PubMed Health⌕ Search

Biomedical subjects

C Vogtmann

Publications and source records attributed to C Vogtmann.

At least 55 records · Page 3Linked to original sources
PubMed1982

[Prematurity and placental insufficiency in twin pregnancies. Results during the care of multiple pregnancies at a center for premature births].

An analysis was made of 151 twin pregnancies, in 1975, 1978 and 1979, to study the effectiveness of obstetrico-neonatological attention to bigeminal pregnancies in a premature infant centre. -- Significant rise in early detection of bigeminal pregnancy due to much wider use of ultrasonic diagnosis and intensification of hospital treatment have drastically reduced the number of extremely immature twin births by delaying delivery to somewhere between the 34th and 36th weeks of gravidity. With the use of tocolysis nearly unchanged throughout the period of observation, change in average gestational age at birth should be interpreted primarily as the result of more long-time prepartum hospitalisation, with attention being offered for periods of more than three weeks. This conclusion was supported by unsatisfactory results regarding average gestational age and birth weight, following exclusive outpatient attention to women with bigeminal pregnancies. Improvement of foetal prognosis was found to depend primarily on proper therapeutic approach to prematurity. -- The authors' own experience differed from reports of other workers, in that the rate of hypotrophy declined in the wake of intensive prepartum care. Substantial reduction of the gap between average birth weights of first multiple foetuses and those of second multiple foetuses as well as declining differences between average birth weights of heavier twins, on the one hand, and those of less heavy twins, on the other, were recorded from all gestational age groups and attributed to improvement in intra-uterine care for all multiple foetuses due to intensified treatment. -- Significant rise in survival rates (after deduction of all foetal loss up to the 28th day of age) of all premature twins is considered an expression of increasingly improving life chances of twins, in general. It was based on growing numbers of highly immature survivors, but even more on significant rise in the number of premature survivors between the 34th and 36th weeks of gestation.

Birth Weight↗
PubMed1982

[Studies of the clinical effectiveness of intravenous long-term tocolysis].

Possible retardation of delivery following different periods of intravenous Partusisten tocolysis was studied in 701 premature births, between the 28th and 36th weeks of pregnancy. The studies were conducted separately, for all probands together and by gestational age groups. Various symptoms of imminent premature birth were not weighed. The rate of failure amounted to 23 per cent, that is delivery occurred within 24 hours from beginning of treatment. Extension of pregnancy by something between two and seven days was achieved in 45 per cent of the probands or by more than seven days in 32 per cent. Growing length of intravenous tocolysis was followed by significant rise in the number of women with genuine prolongation of pregnancy (between eight and 28 days or even more), however, without any unambiguous evidence to differentiation between gestational age groups with regard to therapeutic responsiveness. Significant percentual rise in prematurity between the 34th and 36th weeks of pregnancy by almost 30 per cent (with 20 per cent in the 36th week of pregnancy alone) seems to indicate a measurable clinical benefit of intravenous long-term tocolysis in terms of higher life expectancy and better survival quality. --The above findings were compared with results that had been obtained from 1,037 prematurely born infants of the same gestational age groups without preceding tocolysis. The conclusion was that intravenous tocolysis in general and long-term tocolysis in particular failed to have the slightest negative impact in terms of acidosis and RDS morbidity, average birth weight, hypotrophy, and survival chance. The need for properly timed detection of prematurity as part of routine care may be seen from the great number of untreated premature births, that is cases beyond any possibility of treatment. The point is made that the effectiveness of tocolytic therapy can be measured only by those premature newborns who had received treatment rather than by the totality of premature newborns.

Ethanolamines↗
PubMed1982

[Choice of delivery methods for cases of breech presentation, with particular reference to premature birth (author's transl)].

Overall mortality, stillbirths and neonatal deaths up to the 28th day of age included, were tested together with selected morbidity parameters, depending on delivery methods used (vaginal route or caesarean section). The group of probands included 112 single births on terms and 136 genuine single premature births (31st to 35th weeks of pregnancy), all of them delivered from breech presentation. Caesarean section for breech presentation deliveries on full term was found to be indicated primarily for cases of cephalopelvic disproportionality and severe risk factors and secondarily on account of cardiotocographic monitoring. Caesarean section has been the method of choice from 1979 for premature births from breech presentation, delivery dates being between the 31st and 35th weeks of pregnancy.--Breech presentation delivery goes along with higher morbidity or mortality risk and, therefore, has become a priority problem in the context of prematurity and its prevention. Efforts should be made to achieve vaginal birth on full term by abandonment of oxytocics and with general cardiotocographic monitoring, despite higher risk of acidosis, however, only in the absence of cephalopelvic disproportionally and grave risk factors. Higher mortality and acidosis risks, accumulation of pulmonary complications, and the need for neonatal intensive care for newborns vaginally delivered from breech presentation were all found by more detailed analysis to be concentrated in the period just before the 35th week of pregnancy. In cases of premature births from breech presentation which could not be therapeutically prevented, caesarean section should be performed up to the 35th week of pregnancy. Vaginal delivery of newborns from breech presentation is considered acceptable beyond the 35th week of pregnancy, with due consideration to be given to the selection criteria generally valid for births on term.

