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Biomedical subjects

E Koepcke

Publications and source records attributed to E Koepcke.

At least 19 recordsLinked to original sources

[Neonatal percentile values for the GDR--1985. Correlation of body weight and length in newborn infants (calculation of birth weight/body length in cm. with reference to gestational age)].

Taking account of the gestational age (28th to 42nd completed week of pregnancy) the sex-related ratio of birth weight to length (g/cm) for newborn infants is reported. This shows that observation of the correlation between birth weight and length with reference to gestational age makes a more accurate classification of newborn infants possible, rather than using a two dimensional classification (birth weight week of gestation).

Birth Weight

[Multicenter study of obstetrico-perinatologic quality control in the Rostock district. I. Comparative medical statistics].

Report about outcome-quality assessment in obstetrics and perinatology using an uniform check list for data collection in the district of Rostock. Various possibilities of outprint of the results in 1985 are demonstrated. For daily data collection in obstetrics a special book has been developed. The investigation concerns a data pool of more than 55,000 deliveries. Considering a trend of the results the following optimal criteria in obstetrics and perinatology are postulated: (table; see text) The check list of the Society of Perinatal Medicine of the GDR for obstetrical and neonatal data collection should be generally used. The soft ware for the computed data analyses has been developed by the "Rechenzentrum der Ernst-Moritz-Arndt-Universität Greifswald". Analysis and output of obstetrical and perinatological datas by means of a personal computer are prepared.

Birth Rate

[Neonatal percentile values for East Germany--1985. 3. On the correlation of body height and weight of the mother in a two-dimensional classification of newborn infants according to birth weight and gestational age].

There were published percentiles of birthweight in relation to bodyheight of the mother as well as in relation to bodyweight and parity, bodyheight and bodyweight of the mother for term range 37th to 41st week of pregnancy. They were calculated through median quantities. The dates again derive from the investigation of 51,570 single births in elected regions of GDR in 1984 and 1985. The length of pregnancy was stated in full weeks. It was determined on the base of three parameters (by Naegele method, by sonography, and by neonatal maturity judgment). Selected percentiles of birthweight regarding the above influencing factors, distributed into sex, were summarized for use in practice.

Birth Weight

[The East German Twin Study l984/85. Report of selected aspects].

Analysis of a multicentre study of the GDR in which 67 clinics with a total of 1,200 twin pairs participated over a scheduled period of 18 months. In the result a recommendation for the antenatal, intrapartal and neonatal care of gemini-pregnancy was prepared.

Clinical Trials as Topic

[Telemetric labor monitoring. Clinical aspects, cardiotocographic findings and acceptance of free mobilization in labor].

Telemetric signal transmission represents a suitable technical concept for combining free mobilisation with continuous electronic monitoring of birth. The obstetric aspect of telemetric birth monitoring is discussed on the basis of a clinical-statistical analysis: a group of 127 women in labour (64 primigravidae and 63 multigravidae) were examined and the specific effect of mobilisation on obstetrically relevant parameters was analysed. The results show the advantages of this method of birth management. Freedom of decision as regards choice of posture during birth, better subjective control and less painful labour, better birth mechanics, more effective labour, shorter duration of birth, better heart-rate patterns, optimal exterior conditions and an active basic attitude of the woman in labour are the proven advantages of this method. The highly significant relationship between the degree of mobilisation and the duration of birth is emphasised as one of the most important results.

Female

[Experiences with a mobile monitoring system for fetal and neonatal cardiotachometry].

A monitoring system for fetal and neonatal cardiotachometry which set up in own instrumentation at the Department of obstetrics of the Regional Hospital of Rostock. With aid of a wireless telemetric system is it possible to estimate the fetal condition before and during of caesarean section as well as at transfer of high risk neonates.

Cesarean Section

[Economic aspects of intensive care in obstetrics].

