[Tuberculosis, the old fellow].

There are many issues concerning tuberculosis during pregnancy. In our case report we discuss a 24-year-old Portuguese woman with unclear weight loss and non-specific symptoms such as fatigue and nausea during pregnancy. After diagnostic work up a pulmonary tuberculosis was diagnosed close to delivery.

Cognitive-behavioural group intervention for climacteric syndrome.

Background: During peri- and postmenopause there is a high prevalence of psychological symptoms such as emotional instability, depressive moods, anxiety, sleep disorders, and sexual dysfunction. Aetiologically relevant factors for discomfort are decline of sex hormones and psychosocial factors such as lifestyle, attitude towards menopause, pre-menopausal mental health and sociocultural factors. In contrast to the relevance of psychosocial factors, there are few studies on psychological interventions.

[Sonographic first trimester screening in Switzerland].

The sonographic measurement of the nuchal translucency is already regarded as the most valuable screening parameter for chromosomal anomalies. Beside standardised examinations profound information and counselling of the pregnant women should be emphasised. With the improvement of the specific maternal risk calculation using the sonographic measurement of the nuchal translucency, the biochemical markers and the maternal age, unnecessary invasive examinations may be prevented and their overall number can be reduced significantly.

Umbilical cord edema associated with patent urachus.

Umbilical cord anomalies can often be detected prenatally by ultrasound, but a definitive prenatal diagnosis is not always possible. We present a case with increasing edema of the Wharton's jelly followed by the development of pseudocysts in the proximal umbilical cord due to a patent urachus. The first abnormal findings were detected by ultrasound in the 14th week of gestation.

[Current aspects of labor induction].

Induction of labor is one of the most important means for therapeutic intervention in modern obstetrics. The aim of labor induction is to achieve a better perinatal result for mother and baby as compared to expectative management. Different methods for induction include administration of oxytocin or prostaglandins, amniotomy, and mechanical means of cervical dilatation.

Split hand and foot malformation: ultrasound detection in the first trimester.

The split hand split foot malformation is a rare disorder inherited in an autosomal dominant pattern with variable expression. In our case it was detected early by ultrasound in the twelfth week of gestation. To our knowledge, this is the earliest finding by ultrasound of this malformation.

[Non-invasive prenatal diagnosis--already a reality?].

The genetic analysis of fetal cells enriched from the blood of pregnant women has been a long-standing goal of those researchers and clinicians who want to use this technology for the development of a non-invasive risk-free method for prenatal diagnosis. Recent large-scale studies, such as the NIH 'NIFTY Study', have reiterated that promise of this approach, but have reinforced also the consensus amongst researchers that current technology is not yet sufficiently advanced to permit routine use. The new observation of cell-free fetal DNA in maternal plasma has been eagerly seized upon by several research groups, who have shown in independent large-scale studies that this technology can be used for the extremely reliable identification of facile fetal genetic traits such as the fetal RhD status.

[Screening for aneuploidy by first trimester nuchal translucency measurement: results from a prospective trial including 1980 cases in a single center in Switzerland].

Aim: The purpose of this study was to evaluate the efficiency of first trimester screening for chromosomal abnormalities using the sonographically determined thickness of nuchal translucency (NT) combined with maternal age.

Patients And Methods: Risk screening was offered to all patients with a fetal crown rump length (CRL) between 45 and 84 mm after extensive counselling. For the risk assessment the software provided by the Fetal Medicine Foundation was used.

[Use of 3-dimensional ultrasound for assessment of intrauterine device position].

Aim Of The Study: The purpose of our prospective study was to assess the accuracy of measuring and visualizing different types of IUDs with three dimensional ultrasound (3D) and two dimensional ultrasound (2D).

Methods: Ultrasound investigation was carried out in 147 patients 6 weeks after insertion of the IUD; in 127 cases a copper IUD was inserted, in 20 cases a Levonorgestrel-containing (LNG) IUD. Correct measurement was defined as the distance between top of the IUD and inner endometrium as well as IUD and myometrium (fundus) in the longitudinal plane (2D) plus the frontal plane (3D).

[Prenatal diagnosis and management in VACTERL association].

In terms of the VACTERL-Association we are dealing with a non-random association of malformations following a defect during mesodermal development of embryogenesis due to a variety of causes. We report on three cases with VACTERL-type malformations diagnosed by prenatal ultrasound presenting cardial defects, renal abnormalities, single umbilical arteries and esophageal stenosis. We present sonographical, clinical and autopsy findings and discuss the pathogenesis of VACTERL-Association as a defect of mesenchymal development in early embryogenesis.

