)-syndrome and placental insufficiency. The aim of our study was to investigate the alterations of homocysteine catabolism in these patients in relation to serum B-vitamins and renal function. Maternal fasting serum from pre-eclampsia (n=24), HELLP (n=20) and placental insufficiency (n=25) patients at the time of diagnosis and pregnant controls (n=34) was analyzed for homocysteine and its metabolites cystathionine and methylmalonic acid, the vitamins B6, B12 and folate, renal and additional parameters.

[Hormone replacement therapy (HRT) in peri- and postmenopause. Is it also allowed after treatment of breast carcinoma?].

Hormone Replacement Therapy (HRT) is an approved strategy of health care. Its characteristic features and benefits for women in the perimenopausal and postmenopausal state are represented. HRT is justifiable and necessary for prophylaxis and therapy of estrogen deficiency.

[Integration of plastic surgery-esthetic aspects in surgical therapy of breast carcinoma].

Within the last 20 years there was an important change in the operative treatment of breast cancer. New considerations on the tumor biology resulted to the conviction, that the operative radicality does not affect the overall survival rate. This was in addition the birth hour of the breast conserving surgery and of the efforts of reconstructive procedures of the female breast.

[Appendicitis in pregnancy].

The incidence of appendicitis is about 1:1000-1:1500 pregnancies. Therefore, it seems to be in pregnancy as frequent as in the general population. The common signs and symptoms of appendicitis are in pregnancy less reliable than in nonpregnant women.

[Tubal pregnancy after tubal sterilization by bipolar electrocoagulation].

Sterilization belongs to the safest contraceptive methods. The most popular sterilization procedure is by coagulation of the fallopian tube. The failure rate is mainly attributed to ectopic pregnancies which can lead to the risk of life.

[Weight discordance of the second twin: effect on perinatal morbidity and mortality. An 8-year analysis of 213 twin deliveries].

In this retrospective eight-years-study we examine factors to be considered responsible for higher perinatal mortality in twins, especially in twins with discordant body weight. As a main risk factor for this we find vaginal delivery, i.e.

[Incidence of hypertension in pregnancy in relation to the definition of hypertension].

According to a proposal of the International Society for the Study of Hypertension in Pregnancy (ISSHP) the definition of hypertension is based on a diastolic blood pressure of 90 mmHg or more. Systolic and mean arterial blood pressure (e.g.

[The new terminology and classification of hypertensive diseases in pregnancy].

For hypertensive disorders of pregnancy there are not only a lot of terms and trials for classification--but also the definition of hypertension as the leading sign is unclear. This explains the confusion around this meaning-full problem. The International Society for the Study of hypertension in Pregnancy (ISSHP) submitted proposals for a new terminology and classification of hypertensive disorders in pregnancy.

[The clinical value of plasma fibronectin in pregnancy].

We have measured plasmatic fibronectin in 23 normotensive pregnant women during pregnancy (overall 161 values). On the average 6 samples from every woman have been taken. Plasmatic fibronectin rose continuously from 313 +/- 76 mg/l in the first trimester to 416 +/- 194 mg/l in the third trimester.

[Blood pressure values in normal pregnancy].

In two studies independent from each other we examined the behaviour of arterial blood pressure in normal pregnancy. Study 1 was performed in exactly defined external conditions, study 2 in normal antenatal clinic. Especially in study 1 a distinct reduction of blood pressure could be proved.

[Reaction of the anterior eye segment to preventive Credé treatment].

A controversily carried discussion concerning the prophylaxis according to Credé is in process. Reviewer decline the Credé-prophylaxis. The high rate of side effects (Argentum conjunctivitis) interdicts with applications of Argentum nitricum.

[The circadian rhythm of the colloid osmotic pressure of the blood].

In 29 normotensive nonpregnant women, the circadian rhythm of the colloid-osmotic (oncotic) pressure (COP) was estimated. On average the COP was 25.3 mmHg (3.

[Occlusion of a vesicovaginal fistula with Latzko-repair].