Breech Presentation↗
PubMed1982

[Adaptational behavior and late prognosis in newborn infants following severe intrauterine hypoxia with fetal pH under 7.0].

The course of perinatal periods as well as the latest statomotor and psychomotor developments were examined in 30 children (gestational age: 38.8 +/- 2.2 weeks; weight: 3,118 g +/- 668 g) with umbilical blood pH below 7.0 for assessment of the risk of neuromotor and psycho-intellectual retardation in newborns who had undergone severe intra-uterine hypoxia. The following findings were established from the probands at ages between seven and 80 months: normal condition of 15 children, mild retardation with normal neurological status in eight children, medium retardation with emphasis on psychoneurotic symptoms in five children, and severe retardation with multiple symptoms in two children. The strongest informative potential in terms of long-range prognosis was established for the perinatal combination of low pH with neurological and respiratory findings. Good long-range prognosis was recorded even for children with a record of pH below 7.0, provided well-timed and adequate treatment for severe intra-uterine hypoxia and unimpaired adaptation following primary re-animation.

Adaptation, Physiological↗
PubMed1981

[Prematurity and placental insufficiency].

The authors analysed 1,528 "genuine" single premature births, between the 28th and 36th weeks of pregnancy and over a period between 1975 and 1979, with the view to establishing clinical manifestations of nutritive, respiratory, and hormonosynthetic disorders of the placenta as possible causes of prematurity. A high percentage of hypotrophic prematurely born infants (birth weights being 10. bis 5. and below 5. percentile) and even more latent nutritional deficiency in eutrophic prematurely born infants (average weight being below the 50th percentile in all weeks of pregnancy) seem to suggest the existence of a relationship between prematurity and nutritive placental insufficiency. Retardation of growth was found to aggravate along with growing age of gestation, but it was not found to result from previous tocolysis. Prematurely born infants are extremely endangered by reduced respiratory functionality of the placenta under the stress of birth, but this endangerment cannot be equally established before labour, with premature birth imminent.--Deficiently nourished foetuses are exposed to dangers of prepartum and intrapartum respiratory complications, even in cases of premature birth. These risk is likely to worsen along with aggravating impairment of nutritional functionality of the placenta. The effects of nutritional and respiratory placental insufficiency on acidosis morbidity, RDS incidence, and overall mortality (stillbirths and neonatal mortality included) of prematurely born infants are described and discussed. Biochemical hormone investigations have pointed in the direction of latent functional impairment of the placental or of foetoplacental unity in cases of prematurity at large. The morphological functionality of the placental villus trophoblast was found to be impaired in all cases so far reviewed, whatever the established clinical causes had been. This seems to be an important foundation for the concept of relationship between prematurity and placental insufficiency.

Acidosis↗
PubMed1980

[Anaesthesia and therapy for gestosis - impact on the newborn (author's transl)].

Adaptation of 33 newborns and their clinical symptoms during the first weeks of age were studied retrospectively, with reference to cases in which the pregnant mothers had undergone treatment for hypertension, anaesthesia, and caesarean section. Primary adaptability was unambiguously limited in all newborns, with symptoms of impaired sensual motoricity being additionally recorded from 16 of them. Apnoeic seizures occurred to six children on their first day of age and called for continuous cardiorespiratory monitoring. Premature and hypotrophic newborns were primarily affected. Those delayed symptoms were attributed, first of all, to medicamentous effects. More caution should be exercised in prescribing neurodepressors of the Diazepam type, particularly in early pregnancy, say, prior to the 37th week. - An analysis was made of blood gas data in the blood of umbilical arteries of infants whose birth had been preceded by gestosis or eclampsia. Yet, their intranatal respiratory situation was not found to be basically worse than that of a control group.

Adaptation, Physiological↗
PubMed1979

[Mode of delivery, postnatal condition and neonatal outcome in preterm infants].

There were under examination 578 preterm infants of two groups--28. up to 31. and 32. up to 36. week of gestation--after birth of vertex as well as breech prevention. Postnatal condition and neonatal outcome were put into relation to the mode of delivery. We compared Apgar-Score (one and five minute value), morbidity on respiratory distress syndrom as well as rate of survival and neonatal mortality in spontaneous delivery with and without episiotomia, with specula delivery, Shute-forceps and vacuum extraction of vertex presentation as well as with breech presentation after vaginal delivery and primary Caesarean section. In respect of the management of the second stage of labour it is our opinion that prophylactic additional measures in preterm delivery of vertex presentation after 32 weeks of gestation are not necessary and that this question should be examined in a larger study of much more cases. But we were able to demonstrate that up to 32. week of gestation well-timed episiotomia of optimal size is necessary. Our good experiences in breech presentation between 31. and 35. week of gestation treated by obligate Caesarean section have to prove true in future.

Apgar Score↗
PubMed1976

[Use of hypertonic solutions through umbilical cord vessels].

The authors report on a newborn with skin necroses and fibularis paresis after postnatal administration of NaHCO3 via the umbilical cord. Then some problems of postnatal buffer therapy are discussed. After a review of advantages and disadvantages of puncture or cannulation of the umbilical vein on the one hand and its catheterization on the other, the former procedures are preferred for an effective buffer therapy, provided strict indications are followed.

Catheterization↗