Biomedical subjects

E Gödel

Publications and source records attributed to E Gödel.

At least 19 recordsLinked to original sources

PubMed1982

[Placental maturation disorders in relation to the quality of metabolic control during pregnancy in insulin-dependent and gestational diabetes].

In 1969/70 and 1979/80, 100 placentas each of diabetics were morphologically examined. The findings obtained were evaluated against the background of metabolic monitoring and typical phenomena of perinatal morbidity. The studies were conducted for the purpose of finding out the extent to which maintenance of normal glycaemic metabolism throughout pregnancy could affect the severity of diabetic disorders of placental maturation. Medium to severe placental maturation disorders were found to be closely correlated with quality of metabolic control (P less than 0.01). The findings thus obtained have produced evidence to the effect that maintenance of normal glycaemic metabolism throughout pregnancy would be of favourable impact not only upon perinatal mortality and morbidity. It would also cause significant reduction of placental maturation disorders.

Birth Weight↗

PubMed1978

[Morphology of the placenta in premanifest maternal diabetes mellitus (author's transl)].

66 placentas of mothers with protodiabetes or of the White-classes A/a, respectively, are investigated morphologically. The results are correlated with the clinical findings. Complications during pregnancy as well as the perinatal mortality (5.7 per cent) are less frequent in early stages before the diabetes become manifest. Severe diabetic disturbances of placental maturation we have found in protodiabetics in 15.4 per cent, in the White-classes A/a in 18.9%. In the White-classe D the frequency is 49.5 per cent. Accordingly, the diagnostic possibilities are smaller than in cases with manifest diabetes mellitus. Diabetic disturbances of placental maturation can be demonstrated already in few cases of the material in protodiabetics and in patients with glucosuria during pregnancy and with suspicion of diabetes mellitus, but without diabetic fetopathy. Therefore in our opinion diagnosis of diabetic metabolic disorder may be possible by some morphologic criterias of the placenta in very early stages of diabetes before clinical manifestation.

Female↗

PubMed1978

[Cysts in the villous stroma of the placenta in maternal diabetes mellitus (author's transl)].

Edemateous placentae of diabetic mothers have been examined by light as well as electron microscopy. In addition to typical fetal capillaries there were observed thin-walled cysts containing Hofbauer-cells rather than blood cells which, unlike the capillary system, cannot be filled up with intraarterially injected ink. Derivation and significance of these cavities are discussed. They are considered to be a possible expression of frustraneous extracapillary formation of new vessels. The changes, while not specific, are characteristic of the placenta in maternal diabetes mellitus.

Cysts↗

PubMed1976

[Oscillation spectrum of the fetal heart rate in diabetic mothers].

Antepartum monitoring of fetal heart rate throughout the last weeks of diabetic pregnancy revealed a significant restriction of the baseline irregularity towards the end of the antepartum period. The quantitative amount (in % of total recording time/week) of the patterns of reduced irregularity ('silent', 'narrowed undulatory') increased from the 34th to the 40th week of pregnancy whereas the amount of normal ('undulatory') irregularity became smaller. The results were discussed in regard of the disturbed fetoplacental unit in the diabetic pregnancy.

Female↗

PubMed1976

[Morphology of the placenta and quality of the metabolic control during pregnancy in diabetes mellitus].

The quality of metabolic control during diabetic pregnancy and the severity of morphological alterations of the placenta are statistically correlated independent of White's classification. In cases of inadequate metabolic control typical diabetic maturation disturbances of the placenta are to be seen more often and more severe. But there are also severe maturation disturbances of the placenta in well controlled diabetics with normoglycaemic blood glucose levels during last months of pregnancy. In such cases the metabolic regulation in earlier periods of pregnancy was mostly insufficient. On the other hand unimportant maturation disturbances of the placenta in some badly controlled diabetics were seen. Such pregnancies were mostly complicated by toxaemia.

Blood Glucose↗

PubMed1976

The epithelial and capillary basal laminae of the placenta in maternal diabetes mellitus.