Unlabelled: The Latzko procedure is a well-known method for the closure of small vesico-vaginal fistulas occurring in the vaginal dome after hysterectomy. This method is favoured by gynaecologists. In three Departments of gynaecology, a total of 104 patients were treated.

[Urinary fistula after radical hysterectomy with lymph node excision].

In 908 radical hysterectomies including dissection of pelvic lymph nodes, 13 (= 1.43%) urogenital fistulas were seen. They occurred postoperatively between the 7th and 15th day.

[Decrease in premature birth rate through consequent application of diagnostic and therapeutic standards in pregnancy monitoring].

All pregnant women living in the district of Suhl have been observed in our prenatal outpatient department. All gave birth in our department for obstetrics and gynaecology. This observation is made on the base of a standard.

[The colloid osmotic pressure of blood. Physiology, measuring technique and pre-analytic factors of influence].

Since the fundamental work of Starling the central of colloid osmotic pressure for maintaining volume homoeostasis and for transcapillary fluid exchange has been well known. To treat an intravasal volume deficit colloidal plasma substitution solutions are able to secure a sufficient colloid osmotic pressure. The last one can be measured by oncometry.

[Micturition and incidence of postoperative urinary tract infections in surgical gynecology].

In a retrospective analysis postoperative courses of 879 patients (1987-1989) have been analysed with respect to micturition behaviour and incidence of postoperative urinary tract infections. 58.5 per cent urinary tracts infections could be registered following uro-gynecology operations and 48.

[Course and outcome of pregnancy in adolescents].

All pregnant women living in the district of Suhl were observed and delivered in our Department for Obstetrics and Gynaecology, County Hospital of Suhl. In a retrospective study, the course and outcome of 732 pregnancies in adolescents (less than or equal to 19 years) were analysed. In all women bearing to maturity, the course of delivery and the neonatal outcome were studied.

[Pelvimetry using computerized tomography. I. Theoretical and methodical fundamentals].

The first part of our article deals with the basic aspects of using computed tomography in obstetrical pelvimetry. A macerated osseous female pelvis was used to measure the true conjugate, the transverse plane of the pelvic inlet, the interspinous line and the distance between the ischial tuberosities. The same pelvis was then examined computed tomographically.

[Diagnosis of urinary tract infections in puerperium].

In 225 puerperant urine proofs were taken both by suprapubic puncture and by mid stream technique. The corresponding proofs were examined culturally and microscopically. 42% of the mid stream proofs containing more than 10(5) germs/ml were evaluated to be false-positive.

[Bacteriuria screening in gynecologic practice: what is the value of mid-stream urine?].

In 55 healthy women corresponding urine proofs were taken by suprapubic punction and by mid stream technique from the same content of the urinary bladder. For detection or exclusion of bacteriuria both collection-methods are of equal value. In 96% of the cases the microbiological results were corresponding.

[Ectopic pregnancy--still a challenge in gynecology. A contribution to diagnosis and therapy].

The diagnostic and therapeutic management in 80 cases with ectopic pregnancy is analysed. Only in 36 cases (45%) there was an accordance of installation diagnosis with the intraoperative status. 44 patients (55%) were suspicious to suffer from acute pelvic inflammatory disease, abortion or irregular uterine bleedings.

[Estrogen and progesterone receptors in mesenchymal structures of the female urogenital tract].

In 37 women being operated on gynecologically small portions of mesenchymatic tissue have been sampled and analysed with respect to the presence and concentration of estrogen and progesterone receptors within the cytosol fraction. The proofs were taken from: ligamentum cardinale, ligamentum sacrouterinum, pubo-vesico-cervical fascia, paracolpium, ligamentum teres uteri, levator muscle and serving as a comparison tissue from fornix vaginae posterior. In the proofs of pubo-vesico-cervical fascia and paracolpium there were no progesterone receptors.

[Rectal examination during labor--tradition or compelling necessity?].

6,639 consecutive deliveries are followed up with respect to the course of puerperium. All these patients were examined during delivery vaginally. Febrile temperatures sub partu were to be stated in 1.