An intensive obstetric care unit has been established at investment costs of 646,167.--Mark which broke down into 220,248.--Mark for prepartum attention, 268,010.--Mark for intrapartum attention, and 157,909.--Mark for neonatal attention. Operational expenditures on equipment and services were found to amount to 144,052.--Mark per annum.--Specific outlays resulted from intensive obstetrics, as compared to conventional procedures. They varied between 48.--Mark and 96.--Mark per delivery, depending on annual numbers of deliveries and on the use of equipment quantitatively adapted to requirements. Individual costs for intrapartum attention varied by bedside equipment combinations and turnover of patients (n/labour bed/d) and were between 12.--Mark and 36.10 Mark.--Something between 2000 and 3000 births per annum, with patient turnovers between 1.5 and 2.0 per bed and die, was considered optimum. The cost of intensive obstetrics went up under such optimum conditions to something between 48.--Mark and 58.--Mark, with something between 14.80 Mark (BMT 504 biomonitor, Lineomat, FTS 101 foetal-function recorder) and 21.60 Mark (BMT 9141 biomonitor, Lineomat) being required for intrapartum monitoring of one birth.--Reduction in perinatal mortality, as compared to figures of conventional obstetrics and to cost factor between 519,168.--Mark and 627,328.--Mark for equipment and other hardware, yielded a benefit for 10,816 births of something between 46.9 and 167,5 million Mark.

Cost-Benefit Analysis

Fetal risk in delivery with the Shute parallel forceps: analysis of 1,503 forceps deliveries.

A total of 1,503 vaginal deliveries with the Shute parallel forceps during a 10 year period are analyzed as to the risk of instrumental damage. In this series, 35 infants died intrapartum or neonatally. Eliminating all deaths from unrelated causes, three remain in which the forceps could possibly have been implicated. Investigation of these, however, revealed in each case the presence of other concomitant and potentially lethal factors, none of which could be completely ruled out as the primary cause of fetal death. Each of the three cases is discussed in detail. We conclude from our series that the Shute forceps is useful in the delivery of premature infants, but should be employed for this maneuver only by very experienced operators. In these cases, midforceps should be performed only for critical indications. The risk of damage with parallel forceps deliveries from the pelvic floor is minimal if decision for operation is based on cardiotocographic criteria, and under favorable degrees of oxygenation. In the delivery of the immature infants, the parallel forceps can, in fact, hardly be superseded by any other instrument because of its unique controlled protection of the fragile fetal head from even the pressures of the birth canal. Delivery with the Shute forceps can be performed effectively under pudendal block or local infiltration anesthesia.

Adult

[Histological changes in the placenta following tokolysis therapy (author's transl)].

In 138 tokolytically treated cases of imminent abortion or premature birth the secundines were examined histologically and compared with 390 cases of pathological gravidities or births without tokolysis therapy. The frequency of occurrence of morphologically manifested circulatory disturbances following tokolysis therapy was equal to that in the untreated cases, the rate of ascendent infections was only slightly increased. In tokolytically treated placentas with the histological pattern of "dissociated disturbed maturation" and "Maturitias retarda" are prevailing. Thus in most cases sufficient supply of the fetus is possible and the critical phase of uteroplacental insufficiency with the danger of abortion or premature birth may be overcome. There were no hints at direct influences of tokolysis on placental morphology.

Abortion, Threatened

[Injury hazards in deliveries using the Shute forceps (analysis of 1016 forceps deliveries)].

Report about 1016 deliveries by means of the parallel forceps (W. B. Shute). This group contains pathologic-anatomical results of 30 stillbirthes or died newborns. Accordingly to the classification in subarachnoidal, subependymal or subdural hämorrhage there are only in two cases signs of obstetrical brain damage. The hypoxia is the most important reason of intracraniale haemorrhage. In order to an objektive indication, without progredient signs of fetal hypoxia the extraction by means of parallel forceps is not dangerous. We have used the instrument for extraction as well term as preterm infants with good results.

Adult

[Isolated thrombotic omphalovasculitis with marginal insertion--a rare umbilical cord complication].

Report about 2 cases of a rare umbilical cord complication, the isolated omphalovasculitis thrombotica with marginal insertion and about their effects at the feto-placentare unity. Reference is given to an eventual embolic cause of praenatal thrombosis. It will be recommended a regular histological examination of the marginal respectively velamentous insertion for clarification of unclearly fetal deaths.

Adult

[Ambulatory tocography].

The value of the ambulant tocography was tested in 127 cases by ambulant tocograph T 500. The average frequency of uterine contractions was in 66 normal cases 0,5/30 min. This frequency of uterine contraction was higher in a group with anamnestic risk (1,1/30 min) and in patients with tocolytic medication (2,3/30 min). Nearly term all groups tended to higher frequency of uterine contractions. The ambulant tocography is a new method to completed the diagnostic.

Ambulatory Care