[Adverse effects of misprostol in pregnancy].

Background: Although Misoprostol is an already widely used medication in gynecology and obstetrics, extended studies on dosage and safety are still missing. As far as the application of Misoprostol in gynecology and obstetrics is concerned, we are moving between legality and illegality, because in countries like Switzerland and Germany this drug wasn't officially approved for obstetric-gynecologic indications yet.

Materials: The aim of the recent work is to give an overview on the indications of Misoprostol in gynecology and obstetrics, the dosages and side effects.

[Fetal cells in maternal blood--their significance in non-invasive prenatal diagnosis and in etiologically determined diseases].

The first report of the occurrence of fetal cells in maternal circulation dates back to 1893 when the German pathologist Schmorl identified trophoblast cells in the lungs of women who had died from eclampsia. Till recently, however, the existence of fetal cells in maternal blood was a matter of considerable debate. The main reason for this dispute was the inability to successfully and reliably enrich for these cells, which has also hindered their clinical use.

[Desire for children in tumor patients].

After a chemo- and/or radiotherapy not only acute side effects but also longterm side effects do occur. The following longterm side effects are observed: irregularities in the menstrual cycle, early onset of menopause and infertility. They are of special importance to children, teenagers and young adults having survived a malignancy.

[Umbilical cord blood transplantation: acceptance of umbilical cord blood donation by pregnant patients].

Background/objective: Umbilical cord blood is an alternative source for allogeneic transplantation of hematopoietic stem cells from related and unrelated donors. It can easily be collected, cryopreserved and stored in cord blood banks for later use. In Switzerland, cord blood banks for related and unrelated stem cell transplantation are being established.

[Intrauterine transplantation of hematopoietic stem cells for therapy of genetic diseases].

In utero transplantation of hematopoietic stem cells is a most promising fetal therapy. The aim is to treat a genetic disease prenatally before the onset of irreversible organ damage. As the fetus is immunoincompetent in the first and early second trimester of pregnancy and thus tolerant to foreign antigen, engraftment of transplanted stem cells is possible without rejection and without the need for immunosuppression.

[Prenatal medicine: development, current status and future perspectives].

Prenatal diagnosis and therapy are based mainly on the progress of diagnostic ultrasound and laboratory methods in genetics. There is a general tendency to replace second trimester fetal diagnoses by first trimester approaches. Transvaginal sonography and chorionic villus sampling in particular have been proven helpful in this context.

[Fetal fibronectin as a marker of prematurity in a high risk patient sample].

The accuracy of cervicovaginal fetal fibronectin as a predictor of preterm birth was studied in patients with increased risk for preterm delivery (according to the Creasy-score). In a prospective blind observational study the smear from the posterior fornix vaginae of 56 pregnant patients without PROM was examined using a quantitative immunoassay for the detection of fetal fibronectin. The patients who tested positively for fetal fibronectin had significantly more preterm deliveries than those with a negative result (CHI square-test, p < 0.

[Septic abortion in Campylobacter jejuni infection].

Case report of a 24 year old woman II G/I P with enterocolitis and septicaemia caused by Campylobacter jejuni (C.) in the following time abortion at 16 weeks of gestation. Diagnostics, therapy, review of literature.

[Contraception and sexuality].

Contraception implies the responsible confrontation with fertility and sexuality. Contraceptive counselling deals directly or indirectly with sexuality and comprises therefore frequently sexual counselling. 25% of women consulting our Family Planning Clinic complain spontaneously about sexual difficulties.

[Sarcoma of the breast: what is the contribution of immunohistochemistry and flow cytometry?].

Only 0.2-1% of all mammary malignancies are sarcomas of the breast. This study includes 4 cases: 2 osteosarcomas, 1 fibrosarcoma, and 1 malignant undifferentiated stromal sarcoma.

[Laparoscopy-assisted vaginal hysterectomy: initial experiences with an extrafascial technique].

This is a report on 4 cases of vaginal hysterectomy assisted by laparoscopy. The indications were dysfunctional hemorrhages, uterus myomatosus as well as 1 case of cervical intraepithelial neoplasia. Postoperatively, no complications were observed.

[Clinical experience with Mercilon and Marvelon with special reference to ovarian function].

The effects of two oral contraceptive combinations either containing 0.020 mg ethynilestradiol (EE) + 0.150 mg desogestrel (Mercilon) or 0.