The thickness of the epithelial and endothelial basal laminae was determined in placentas from mothers without known metabolic disease (control) and mothers with diabetes mellitus. The measurements were carried out on electron micrographs. Frequency distributions and statistical parameters were calculated; in 20 cases, 16,331 values were measured. In all cases, the epithelial and endothelial basal laminae were thickest in edematous and fibrotic villi. They were thinner in placentas from diabetic mothers than in controls. Particularly thin basal laminae were found in regions with syncytiovascular membrances. The thinner basal laminae found in the placentas of diabetic mothers are considered to be the result of compensatory growth processes with formation of ontogenetically younger villous parts. The thicker basal laminae in fibrotic and edematous villi may result from a swelling of the basal laminae or possibly from an increased synthesis or a decreased decomposition of the basal laminae. The finding of very thin basal laminae in the region of the so-called syncytiovascular membranes may be of importance for the placental exchange function.

Capillaries↗

PubMed1975

[Diabetes and pregnancy - a clinical and statistical analysis of 1800 pregnancies and deliveries in the years 1952 - 1971. 3. Birth weights percent values of newborn infants of diabetic mothers and further studies on the birth weight].

Newborn babies of diabetic mothers have a higher birth weight in comparison with newborns of nondiabetic mothers in the same gestational age (35. to 39. week). Body weight percentiles were estimated for new borns of diabetics (excluding stillborn babies), it was to be shown that birth weight lower than 2750 gm in the 38. to 39. gestational week (less than 10. percentile) characterizes "small for gestational age babies". Not any influence of maternal blood glucose values during the second part of pregnancy was to be seen. Severe toxaemias and vascular-renal complications (WHITE-class F) were statistically significant correlated with underweight in newborns. The lowest perinatal mortality was found in the weight class 3500 to 3999 gm.

Birth Weight↗

PubMed1975

[Acute and long-term tocolysis by means of buphenin (Dilatol) in insulin dependent pregnant diabetics].

During two years 73 insulindependent pregnant diabetics (43,2% of the total material) were treated with Dilatol (Buphenin) and Isoptin. The requirement of insulin increased dependent on the dosage and on the application of the tocolytic drugs. Despite the considerable influence on blood sugar it is possible to maintain metabolic conditions at normoglycaemic levels during short- or longterm tocolysis, provided exact metabolic controls and adapted insulin treatment. The prophylactic administration of contractionreducing drugs is indicated in pregnant diabetics.

Blood Glucose↗

PubMed1975

[Pregnancy of diabetic women with diabetic angiopathy. Clinical results in correlation of morphological findings on the placenta].

In comparison with morphological changes of the placentae 58 pregnancies of class D and F-diabetics (with diabetic angiolopathy) were analysed. The incidence of toxaemia was 55%. Insulin requirement decreased some days before delivery in 8 cases (14%). The perinatal mortality rate amounted to 17%. Birth weights were found between 2500 and 3000 g in 9 cases, below 2500 g in 8 cases with signs of intrauterine growth retardation. The majority of placentae showed medium-sized to severe diabetic disturbances of maturation on an average more severe than in diabetics without angiolopathy. A "modification" or "mascing" of maturation disturbances by severe toxaemia is discussed. The antenatal retardation of fetal growth in some cases was attributed in part to the diabetic maturation disturbances of the placentae. Another cause may be the defective uteroplacental circulation caused by narrowing processes of myometrial and decidual arteries in consequence of long-term diabetes and hypertension.

Diabetic Angiopathies↗

PubMed1975

[Morphology of myometrial and decidual arteries in normal pregnancy, in toxemia of pregnancy, and in maternal diabetes (author's transl)].

127 specimens, obtained by different methods from the myometrium and the placental bed after parturition, are investigated histologically. This material includes normal pregnancies as well as cases of maternal diabetes with and without hypertension and cases of hypertension in EPH-gestosis. The different parts of the arterial system (spiral arteries, basal arteries, radial arteries) are separately investigated. Physiologically, the pregnancy induces changes in the wall of the decidual arteries and possibly in the distal part of the radial arteries. The fibromuscular layer including the elastic fibers were destructed and replaced by fibrin and connective tissue. For this reason, in these parts of arteries it is very difficult to separate pathological from physiological changes.

Arteries↗

PubMed1975